Controversy over the recreational use of marijuana still rages on. It raises the question is marijuana addictive? The question arises from the psychoactive properties of its primary ingredient, tetrahydrocannabinol (THC). Cannabis also contains nearly 500 compounds that include 85 other cannabinoids and tetrahydrocannabivarins, which contribute to the acuteness of marijuana’s affect on the brain.
Marijuana is a dry, shredded green and brown mix of flowers, stems, seeds, and leaves derived from the hemp plant, known as “cannabis sativa”. The active chemical in marijuana which provides the mind-altering effect is tetrahydrocannabinol (THC).
The most popular method of using marijuana is smoking it in hand-rolled cigarettes, known as a “joint”. It can also be smoked in small pipes or large water-filled devices called “bongs”. It can also be put into varies foods, like cookies or brownies. Marijuana smoke gives off a very pungent order.
Cannabis Use Disorder
Do you think the medical community would have a specific diagnosis, Cannabis Use Disorder, if it wasn’t addictive? The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) combines substance dependence and cannabis abuse into one disorder called Cannabis Use Disorder (CUD). Addicted weed users diagnosed with CUD exhibit the following criteria (according to the DSM-V):
- Tolerance of weed (more marijuana is needed to feel its psychoactive effects)
- User suffers withdrawal symptoms within 24 to 48 hours of abstaining from marijuana
- Users have unsuccessfully tried to control or reduce cannabis use
- Recreational, occupational and social activities are given up in favor of their addiction
- Much of their free time is spent finding, obtaining and using marijuana
- Smoking weed in high-risk situations (while driving, operating machinery or around their children)
According to the American Journal of Psychiatry, “…Cannabis use disorder is prevalent, associated with mood disorders and disability, and largely untreated. Findings suggest the need to improve prevention and educate the public, professionals, and policy makers about possible harms associated with cannabis use disorders and available interventions.”
Marijuana Withdrawal Syndrome (MWS) resembles symptoms of withdrawal from other so called “harder” drugs. Withdrawal, which starts 24 to 48 hours after abstinence, can be difficult and painful enough that many users find it difficult to quit for very long. Symptoms peak in four to six days, but withdrawal can last anywhere from one to three weeks. Marijuana withdrawal syndrome can include a variety of symptoms. Diagnostic criteria exemplifying withdrawal marijuana include but are not limited to these complaints:
- Anger, Irritability, Mood Swings
- Depression, Anxiety, Restlessness
- Sleep Disturbances
- Decreased Appetite
- Drug Cravings
- Stomach Aches
- Sweating, Fever
Today there still seems to be some debate about whether you can become addicted to cannabis, or not. Make no mistake about it, marijuana can be very addictive, especially if the person has a dependency type of personality.
For too long, popular culture has cast it as a near harmless source of “mind-altering entertainment”. Simply put, that is untrue. Pot is the most widely used and abused illicit drug in the world. Clinical studies, diagnostic and laboratory research, as well as anecdotal evidence, has shown that marijuana use can and does lead to dependence, abuse and addiction.
Marijuana over-stimulates the endocannabinoid system in the brain, leading to both psychological and physical dependency. In fact, nearly 10 percent of people who smoke marijuana will eventually develop a dependency. Further, of the seven million Americans addicted to drugs, over four million are hooked on “pot”.
Surgeon General’s 2016 report entitled “Facing Addiction in America” describes marijuana as one of the “most addictive drugs”.
Statistics on Marijuana Use
These were the numbers 2-3 years ago and the laws have changed dramatically since then to make smoking pot much easier. According to the U.S. government statistics (SAMHSA).
- Marijuana is the most-used drug after alcohol and tobacco in the United States
- In 2014, about 22.2 million people ages 12 and up reported using marijuana during the past month
- Also in 2014, there were 2.6 million people who had used marijuana for the first time
- People between the ages of 12 and 49 report first using the drug at an average age of 18.5
- In the past year, 4.2 million people ages 12 and up met the criteria for a substance use disorder
Effects Brain Structure
Altering the brain structure is a common denominator of drug addiction. In 2014, Harvard researchers recruited 20 weed users and 20 non-users to investigate whether marijuana discernibly modified brain volume. Results clearly showed that subjects smoking weed experienced changes in topography, density and volume in the amygdala and nucleus accumbens.
Another study published in “Nature” magazine used magnetic resonance imaging (MRI) to examine effects of cannabis smoking on the brain. Subjects included in this study were occasional smokers (several times a week) and heavy (daily) smokers.
MRI scans revealed that the volume of gray matter (brain matter teeming with cannabinoid receptors) in both light and heavy weed smokers were significantly reduced. Regions of gray matter include a network of structures that control emotions, learning, reward and, in particular, motivation.
In the brain, there’s a lot of collaboration between cannabinoid receptors and opioid receptors. THC, the psychoactive ingredient in marijuana, triggers the same receptors that other drugs like morphine, OxyContin and heroin. These receptors then release dopamine, which activate the brain’s reward or “feel good” centers. Such a close connection between opioid and cannabinoid receptors proves that marijuana has the potential for addiction.
Most advocates of marijuana use, both medicinal and recreational, are skeptical or flat out deny pot’s addictive properties. The National Institute of Health, though, reports that cannabis dependence is twice as prevalent as dependence on other psychoactive drugs, such as cocaine and heroin. One of the reasons, pot can lead to addiction has to do with the brain’s chemistry.
According to the National Institute on Drug Abuse, out of the 6.9 million Americans abusing illicit drugs in 2013, 4.9 million (71%) were marijuana dependent. Experts believe that the rise in cannabis dependency relates to a number of factors. First, there’s more available pot than ever before. In the U.S., 24 states allow the sale and use of medicinal marijuana, and five states, including the District of Columbia, permit the sale and use of recreational marijuana.
Another component to the rise in addiction is potency. The science around growing pot has made leaps and bounds, even since the 1990’s when the average sample was approximately 3.7 percent THC. Today, growers are harvesting marijuana plants that are as high as 16 percent THC. And marijuana extracts, commonly referred to as “dabs” or butane hash oils, can be produced at 90 percent THC.
A simple Internet search reveals the volumes of misinformation about cannabis. Whether anyone agrees or disagrees with marijuana use, the idea or belief that it’s non-addictive has a short lifespan. As state laws lean more toward legalization, a growing number of studies will be released revealing that pot is not a guilt or consequence-free indulgence for everyone, most especially for teenagers and young adults.
A growing body of statistically significant evidence shows that brain deficits resulting from cannabis use persist even if the user stops smoking marijuana. Certain factors, such as when the user began smoking weed and how long they have been using, may play an important role in worsening motor and cognitive impairments. These factors are also increasingly being attributed to inhibiting any possible recovery of minimized brain functioning.
Cannabis may also exacerbate pre-existing mental illnesses in both recreational and heavy users. In addition, longitudinal investigations regarding marijuana smokers who suffered childhood traumas indicates that these users are at an increased risk for being diagnosed with a serious psychiatric disorder at some point in their lives.
Not surprisingly, marijuana intoxication can cause distorted perceptions, impaired coordination, difficulty in thinking and problem solving, and difficulty with learning and memory. Research has shown that marijuana’s adverse impact on learning and memory can last for days or weeks. As a result, someone who smokes marijuana every day may be functioning at a sub-optimal intellectual level all of the time.
Research on the long-term effects of marijuana abuse indicates some changes in the brain similar to those seen after long-term abuse of other major drugs. Cannabis withdrawal in chronically exposed animals lead to an increase in the activation of the stress-response system and changes in the activity of nerve cells containing dopamine. Dopamine neurons are involved in the regulation of motivation and reward, and are directly or indirectly affected by all drugs of abuse.
A number of studies have shown an association between chronic marijuana use and increased mental illness such as anxiety, depression, suicidal ideation, and schizophrenia. Some of these studies have shown age at first use to be a factor, where early use is a marker of vulnerability to later problems. However, at this time, it not clear whether marijuana use causes mental problems, exacerbates them, or is used in attempt to self-medicate symptoms already in existence.
A particular class of neurons express elevated levels of cannabinoid receptors in the cerebral cortex, hippocampus and amygdala. When activated by THC, these cannabinoid receptors inhibit release of monoamine neurotransmitters and amino acids. Disruption of normal brain chemical processes by THC causes:
- Impairment of short term memory
- Delayed psycho-motor activity
- Appetite increase
- Heightened mood/euphoria
- Distortion in the perception of time and space
Some users may also experience anxiety, tachycardia, headache and nausea. Researchers suspect that the way someone reacts to marijuana depends on their genetics, mental health status and other bio psychosocial components.
Marijuana is the most used drug in the world, followed by opioids/opiates and cocaine. The World Drug Report states that nearly five percent of the world’s population has used or is using marijuana. In 2015, nearly 50 percent of the U.S. population reported trying marijuana at least once. The heaviest marijuana users are males between the ages of 18 and 29, with 45 to 50 percent of young adult males smoking marijuana occasionally or regularly.
Marijuana is usually smoked in pipes, water bongs or rolled into cigarettes (blunts or joints). It can also be consumed as a tea by adding milk or cream to a 1/2 gram of marijuana. “Pot brownies” containing finely shredded marijuana are a popular form of “edible” cannabis that can provide the same psychoactive effects produced by smoking marijuana.
Chemical compounds found in marijuana smoke are similar compounds in tobacco smoke. In fact, at least 50 carcinogens have been identified in marijuana smoke. Also, since weed users inhale smoke more deeply than cigarette smokers, it may be assumed that absorption of carcinogenic compounds is facilitated and emphasized within the lungs.
A 2006 systematic review of research regarding correlations between cannabis and lung cancer found that smoking marijuana is associated with “increased tar exposure, increased oxidative stress, alveolar macrophage tumoricidal dysfunction and bronchial mucosal histopathologic abnormalities” when compared to smoking tobacco.
A little of over half of U.S. states have not decriminalized marijuana possession or use. In these states, you will do jail time and pay large fines if caught with marijuana. States that have decriminalized marijuana only issue a citation and small fine if you are found with less than 10 grams of weed on your person. To learn more about state marijuana laws, visit http://norml.org/laws/.
Medical marijuana in the U.S. is controlled at the state level. Per federal law, cannabis is illegal as noted in the Controlled Substances Act, but the federal government has stated they will not actively prosecute patients and caregivers complying with state medical marijuana laws. However, use of medical marijuana outside of the state laws for illegal use or state or federal government will not tolerate trafficking.
There are eight medical conditions for which patients can use cannabis:
- Muscle spasms
- Severe pain
- Severe nausea
- Cachexia or dramatic weight loss and muscle atrophy (wasting syndrome)
According to various state laws, medical marijuana can be used for treatment of other debilitating medical conditions, such as decompensated cirrhosis, amyotrophic lateral sclerosis (ALS), Alzheimer’s disease, and post-traumatic stress disorder. Not all states that approve of medical marijuana have enacted laws to allow its use for all of these conditions. Another difference between states – the amount of marijuana for medical use that can be possessed by the individual patient or primary caregiver varies, but may include dried marijuana and live plants.
Marijuana use is on the rise.
- In 2013, 5.7 million persons aged 12 or older used marijuana daily
- In 2016, 8.1 million persons aged 12 or older used marijuana on 20 or more days in the past month
Current treatments methods used to address a marijuana addiction include cognitive behavioral therapy, motivational enhancement therapy and contingency management, a type of behavioral reinforcement strategy also used to help alcoholics. Although no medications exist to manage marijuana withdrawal, anti-anxiety medications or antidepressants may be prescribed to relieve anxiety and insomnia during treatment.