Why is Marijuana Use Addictive?
Marijuana use has been shrouded in myth and misconception for centuries. In our lifetime, this situation is being exacerbated by a growing marijuana industry stemming from the legalization of recreational and medical cannabis use.
The marijuana industry markets cannabis use not just to have fun and socialize, but as part of a hip lifestyle, and to self-medicate everything from anxiety to low energy. It also portrays cannabis consumption as innocuous and as normal a part of daily life as having a glass of wine with dinner.
One of the more frequently espoused marijuana myths is that its use is not addictive like other drugs. Others think that addiction from marijuana is possible, but that it is very rare. Still others think that if marijuana use does become addictive, it’s easy to just stop using it.
Each of these beliefs is incorrect. Below we’ll discuss why.
Cannabis Use Disorder
First, let’s examine a key addiction concept. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association defines marijuana or cannabis use disorder as a substance use disorder (http://www.dsm5.org/Documents/Substance%20Use%20Disorder%20Fact%20Sheet.pdf)).
Cannabis use disorder, like alcohol or heroin use disorders, are measured on a continuum determined by the number of symptoms assessed, ranging from mild (2-3 symptoms), to moderate (4-5 symptoms) and severe (6 or more symptoms). More specifically, cannabis use disorder is clinically diagnosed if two or more of the following 11 symptoms are experienced in a 12-month period:
- Taking more cannabis than was intended
- Difficulty controlling or cutting down cannabis use
- Spending a lot of time on cannabis use
- Craving cannabis
- Problems at work, school, and home resulting from cannabis use
- Continuing to use cannabis despite social or relationship problems
- Giving up or reducing other activities in favor of cannabis
- Taking cannabis in high risk situations
- Continuing to use cannabis despite physical or psychological problems
- Tolerance to cannabis
- Withdrawal when discontinuing cannabis
As you can see by this list of symptoms, marijuana, like other drug and alcohol use disorders, can cause serious problems, resulting in pain and suffering for users and those close to them.
These symptoms paint a picture of the insidious nature of marijuana addiction in which its use can become increasingly important and even central in one’s life. For some, cannabis use supplants other activities, causes problems at home, work and school, exposes you to dangerous situations and potential harm, and results in physical dependence.
Other Marijuana Use Terms
The current definition of cannabis use disorder in the DSM-5 replaced the previously used terms “abuse” and “dependence” which were sometimes misinterpreted and thought to be less accurate than the present definition.
However, it is important to define these and a few other terms commonly used when discussing marijuana and other substance use to help us more clearly and accurately understand and discuss marijuana use and marijuana use problems.
Here are some other important cannabis use terms:
Abuse: A non-scientific and subjective term referring to a person’s misuse, excessive use, or problem use of marijuana. Since one person’s abuse is another’s use, I suggest avoiding this term and using the less pejorative and more accurate terms “marijuana use,” or “marijuana use disorder” if referring to problem use.
Addiction: Addiction is defined by the National Institute of Drug Abuse as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences (https://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics), of which marijuana addiction is one example. That means a marijuana “addiction” is a severe form of “cannabis use disorder.”
Dependence: A state in which a person functions normally only in the presence of a drug, such as marijuana. Dependence develops when the brain neurons adapt to repeated drug exposure and only function normally in the presence of the drug. Dependence is evidenced by withdrawal symptoms which result from abruptly stopping marijuana use.
Tolerance: The body’s adaptation to regular use of marijuana so that a greater quantity is required to experience the same effects felt at an earlier time when using a lesser amount.
Withdrawal: Symptoms that occur from dependence upon marijuana when an individual abruptly stops using it. These can include irritability, mood and sleep problems, decreased appetite, cravings, restlessness, and/or physical discomfort, and can last up to two weeks.
Some Key Numbers
National data show 30% of marijuana users experience marijuana use disorder. That’s nearly 1 in 3 cannabis users who report experiencing two or more negative effects from their marijuana consumption.
Of even greater concern is that youth who start using marijuana before the age of 18 are 4-7 times more likely to develop a cannabis use disorder, according to the National Institute on Drug Abuse (https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive). In the past year, over 4.1 million Americans experienced a marijuana use disorder.
Epidemiological estimates indicate that 9 percent of people using marijuana will become dependent on it. However, among teens who start using marijuana, 17% will eventually become dependent. These data highlight the greater vulnerability of youth to becoming dependent upon marijuana, as well as to experiencing a marijuana use disorder.
Individuals with cannabis use disorders, particularly adolescents, are also likely to suffer from other psychiatric disorders. These comorbidities can include psychosis, depression and anxiety. In addition, those with a marijuana use disorder are more likely to experience co-occurring addictions, like alcohol or cocaine use disorders.
Data on adults seeking treatment for cannabis use disorder show that on average, those presenting for treatment have been using cannabis nearly every day for over 10 years. In addition, these individuals tried to quit using marijuana more than six times, without success. These numbers highlight the long-term nature of marijuana use disorders, and the difficulties of trying to control marijuana use and its problems.
I’ve corrected several myths many people have related to marijuana and its potential for addiction. It is clear from the above presentation of science-based information that marijuana addiction in the form of cannabis use disorder and dependence is not only possible, it is relatively common, particularly among youth. In addition, cannabis use disorders can result in serious life-altering problems, and it is not easy to stop using marijuana once it becomes an addiction.
Preventing the early onset of marijuana use in adolescence, as well as regular and heavy use, should be primary goals for health and medical professionals, youth services workers, police officers, addiction and mental health specialists, lawmakers, and parents.
Youth, and those who care about youth, should become more aware of the risks of cannabis use to young people. Furthermore, healthier alternatives to marijuana consumption should be promoted among youth and young adults who may initiate using cannabis to have fun, socialize, or self-medicate life problems.
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Please share this critical information with all of your friends, co-workers, and kid’s teachers. Thank you!