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Can You Become Addicted To Cannabis?

Posted: December 9, 2019 in Cannabis Addiction vs Dependency, Is Cannabis Addictive?

When I was tasked with writing a post about cannabis addiction, my initial response was that it is not addictive, based on my personal experience. Then, I decided that was unfairly dismissive and that an investigation of cannabis addiction was warranted. The answer to the question Is Cannabis Addictive? seems to be twofold; it depends on whom you ask and on your definition of addiction. There is a lot of gray area here and I will do my best to lay it all out for you so that you can make your own decision.

The Definition of Addiction

According to Roger Roffman, Professor Emeritus of Social Work at University of Washington, who has studied cannabis dependence and interventions for 30 years:

“Addiction results from a combination of biological and psychological factors that contribute to conditioned behavioral patterns that are very difficult to stop or resist.”

According to the National Institute on Drug Abuse (NIDA), a federal run government research institute, the definition of addiction is as follows:

Addiction is characterized as an inability to stop using a substance even though the user is aware that it interferes with the quality of their life.While Dr. Roffman supports decriminalizing cannabis, he believes it is not just a harmless drug and it carries health and behavioral risks. He acknowledges that for the majority of cannabis users, it can be used responsibly and it not only heals but it enriches their lives. However, there is a significant minority of users who experience a moderate to severe disorder. They need understanding and help rather than punishment. An individual’s relationship with cannabis is unique and must not be used to define the experience of anyone else.

On the flip side of this debate, NIDA has updated its latest research and concluded that as many as 30% of cannabis users may have some degree of “marijuana use disorder.”

They have cited this study, which combines the findings of both cannabis and alcohol use, to substantiate the claim that “those who start using cannabis before age 18 are four to seven times more likely to develop a marijuana use disorder than an adult.”

The NIDA also makes a distinction between a dependence and an addiction; you can become dependent without being addicted.

Dependency

According to the NIDA , 9% of cannabis users develop a dependency, with an increase to 17% for those who start before age 18. A cannabis dependence refers to a person who experiences the following withdrawal symptoms when they stop using it:

  • Irritability
  • Mood and sleep disturbances
  • Decrease in appetite
  • Cravings
  • Restlessness
  • Physical discomfort

These symptoms peak within the first week and last up to 2 weeks.

Cannabis Use Disorder (CUD)

I thought it would be interesting to define CUD which is not a term with which I was previously familiar.

Cannabis Use Disorder is the term used by scientists and the medical community to describe cannabis addiction. It is a condition that now appears in the DSM-V, which is the manual of psychiatric diagnoses. Listed below are the indicators used to assess the presence of the disorder. The higher the number of indicators that an individual experiences, the more severe their disorder. When cannabis usage causing significant impairment or distress leads to at least 2 of these indicators within 12 months, an individual is diagnosed with CUD.

  1. Consumption of cannabis gradually increases or it lasts longer than was intended
  2. Efforts to reduce cannabis usage are unsuccessful despite a desire to do so
  3. Obtaining, using and recovering from its effects take over the user’s life
  4. A craving, urge or desire to use cannabis is constant
  5. Excessive cannabis usage diminishes the ability to function at work, school or at home
  6. The prolonged usage of cannabis causes deleterious effects on social and interpersonal relationships
  7. Excessive cannabis usage results in the loss of interest in engaging in social, work or recreational activities
  8. Continued cannabis usage results in physically hazardous situations
  9. The build up of a tolerance to cannabis results in a need to increase the amount ingested to achieve the same effect
  10. Withdrawal symptoms occur with a discontinuation of cannabis usage

Cannabis Withdrawal Symptoms

Once heavy or prolonged cannabis usage ceases, described as daily or almost daily for at least a few months, at least 3 of the following signs and symptoms that develop after a week are considered to be withdrawal:

  • Irritability, anger or aggression
  • Nervousness or anxiety
  • Sleep difficulty such as insomnia or disturbing dreams
  • Decreased appetite or weight loss
  • Restlessness
  • Depressed mood

One or more of the following physical symptoms causing discomfort:

  • Abdominal pain
  • Shakiness or tremors
  • Sweating
  • Fever
  • Chills
  • Headache

This is relevant especially in states where rehab programs are required for drug-related crimes. A determination of the need for treatment depends on the number of criteria that an individual meets. The big problem with this diagnostic criteria is that individuals who meet as few as 2 criteria would be diagnosed with minor to severe cannabis use disorder when in fact that describes the majority of cannabis users.

Comparing the Addiction Rate of Cannabis to Other Drugs

Another perspective on assessing the addiction rate of cannabis is to compare it to several other addictive substances. Typically, neither caffeine nor sugar are included in such lists, but they should be. Here you go:

Caffeine 50-90%? (I was unable to find conclusive numbers)
Sugar 75%
Tobacco 20-30%
Heroin 23-25%
Cocaine 15-20%
Alcohol 15%
Cannabis 9%

In my mind, the interpretation of addiction by Johann Hari, a Swiss-British writer and journalist with expertise in the study of addiction, is the most relevant one. He sees addiction as a symptom of human disconnection. Humans are innately social beings who need to connect with other people, typically those who surround them, in order to function well. When that doesn’t happen as a result of trauma, isolation or circumstances out of our control, humans will seek out some type of relief that may be harmful to their well-being. According to Hari, the opposite of addiction is not sobriety, it is connection.

Sources:
leafly.com, Is Cannabis Addictive, Bailey Rahn, Nov. 22, 2015
emedicine.medscape.com, Cannabis-Related Disorders Clinical Presentation, Lawrence Genen, John Franzen, et al, updated May 23, 2017
drugabuse.gov, National Institute on Drug Abuse, Is Marijuana Addictive?
washington.edu, Roger Roffman Chronicles Society’s Long Struggle with Pot in “Marijuana Nation,” April 24, 2014, Doree Armstrong
addictioncenter.com, Sugar Addiction
youtube.com, Everything You Thought You Knew About Addiction Was Wrong, Johann Hari, 2017
ncbi.nlm.nih.gov, Likelihood of Developing an Alcohol and Cannabis Use Disorder During Youth: Association with Recent Use and Age, Winter KC, Lee CY, 2008

 

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