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Marijuana Abuse and Addiction

Marijuana, sometimes known as weed, pot, or dope, contains the dried flowers and leaves of the cannabis plant.1 Continued marijuana use can lead to addiction—an outcome that may become more likely with an increasingly potent supply of the drug.2 Despite its perception for some as a gateway drug, the majority of people who do use marijuana do not go on to use other “harder” drugs.2

In the United States, marijuana is the third most used addictive drug after tobacco and alcohol.2 It is most often used among younger people, with around 12 million young adults using it during 2018.2 The drug can be smoked in joints, pipes, or bongs; other people prefer to use vaporizers to avoid inhaling smoke. Marijuana can also be mixed into food, known as edibles.

What is Marijuana?

Weed or marijuana is made up of dried plant materials—leaves, flowers, and sometimes stems and seeds—of the plant Cannabis sativa or Cannabis indica.2 The plant contains tetrahydrocannabinol, or THC, which affects the brain and changes your mood or consciousness, leading to the sensation of feeling high.1,3

It is unlikely that marijuana itself will result in fatal overdose, but too much of it can cause severe adverse reactions. Some of the signs and symptoms that you have used too much weed include:4

  • Anxiety.
  • Panic.
  • Rapid heart rate.
  • Increased blood pressure.
  • Delusions.
  • Paranoia.
  • Hallucinations.
  • Severe nausea and vomiting.

Daily use of weed can lead to the development of marijuana addiction, or marijuana use disorder. The various substance use disorders (SUDs), diagnoses commonly used interchangeably with the concept of addiction, are medical conditions that affect a person’s brain and behavior. In cases of marijuana use disorder (or cannabis use disorder), it becomes difficult for them to stop using the drug despite its potential for drastic health effects and social consequences. About 10-30% of people who use weed may develop some degree of marijuana use disorder.2

What Are the Effects of Marijuana?

There are both short-term and long-term effects of marijuana use.

Short-term effects include:3

  • Altered perception of senses.
  • Altered sense of time (e.g., minutes feeling like hours).
  • Changes in mood.
  • Changes in cognition (e.g., decreased memory and problem-solving ability).
  • Increased appetite.
  • Impaired body movements.

Early marijuana use may be associated with certain brain development issues; as a result, some teenagers may experience long-term problems with thinking, memory, and learning.3 One study suggests that use at a young age may also decrease a person’s IQ by as much as 8 points.2,5

Long-term effects of frequent smoking include coughing and breathing problems.3 Though lung cancer risks do not appear to be elevated in those who smoke marijuana, other issues such as daily cough and increased phlegm production, more frequent pulmonary illness and higher risk of lung infections remain a concern.2

With the rise of vaping as a method of smoking marijuana, the Food and Drug Administration (FDA) has warned the public about hundreds of reports of serious lung injury related to vaping.2 Smoking marijuana can also affect your mental health, with studies linking marijuana’s use to depression, anxiety, thoughts of suicide, and psychotic episodes.5

Different Methods for Using Marijuana

Marijuana can be used in different ways.6

  • Smoking is the most common form of consuming marijuana. Vaporizing methods have gained popularity recently, in part due to the belief that it reduces the respiratory risks associated with smoking marijuana. Smoked or inhaled routes of marijuana use elicit relatively quick onset of symptoms, with peak plasma concentrations of THC being attained within 3-10 minutes, and peak effects occurring at 1 hour. Its effects usually last 2-4 hours.6
  • THC is relatively poorly absorbed when consumed orally, and it also undergoes additional metabolic clearance in the liver before it reaches the blood. Therefore, when used in edible products, peak levels are delayed in comparison to those that are inhaled, and it takes longer for effects to occur. The onset of symptoms may be expected to take 1-2 hours, with the resulting high lasting about 2-4 hours.6

What Causes Marijuana Addiction?

SUD, or addiction, is a chronic complex disease. For many, it takes more than good intentions, morals, or a strong will to simply stop using drugs. Marijuana is one such drug that can lead to addiction.

Some people may progress toward addiction in a stepwise or staged manner. Young people appear to move faster through these stages than adults. They include:10

  • Experimental drug use, which involves peers and recreational use by teens, usually in defiance of parents or other authority figures.
  • Regular use to quell negative feelings. People can start missing school or work, become worried about losing drug sources, and begin to seek relationships with regular users.
  • Problem or risky use, wherein drug use becomes more important than all other interests. People may experience a loss of motivation and stop caring about school or work. The person’s behavior changes; they may begin to neglect relationships and become increasingly secretive.
  • The final phase of addiction, where the person cannot control their drug use. They may be unable to get through their day without drugs, and they may experience worsening employment, financial, and social problems.

Like many drugs, marijuana is thought to affect the reward circuit in the brain. The reward circuit functions to motivate people to repeat behaviors that make us feel good, including searching for delicious food and having social relationships.11 Though the brain chemical details may be somewhat different from other drugs of abuse like opioids, marijuana use results in a stimulation of this reward system, which reinforces its continued use.11,12

The chemical structure of marijuana that affects the brain is THC. The THC molecule is structurally similar to naturally occurring chemicals (i.e., endocannabinoids) that we have in our brains. These endogenous cannabinoids, meaning cannabinoids that grow from within an organism, act as signals between the nerve cells that affect areas of pleasure, memory, thinking, concentration, coordination, sensation, and perception of time.12 When marijuana is ingested, THC attaches to and activates receptors that normally react to the naturally occurring molecules, disrupting brain signaling and leading to the sensation of being high.

The elevated THC potency of current marijuana strains has led to a greater release of dopamine, increasing the effects of pleasure. This teaches the brain to seek this rewarding behavior, contributing to marijuana’s addictive properties.12

Signs and Symptoms of Marijuana Addiction

To be diagnosed with a cannabis use disorder, an individual needs to meet at least 2 of the following criteria within a 12-month period:13

  • Having cravings, or a strong desire or urge to use marijuana.
  • Marijuana is used in larger amounts over a longer period than intended.
  • Continued marijuana use despite having persistent or recurrent social or interpersonal problems caused or worsened by drug use.
  • Important social, work-related, or recreational activities given up due to marijuana use.
  • There is a persistent desire or unsuccessful effort to cut down or control marijuana use.
  • Continuing use despite knowing that a persistent or recurrent physical or psychological problem is caused or worsened by marijuana use.
  • Recurrent marijuana use in situations where it is dangerous.
  • Needing more marijuana to achieve the previous effect, known as tolerance.
  • Experiencing withdrawal symptoms.
  • There is a large amount of time spent obtaining marijuana, using it, or recovering from its effects.
  • Recurrent marijuana use resulting in failure to fulfill obligations at work, school, or home.

Other symptoms of marijuana addiction include the development of withdrawal symptoms after stopping use:3

  • Irritability
  • Trouble sleeping
  • Decreased appetite, nausea, and vomiting
  • Anxiety
  • Cravings

It is important to remember that when people are addicted to marijuana, they are also at greater risk of developing its negative long-term effects including lung problems or issues with attention and memory learning.

Marijuana Withdrawal

With continued long-term use of marijuana, dependence can develop. A person with physiological marijuana dependence who tries to quit may experience withdrawal symptoms that make stopping additionally difficult. The symptoms of marijuana withdrawal include:2,13

  • Irritablility.
  • Restlessness.
  • Anxiety.
  • Depressed mood.
  • Sleep problems (e.g., nightmares, insomnia).
  • Abdominal pain.
  • Decreased appetite.
  • Fever, chills, or sweating.
  • Shakiness or tremors.
  • Cravings for more weed.

Treatment for Marijuana Abuse

Like other drugs, treatment is available for marijuana use disorder. On average, adults who seek treatment for marijuana addiction have used the drug daily for many years and have made repeated efforts to quit previously.14 It can be important that people with marijuana use disorder are simultaneously treated for any mental health issues and additional substance addictions, since both prevalently co-occur. Behavioral therapy like cognitive-behavioral therapy (CBT), motivational enhancement therapy, and contingency management are helpful behavioral treatment options for the treatment of marijuana abuse.14

There is currently no approved medication that can help with the treatment of marijuana use disorder, but research in this area is active. An important area of study is insomnia with marijuana withdrawal.14 This research looks at using sleep aids, anti-anxiety/anti-stress medication, and even anti-epileptic medication to help with sleep when undergoing treatment for marijuana use.14

It is important to have an individualized approach to treatment. Your treatment plan should be tailored to your needs and readily accessible. When thinking about treatment options, it is best to consider what treatment is best for you, whether you need residential or inpatient treatment, or if you can start with an outpatient approach.

Inpatient or residential treatment involves staying in a facility that offers 24-hour structured and dedicated care, a safe sober living space, and medical attention if needed.15 In outpatient treatments, you will encounter a variety of programs that involve visiting a behavioral health counselor on a regular basis, followed by group therapy and attending 12-step groups.15

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  1. Centers for Disease Control and Prevention. (2018). What is Marijuana.
  2. National Institute on Drug Abuse. (2019). Marijuana DrugFacts.
  3. S. National Library of Medicine. (2021). MedlinePlus: Marijuana.
  4. Centers for Disease Control and Prevention. (2018). Is it possible to “overdose” or have a “bad reaction” to marijuana?
  5. Substance Abuse and Mental Health Services Administration. (2020). Learn About Marijuana Risks.
  6. Lucas, C. J., Galettis, P., & Schneider, J. (2018). The pharmacokinetics and the pharmacodynamics of cannabinoids.British Journal of Clinical Pharmacology, 84: 2477– 2482.
  7. National Institute on Drug Abuse. (2021). Marijuana Potency.
  8. Cash, M.C., Cunnane, K., Fan, C., & Romero-Sandoval, E.A. (2020). Mapping cannabis potency in medical and recreational programs in the United States. PLOS ONE 15(3).
  9. National Institute on Drug Abuse (2020). Marijuana Concentrates DrugFacts.
  10. S. National Library of Medicine. (2021). Substance use disorder.
  11. National Institute on Drug Abuse. (2018). Understanding Drug Use and Addiction DrugFacts.
  12. National Institute on Drug Abuse. (2020). How does marijuana produce its effects?
  13. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  14. National Institute on Drug Abuse. (2020). Available Treatment for Marijuana Use Disorders.
  15. National Institute on Drug Abuse. (2019). DrugFacts: Treatment Approaches for Drug Addiction DrugFacts.

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