Marijuana addiction, also called marijuana use disorder, occurs in some people who use this drug recreationally. It is characterized by an inability to control use of the drug, an intense focus on using it, cravings, and continuing to use marijuana in spite of problems that it causes. Marijuana use disorders can be effectively treated with an individualized treatment plan that includes a stay at a residential facility, therapy, support, lifestyle changes, and a commitment to preventing relapses.
What Is Marijuana Addiction?
Is marijuana addictive? Whether or not marijuana is an addictive, habit-forming drug has been debated in recent years. The debate has become increasingly important as more states legalize recreational use of marijuana. From research and individual case studies, most experts agree that marijuana can be addictive, but true chemical dependence is not very common. Chemical dependence occurs when habitual use of a drug causes changes to the brain that result in tolerance, withdrawal, and cravings.
While some people may become physically addicted to marijuana like this, more often people addicted to the drug are experiencing a psychological dependence. Their bodies and brains have not become dependent on marijuana, but they still feel as if they need the drug and that they can’t stop using. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), this is called marijuana or cannabis use disorder. This addictive disorder can be just as difficult to overcome as physical dependence, but good treatment, beginning with a residential stay, is an important first step.
Facts and Statistics
The marijuana drug is the dried material—flowers, leaves, stems—of the cannabis plant. It can be used for medical purposes but is primarily used recreationally, to get high. Marijuana is most often smoked, but it can also be mixed into foods, which are called edibles, or vaporized. The compounds in the cannabis plant that are psychoactive are called cannabinoids and the most prominent of these is called THC.
- About half of American adults have tried marijuana at least once.
- Twenty-eight states, as well as Guam, Puerto Rico, and the District of Columbia, have legalized marijuana for medical uses.
- Voters in eight states and the District of Columbia have legalized recreational marijuana.
- Marijuana is the most commonly used substance after alcohol across all age groups.
- According to a 2017 Gallup poll, support for legalizing marijuana is at an all-time high with 64 percent of people who believe recreational use should be decriminalized.
- Use of marijuana by eighth and tenth graders has declined since 2010, while use by twelfth graders has remained steady at about 36 percent in the past year.
- People who begin using marijuana before the age of 18 are at a greater risk of developing a use disorder.
- About nine percent of people who use marijuana will become dependent on it. The number is closer to 17 percent in those who first started using the drug in their teens.
Symptoms and Diagnosis of Marijuana Addiction
According to the DSM-5, there are 11 criteria that indicate a person may be struggling with some degree of marijuana use disorder. The disorder can be rated as mild, moderate or severe. To be diagnosed, a person must experience at least two of the following signs of marijuana addiction within a given 12-month period:
- Using marijuana in larger amounts or for longer than intended
- Trying to cut back on use, but failing
- Spending a significant amount of time or money on getting and using marijuana
- Craving marijuana when not using it
- Failing to meet obligations and responsibilities because of marijuana use
- Continuing to use marijuana even though it causes problems, like relationship conflicts or financial problems
- Giving up other activities to spend more time using marijuana
- Continuing to use marijuana in situations that are harmful
- Developing a tolerance and needing more marijuana to get the same result
- Experiencing uncomfortable symptoms, like anxiety and irritability when not using marijuana
The effects of being high on cannabis can sometimes be easier to mask than those of some other drugs and alcohol. There are some characteristic signs, though, that indicate someone is using marijuana or is considered to be intoxicated because of use:
- Problems with short-term memory
- Dry mouth
- Red, bloodshot eyes
- Impaired coordination and motor control
- Altered perceptions
- Delayed reaction times
- Increased heart rate and blood pressure
- Anxiety or paranoia
- Food cravings
Unlike other drugs, overdosing on marijuana is not an issue. According to the Drug Enforcement Administration, there have been no reports of marijuana overdose fatalities in the U.S. However, when the source of the marijuana is not known there is always the possibility that it has been cut with another substance that could cause harm or an overdose.
In rare cases, marijuana can cause or trigger serious and dangerous psychotic symptoms, such as hallucinations, delusions, and severe paranoia. This is more common in first-time users and those who have an underlying psychiatric condition, especially those with psychosis. It is also more common with higher doses of the drug. Psychosis should be taken seriously and may require emergency medical care.
Causes and Risk Factors
As with any type of addiction or substance use disorder, there is no way to determine a definite cause other than repeated, long-term use. The more often someone uses marijuana, the larger amounts they use, and the longer the period of time of regular use, the more likely they are to develop a use disorder. However, most people who use marijuana do not become addicted or dependent or have even a mild use disorder. Risk factors that make it more likely a person will develop an addiction include:
- A family history of addictive disorders
- Early use of marijuana, beginning as a child or teenager
- Using marijuana with elevated levels of THC
- Misuse of other substances
- Having a mental illness, especially one that is undiagnosed or untreated
- Childhood trauma
- Having a social group in which marijuana use is common
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Marijuana Withdrawal and Detox
Most people who have a marijuana use disorder are diagnosed based on their behaviors rather than a physical or chemical dependence on the drug. That means that withdrawal is not as common or as severe as with other drugs. It is possible to experience withdrawal, even when the addiction is purely psychological. The symptoms can be physical and mental and can be uncomfortable enough to make it very challenging to stop using. Withdrawal is more common after heavy and long-term use of marijuana. Some of the possible symptoms include:
- Irritability and anxiety
- Mood swings
- Loss of appetite
To stop using marijuana requires that an individual go through a period of detox, while the drug leaves the body. This may trigger some of the withdrawal symptoms and is more successful when done with supervision. Supervised detox is usually the first step in residential treatment and an overall treatment plan for marijuana use disorder.
It is not uncommon for someone with a marijuana use disorder to have co-occurring disorders. Two that are common include other substance use disorders and mental illnesses. All of these illnesses have risk factors in common, which is one important reason they co-occur. The phenomenon may also be explained by the fact that many people with mental illnesses, like depression, turn to substances as a form of self-medication.
Long-term marijuana use can also trigger or contribute to physical health conditions. These include respiratory conditions similar to those caused by cigarette smoking: chronic bronchitis or emphysema. Cannabinoid hyperemesis syndrome is a condition that long-term users may develop and that causes severe cycles of nausea and vomiting that can lead to dangerous dehydration.
Treatment and Prognosis for Marijuana Addiction
Marijuana use disorders can be effectively treated, and for those who are committed to a long-term residential stay and with continuing care afterwards, the prognosis is very good. A person can learn to live without marijuana, even heavy users. Residential treatment is most effective because it allows an individual to focus on treatment for an extended period of time while learning necessary skills for returning home and avoiding a relapse.
Marijuana treatment is tailored to each individual and typically includes one-on-one behavioral therapy, group and family therapy, group support, alternative therapies, nutrition, exercise, relaxation strategies and stress management, and learning how to avoid relapses. Relapse prevention is an important part of treatment and includes learning what triggers marijuana use, how to avoid triggers, lifestyle changes, and learning and using healthy coping strategies.
Marijuana use disorder is not an issue for most casual users of this substance. However, for a significant portion of people, use of marijuana does become problematic and affects other areas of their lives. Signs of addiction should be taken seriously. Treatment is available and can be effective, but if professional and committed, long-term treatment is not sought, the consequences can be serious.