Recent Erratic Behavior and a History of Cannabis Use in a Teenager

Bettina Bernstein, DO

Disclosures

July 30, 2024

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Background

The parents of a 16-year-old boy, Dan, report unusual behavior from their son over the past few months; for example, Dan refused to eat food or drink water at a restaurant. When asked, Dan stated that he felt people were trying to poison him. Dan's mother noticed some social media videos of Dan smoking marijuana and drinking; when she asked him about this, he became angry and punched the wall of his room. Dan has been saving his urine in bottles in his room; when his mother used a home test on one of those bottles, it was positive for cannabis.

Dan's high school counselor called his parents because of an incident at school. While Dan was playing sports, a peer bumped into him by accident and Dan began to argue with the peer. Later that day, Dan walked out of the lunchroom; he seemed to be staring at others in the room, and he was wringing his hands and appeared agitated. The school called the mobile crisis center.

During the patient history, Dan's mother stated that his developmental milestones were reported as on time, he was not referred for early intervention, and he did not repeat any grades in elementary school.

Dan's mother reported feeling overwhelmed with the situation, and his school will not allow him to return without a doctor's note stating that he can safely attend.

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