by Laura Geftman, LCSW
Is it or isn’t it? Everyone wants to know. The Schedule I drug has long been said to be as addictive as cocaine and heroine with a “no acceptable medical use and a high potential for abuse.“ While cannabis has since shown many medicinal qualities and solves, it has not been federally rescheduled. But why? Is it addictive? Should we be concerned about using cannabis?
Some people claim they can use cannabis and stop without symptoms of withdrawal. Others note an inability to eat, sleep, relax, calm down, be creative, sensual…function without it. Seems like the gray area on this is considerable. So will your cannabis use lead you into a recovery treatment center? Let’s find out…
What is Cannabis Addiction and Cannabis Use Disorder?
The latest iteration of the Diagnostic and Statistical Manual of Mental Disorders (V) no longer has clinicians diagnosing abuse or dependence. Substance use is diagnosed on a continuum or scale. Cannabis use- just like all other addictive substances- is found under the category of “Addictive Disorders,” and “substance use disorders” is defined by eleven different criteria:
1. Taking the substance in larger amounts or for longer than you’re meant to.
2. Wanting to cut down or stop using the substance but not managing to.
3. Spending a lot of time getting, using, or recovering from use of the substance.
4. Cravings and urges to use the substance.
5. Not managing to do what you should at work, home, or school because of substance use.
6. Continuing to use, even when it causes problems in relationships.
7. Giving up important social, occupational, or recreational activities because of substance use.
8. Using substances again and again, even when it puts you in danger.
9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
10. Needing more of the substance to get the effect you want (tolerance).
11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.
Your evaluating clinician is to gauge how severe of a substance use disorder you maybe experiencing. Two or three symptoms indicates mild substance use disorder; four or five symptoms indicate a moderate substance use disorder, and six or more symptoms define a severe substance use disorder. With six or more symptoms, cannabis use takes the form of addiction.
According to the National Institute on Drug Abuse (NIH), “dependence occurs when the brain adapts to large amounts of the drug by reducing production of and sensitivity to its own endocannabinoid neurotransmitter.” Therefore someone who is unable to stop using cannabis even though it interferes with many aspects of their life would be considered addicted. It is, however, possible to be dependent without being addicted. In that case, your endocannabinoid functionality maybe compromised without lifestyle difficulties. Studies suggest the 9% of people become dependent on cannabis (SOURCE , SOURCE) and about 17% in those who started use as a teen (SOURCE , SOURCE). More than 50% of regular users experience symptoms of withdrawal (SOURCE, SOURCE, SOURCE).
Potential Addiction Factors
So what’s the potential for not just use disorder but addiction? Well there are a few factors: withdrawal, reinforcement, tolerance, dependence, and intoxication.
The potency of today’s cannabis plants increase the risk of addiction. Decades ago the psychoactive component in cannabis concentrations were less than 5% THC. Today we are able to produce much higher concentrations of THC between 20%-50%. This change in potency contributes to the diminishing of previously safer use (SOURCE).
Yup You Can Experience Cannabis Withdrawal
Most people argue that cannabis isn’t addictive because there’s no withdrawal…but there is. Not everyone experiences it. More don’t acknowledge that’s what they are experiencing. More than 50% of regular users experience symptoms of withdrawal (SOURCE, SOURCE, SOURCE).
The National Institute on Drug Abuse reports withdrawal symptoms as irritability, mood and sleep difficulties, decreased appetite, cravings, restlessness and/or physical discomfort. Some even report anxiety, depression, headaches, muscle tension, nausea, nightmares, and unpleasant vivid dreams (SOURCE, SOURCE, SOURCE). Symptoms are generally experienced in the first weeks after cessation and can last up to two weeks (SOURCE, SOURCE).
Cannabis-Induced Mental & Physical Disorders
It’s worth noting there are both mental and physical risks in using cannabis.
The DSM V accounts for cannabis-induced mental disorders including anxiety, depression, personality changes, and psychosis. These disorders are potentially severe though temporary and resolve with the discontinuation of use (SOURCE, SOURCE, SOURCE).
There are many physical health risks to keep in mind in using cannabis including lung damage, bronchial dilation, heart attack, Brian gliomas, prostate and cervical cancer, and use during pregnancy can led to neurological developmental difficulties.
Many studies also show the significantly decreased IQ (SOURCE).
What Contributes to Cannabis Addiction?
Defining addiction is heavily weighted by the physiological manifestation of tolerance, dependence and withdrawal. Strong indicators are behavioral, compulsive use, and relapse.
Simply put here are some questions you should consider if you’re concerned about your use:
-How much cannabis are you using?
-How often are you using cannabis?
-What are the circumstances?
-What do you experience when you stop using cannabis?
-And can you stop using without consequence?
Need More Info…?
So yes, cannabis is addictive but has much lower probability of occurrence. But the potential for addiction still does exist. The most important thing to consider is the effect it’s having on your life.
So did your answers surprise you? Are you concerned about your use? There’s help. Please know there’s always help. Consult your doctor, psychiatrist, therapist, etc… If you need a referral, please get in touch.
About Laura Geftman, LCSW
Laura Geftman, LCSW is the Founder of The Calm, Cool & Collected and a practicing therapist. Beyond all things cannabis and mental health, Laura is passionate about developing greater understanding for kindness and acceptance. In her free time, Laura can be found on her yoga mat, in a kayak or singing karaoke.
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