The cultural position on marijuana is shifting. More and more people don’t see it as a harmful substance when used recreationally. Several states have made it legal to use recreationally and several more have allowed medicinal use. According to a Gallup poll, as many as13 percent of Americans used marijuana in 2016 and 43 percent reported using marijuana at some time in their lives. As marijuana is legalized and decriminalized, its availability for use can grow, but the question as to its safety and long-term effects remains.
While it has several medical applications, it may be a stepping-stone to other drugs. Plus, the use of psychoactive drugs in young people has shown to affect development and lead to addiction later on in life, in some cases.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM 5) recognizes cannabis use disorder as a mental disorder, characterized by the continued use of marijuana, despite impairment and consequences.
Learn more about marijuana addiction and how it can be treated.
Marijuana is a psychoactive drug that comes from drying the leaves, flowers, and stems of the cannabis plant. The two main species of cannabis that are used, Cannabis sativa and Cannabis indica, contain a naturally occurring psychoactive chemical called tetrahydrocannabinol (THC).
The drug is in the cannabinoid class of drugs that interact with cannabinoid receptors in the brain that control a variety of functions, including appetite, mood, and memory. More than 100 other cannabinoids have been identified in marijuana.
Marijuana is currently the most widely used illicit drug in the United States, with young people being the demographic that uses it the most. In fact, more than 11 million people between the ages of 18 and 25 used marijuana in 2015. There was a considerable increase in marijuana use for several years, but its steady incline has ceased in recent years.
The legalization of marijuana for recreational users has been a topic for debate over the past decade, and several states have legalized it already, including Washington, Oregon, California, Nevada, Colorado, Alaska, Massachusetts, Maine, and Vermont.
Marijuana has several medical uses, and medical use of the drug has been allowed in even more states across the country.
It can be used to increase appetite in patients undergoing chemotherapy, manage pain symptoms, and mitigate nausea. Still, marijuana is federally classified as a Schedule I drug in the United States (some prescriptions containing marijuana or THC are scheduled lower).
The potency of street-level marijuana has grown over the past several decades, and today, THC levels in marijuana are four times higher than they were in the 1990s. As marijuana potency grows, the short and long-term consequences of marijuana use may become more severe. Most notably, powerful marijuana may be harmful to its largest demographic of regular users: teens and young adults whose brains are still developing.
To understand marijuana use disorders, it’s important to first understand the difference between dependence and addiction. Dependence occurs when you become tolerant to a substance, and you begin to feel withdrawal symptoms when you haven’t had that substance in a while.
Dependence can be chemical in nature, which is when the brain adapts to the presence of a substance and begins to rely on it to maintain balanced brain chemistry. Dependence can also have psychological roots. For instance, you may get used to smoking marijuana before bed, and when you don’t smoke, you may have trouble getting to sleep. Psychological factors play a role in your perceived need for the drug.
Addiction, on the other hand, is the inability to stop using a drug despite the consequences. Addiction is a disease that primarily affects the reward center of the brain. When the drug triggers a reward response, the brain learns about that drug as a source of good feelings and associates it in the same way as eating a tasty meal or tucking yourself into a warm bed.
The brain mistakes the drug for one of the many activities that are essential to your survival. When this occurs, it can be extremely difficult to stop using the drug on your own, because your brain will trigger cravings and impulses that push you toward drug use, even when you know there will be consequences.
Marijuana has a fairly low addiction potential, especially when compared to other highly addictive drugs like heroin, cocaine, and even cigarettes. Marijuana use disorders typically involve dependency. Your brain produces natural endocannabinoid neurotransmitters that are used for various functions.
If you were to smoke enough marijuana, your brain might start to produce less of its own natural chemicals and begin to rely on the chemicals introduced by marijuana. Plus, excessive use can make you less sensitive to those chemicals. Stopping abruptly can produce withdrawal symptoms that can be telltale signs of marijuana dependence.
While unlikely, addiction to marijuana is possible, especially with street-level marijuana increasing in potency. If you or a loved one is struggling with addiction, you may be able to notice some physical and behavioral signs in yourself or others. Marijuana addiction symptoms include:
With the rise in marijuana availability, it’s important to keep these marijuana addiction symptoms in mind. If you or a loved one is struggling with addiction, help is available.
Marijuana is one of the most popular recreational drugs in the United States, and it’s the most easily attainable illicit drug in the country. According to a 2016 study, more than 35 percent of 12th-graders reported using the drug in the past year. Since so many young adults using marijuana, with there be millions of marijuana-dependent people in a few years?
Marijuana is different from other drugs like opioids, cocaine, and even alcohol in that it doesn’t cause chemical dependence. Chemical dependence occurs when your brain adapts to the presence of the psychoactive drug and starts to rely on it. Dependence usually starts with tolerance, as your adaptation to the drug starts to cause diminishing effects.
Eventually, your brain integrates the drug into a normal chemical balance. Without it, you’ll feel uncomfortable withdrawal symptoms.
However, marijuana doesn’t seem to cause a strong chemical dependence, but it can cause withdrawal symptoms. In the 1970s, researchers conducted studies into the tolerance and dependence causing effects of marijuana. One study found that tolerance does not easily develop in marijuana users unless they take several heavy doses repeatedly. Another study found that long-term use led to mild tolerance and withdrawal effects.
A 1999 study concluded that frequent marijuana users could experience some withdrawal symptoms that could warrant clinical interventions. Withdrawal symptoms are typically mild and psychological, including irritability, anger, depression, difficulty sleeping, cravings, and decreased appetite. A 2007 study found that these symptoms negatively impacted some users’ attempts to cut back or stop marijuana use.
While marijuana doesn’t cause tolerance, chemical dependency, or addiction in the same way that other drugs do, it’s possible for repeated use to turn into a pattern that’s difficult to stop. Withdrawal isn’t likely to be dangerous or even as intensely uncomfortable as stimulant or opioid withdrawals. However, someone who’s been using marijuana for a while may find it difficult to quit, even after they experience negative consequences.
While addiction is a chronic disease, it is treatable. There are a plethora of marijuana addiction treatment options and therapies that can help you get out from under the oppression of active addiction. As the United States is in the middle of an addiction epidemic, researchers and clinicians are working hard to develop new ways to treat addiction and to make tried and true methods readily available.
With so many options and still so much to learn about this disease, there is some debate as to the most effective treatment options. However, there are a few guiding principles that have shown to make effective treatment plans, backed up by scientific studies.
According to the National Institute on Drug Abuse (NIDA), 13 principles make for effective treatment. Many of them are so important that treatment centers build their approach to treatment around them. Here are some of the most notable principles of effective treatment.
There are a variety of treatment options to choose from, and different people will respond to different options. A treatment plan should be customized to fit the individual rather than fitting an individual to a particular plan. This requires hard work and attention to detail on the part of the therapists and clinicians, but your input will also be instrumental in the creation of your addiction treatment plan. During your intake and assessment, your personal history with drug use, family history, concerns, struggles, and goals for treatment will be taken into account.
While treatment plans may vary widely, with no two looking exactly the same, each should come from the perspective that addiction is chronic, long-lasting, and difficult to overcome. Relapse is very common. In fact, it occurs at about the same rate as other diseases like diabetes and hypertension. Relapse prevention strategies must be used to lead to long-lasting recovery.
Treating addiction isn’t just about treating marijuana use disorder. It requires a holistic look at multiple aspects of a person’s life. Several factors can potentially cause or contribute to addiction, and the addiction can wreak havoc in multiple areas of a person’s life. For that reason, effective marijuana addiction treatment has to consider your medical, psychological, social, vocational, financial, and legal needs.
Marijuana addiction treatment is often ineffective if the client doesn’t spend enough time in therapy. It isn’t enough to detox and then return to normal life. Addiction is a deeply rooted disease that requires time to overcome. You will need to learn triggers, learn how to develop coping skills, address underlying issues like depression or trauma, and continue to commit to recovery over a long period. Relapse often occurs when a person neglects their continued recovery. Studies show that the most effective treatment duration is 90 days. While the length of time you spend in treatment is largely up to your needs, three months of varying levels of care is typically required for the best possible treatment.
According to the American Society of Addiction Medicine (ASAM), addiction treatment is separated into four basic levels of care, each with a few subcategories. You may start your treatment plan at any level of care and then move to new levels of care as your progress. This process is known as the continuum of care.
Typically, you will start at a highly intensive level and then scale down as you achieve treatment goals. This allows you to have plenty of support and structure when you need it and then slowly ease yourself back into normal life. Here is a brief description of each level of care in addiction treatment:
Also known as detox, medically managed services are the highest level of care in addiction treatment and involve 24-hour, hands-on medical care, and the administration of medical interventions. This is reserved for people for whom addiction comes with a medical need. Typically, people with marijuana use disorders alone don’t require medical detox. However, if a medical need is present, you may need this level of care. If you have used other drugs, especially benzodiazepines or alcohol, while in active addiction, medical detox is the safest way to start your recovery journey. Medical detox can alleviate withdrawal symptoms, treat co-occurring medical issues or injuries, and avoid serious complications.
This level of care includes inpatient treatment and partial hospitalization. Inpatient treatment is highly intensive and can help people with ongoing medical concerns and people who need 24-7 medical monitoring. Some drugs can have dangerous post-acute withdrawal symptoms for up to a few weeks, and around-the-clock medical monitoring is ideal in such cases. In this level of care, you will receive extra stability for medical, emotional, or psychological needs that require a higher level of care.
Also called IOP, this is a level of care in which clients live independently but spend more than nine hours in treatment every week. This level of care is marked by high-intensity clinical therapies with a degree of independence and self-sufficiency. Though you live on your own or in sober living residence, you will still have access to highly structured care. Therapies can include one-on-one sessions, group sessions, family therapy, and much more.
This is the lowest level of formal addiction treatment and involves fewer than nine hours of clinical therapy every week. Outpatient services are an ideal step between high-intensity levels of care and complete independence. While you live on your own and start to ease back into everyday life, you can still address triggers, cravings, and challenges that arise with your therapist.
After you complete addiction treatment, it’s important not to discontinue your commitment to recovery. Many treatment centers offer aftercare programs that can connect you to support groups, 12-step programs, job search help, and other important services to help you build a productive life while maintaining your sobriety. Twelve-step programs have proven to be helpful in relapse prevention after the completion of a treatment program. Set new goals for your recovery and continue to pursue them with the help of peers and mentors.
Marijuana use in itself is typically not medically dangerous. Unlike other drugs, it has a very low overdose potential, and cannabis itself has not been linked to serious medical complications. Smoking marijuana can be hazardous to lung health. Like tobacco, marijuana smoke can contain harmful chemicals like ammonia, hydrogen cyanide, and formaldehyde that can lead to medical complications later in life like cancer. However, there isn’t hard evidence that marijuana smoke is a direct link to cancer like there is for tobacco.
Marijuana can be linked to indirect dangers like accidents and injuries. Like alcohol, marijuana can be linked to auto accidents and, in states where it has been legalized for recreational use, car crashes are on the rise.
There is some evidence to suggest that marijuana can impact brain development in teenagers and young adults. In marijuana’s largest demographic of users, the drug can disrupt a process of brain development called myelination. Studies show that regular marijuana users have less grey matter, which contributes to cognitive and behavioral impairments.
American Society of Addiction Medicine. (n.d.). American Society of Addiction Medicine. Retrieved April, 2018 from https://www.asam.org/resources/the-asam-criteria/about
Babor, T. F. (1975, December 01). Marijuana Consumption and Tolerance to Physiological and Subjective Effects. Retrieved from https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491465
Budney, A. J., Novy, P. L., & Hughes, J. R. (2002, May 03). Marijuana withdrawal among adults seeking treatment for marijuana dependence – Budney – 1999 – Addiction – Wiley Online Library. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1360-0443.1999.94913114.x
Budney, A. J., Roffman, R., Stephens, R. S., & Walker, D. (2007, December). Marijuana dependence and its treatment. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797098/
Gallup, Inc. (2016, August 08). One in Eight U.S. Adults Say They Smoke Marijuana. Retrieved April, 2018 from http://news.gallup.com/poll/194195/adults-say-smoke-marijuana.aspx
LeBeau, P. (2017, June 22). Auto crashes are on the rise in marijuana states. Retrieved April, 2018 from https://www.cnbc.com/2017/06/21/auto-crashes-are-on-the-rise-in-marijuana-states.html
National Institute on Drug Abuse. (2018, February). Marijuana. Retrieved April, 2018 from https://www.drugabuse.gov/publications/drugfacts/marijuana
National Institute on Drug Abuse. (2018, January). Principles of Effective Treatment. Retrieved April, 2018 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
National Institute on Drug Abuse. (2018, February). What is the scope of marijuana use in the United States? Retrieved April, 2018 from https://www.drugabuse.gov/publications/research-reports/marijuana/what-scope-marijuana-use-in-united-states
Nowlan, R., & Cohen, S. (2016, January 04). Tolerance to marijuana: Heart rate and subjective "high" – Nowlan – 1977 – Clinical Pharmacology & Therapeutics – Wiley Online Library. Retrieved from https://ascpt.onlinelibrary.wiley.com/doi/abs/10.1002/cpt1977225part1550