Marijuana (Cannabis) Addiction | Abuse, Withdrawal & Treatment
Marijuana is the most commonly used federally illegal substance in the United States, and the Centers for Disease Control and Prevention reports that 3 in 10 adults who use marijuana develop cannabis use disorder.
48.2 million people, 18% of Americans, reported using marijuana at least once during 2019. The risk of developing cannabis use disorder rises sharply among people who start using marijuana before the age of 18.
The National Institute on Drug Abuse recorded 4 million people in the United States meeting the diagnostic criteria for cannabis use disorder in 2015. The CDC calls the same condition marijuana use disorder.
What Is Marijuana?
Marijuana, also called cannabis, weed, herb, grass, ganja, bud and Mary Jane, is a mixture of the dried flowers of the Cannabis sativa plant.
The Substance Abuse and Mental Health Services Administration defines marijuana as the dried leaves, stems, seeds and flowers of the Cannabis sativa or Cannabis indica plant. People smoke marijuana in hand-rolled cigarettes, blunts and pipes, or inhale it through vaporizers that pull THC from the plant. Marijuana also goes into foods such as brownies, cookies and gummy candies, and into tea.
State law and federal law diverge on marijuana. States have legalized marijuana and THC, and both substances remain illegal at the federal level.
The main psychoactive chemical in marijuana is delta-9-tetrahydrocannabinol (THC). THC produces the intoxicating and mind-altering effects people experience when using marijuana. THC sits in the resin produced by the leaves and buds of the female cannabis plant. The plant contains more than 500 other chemicals, 100 of which are chemically related to THC and are called cannabinoids.
After tobacco and alcohol, marijuana is the most commonly used addictive drug. More than 11.8 million young adults used marijuana during 2018.
What Are the Health Effects of Marijuana?
Smoking marijuana carries THC from the lungs into the bloodstream within minutes, and large doses produce anxiety, fear, distrust and panic rather than euphoria.
The National Institute on Drug Abuse records that smoking marijuana passes THC and the plant’s other chemicals from the lungs into the bloodstream, which carries them through the body and to the brain.
The effect varies dramatically between people. One person experiences a pleasant euphoria where another does not.
Food and drink delay those effects, because the drug passes through the digestive system first. Eating or drinking marijuana delivers significantly less THC into the bloodstream than smoking an equivalent amount of the plant, which leads people to consume more THC than they intend and to reach adverse effects.
There are 4 effects of THC from large doses of marijuana:
- Anxiety
- Fear
- Distrust
- Panic
Large doses, or marijuana of unexpectedly high potency, produce acute psychosis, which presents as hallucinations, delusions and a loss of personal identity. The noticeable effects of smoked marijuana last 1 to 3 hours, and marijuana in food or drink produces effects that last longer still. Detectable amounts of THC remain in the body for days or weeks after use.
What Are the Short-Term Effects of Marijuana?
Marijuana produces 8 short-term effects, from altered senses and impaired coordination through to hallucinations, delusions and psychosis at high doses.
Smoking marijuana passes THC quickly from the lungs into the bloodstream, and the blood carries THC to the rest of the body. THC binds to cannabinoid receptors in the brain, and those receptors govern normal brain development and function.
The immediate effects of cannabis run in both directions, from pain relief and reduced anxiety through to rapid heartbeat and paranoia. Marijuana activates the brain areas holding the highest number of cannabinoid receptors, and that activation produces the high.
There are 8 short-term effects of marijuana:
- Altered senses, perceptions and mood
- Impaired coordination and movement
- Difficulty with thinking and problem solving
- Difficulty recalling memory
- Decreased appetite
- Hallucinations, at high doses
- Delusions, at high doses
- Psychosis, with the risk highest under regular use of high-potency marijuana
What Are the Long-Term Effects of Marijuana Use?
Long-term marijuana use alters brain development, and the younger a person starts, the greater the damage to thinking, memory and learning.
Marijuana alters the brain’s overall development. The younger a person is when they begin using marijuana, the greater the damage to thinking, memory and learning, because marijuana disrupts how the brain builds connections between the regions those functions depend on.
Research continues on how long the effects of marijuana last and whether the changes are permanent. Researchers at Duke University studied a New Zealand cohort and reported an average loss of 8 IQ points between the ages of 13 and 38. That loss was concentrated among people who began smoking marijuana heavily in their teens and carried an ongoing cannabis use disorder. The same group never recovered the lost abilities after quitting marijuana as adults, and people who began smoking marijuana as adults showed no notable decline in IQ.
There are 3 mental health effects recorded alongside marijuana use:
- Temporary hallucinations
- Temporary paranoia
- Worsened symptoms in patients with schizophrenia
Research also records depression, anxiety and suicidal thoughts among teenagers who use marijuana.
What Other Effects Does Marijuana Use Produce?
Marijuana use produces physical effects on breathing, heart rate and pregnancy, and mental effects on memory, attention and motivation.
The health effects of marijuana use divide into physical effects and mental effects.
What Are the Physical Effects of Marijuana?
There are 4 physical effects of marijuana use:
- Issues with breathing
- Difficulty with child development during and after pregnancy
- Increased heart rate and chance of heart attack
- Intense nausea and vomiting
What Are the Mental Effects of Marijuana?
Marijuana exposure during brain development produces long-term and potentially permanent changes to memory, attention and motivation.
Substantial evidence from animal research, alongside human studies, records that marijuana exposure during development produces long-term and potentially permanent adverse changes in the brain. Clinical studies found cognitive impairment in adult rats exposed to THC during adolescence, alongside structural and functional changes in the hippocampus, the brain region that governs learning and memory formation.
There are 8 effects recorded alongside long-term marijuana use:
- Memory impairment
- Mental illness
- Disorganized thinking and difficulty with attention
- Lung damage
- Lower dopamine production
- Brain fog
- Lowered motivation
- Decline in IQ
Researchers have not established the full consequences of exposing the body and the developing brain to high concentrations of THC. Emergency department visits by people who test positive for marijuana have risen alongside marijuana potency, and the relationship between the two remains undetermined. The average THC content in confiscated marijuana samples was 4% in 1990 and 15% in 2018.
Research on how marijuana changes brain structure in humans has produced conflicting results. Part of that evidence records altered brain connectivity and reduced brain-region volume among regular adolescent users. The rest found no significant structural difference between the brains of people who use marijuana and people who do not.
Is Marijuana Addictive?
Yale Medicine records that 10% of people who begin smoking cannabis develop addiction, and that 30% of current users meet the criteria for addiction.
Chronic marijuana use produces cannabis use disorder, which takes the form of addiction in severe cases. Cannabis use disorder becomes an addiction when a person continues using marijuana even as it damages areas of their life. A person is dependent on marijuana without being addicted to it, which is why estimates of the number of people addicted to marijuana remain contested.
The risk of developing cannabis use disorder is higher among people who begin using marijuana during adolescence, before the age of 18, and the risk rises with the frequency of use. The National Institute on Drug Abuse recorded 4 million people in the United States meeting the diagnostic criteria for cannabis use disorder in 2015, of whom 138,000 voluntarily sought treatment.
NIDA records that people who began using marijuana before the age of 18 are 4 to 7 times more likely to develop cannabis use disorder than adults.
How Is Cannabis Use Disorder Diagnosed?
The American Psychiatric Association lists 11 diagnostic criteria for substance use disorders, and a person meeting 2 of them has cannabis use disorder.
The 11 criteria include an inability to stop or reduce consumption, frequent cravings, and difficulty with socializing and relationships.
Genetic studies record a link between cannabis addiction and hereditary factors, and the research base is not yet large enough to confirm the finding.
What Are the Withdrawal Symptoms of Cannabis Use Disorder?
Cannabis withdrawal produces irritability, mood change, sleep difficulty, decreased appetite, cravings, restlessness and physical discomfort within the first week of quitting, and the symptoms last up to 2 weeks.
People with cannabis use disorder experience withdrawal symptoms when they stop using marijuana, because of the dependence their body has developed on the substance.
Dependence is present when a person displays withdrawal symptoms without the drug. Dependence forms as the brain adapts to large amounts of marijuana by reducing both the production of and the sensitivity to its own endocannabinoid neurotransmitters.
There are 7 cannabis withdrawal symptoms reported within the first week of quitting:
- Irritability
- Changes in mood
- Difficulty sleeping
- Decreased appetite
- Drug cravings
- Restlessness
- Other forms of physical discomfort
Cannabis withdrawal symptoms last up to 2 weeks.
What Are the Signs of Cannabis Use Disorder?
The CDC lists 11 signs of cannabis use disorder, from using more than intended and failed attempts to stop, through to cravings, tolerance and withdrawal.
According to the CDC, there are 11 signs of cannabis use disorder:
- Overusing marijuana, more than intended
- Failing at attempts to stop using marijuana
- Spending a great deal of time obtaining, using or recovering from marijuana
- Craving marijuana
- Continuing marijuana use even when it creates issues in personal life or work
- Continuing marijuana use despite the social or relationship problems it creates
- Prioritizing marijuana use over important activities with friends and family
- Using marijuana in high-risk situations, such as while driving a car
- Continuing to use marijuana despite physical or psychological problems
- Needing to increase the amount of marijuana used to reach the same high
- Experiencing withdrawal symptoms when stopping marijuana use
People with cannabis use disorder increase their marijuana dose over time to reach a high, which exposes the brain to greater adverse THC effects.
Researchers have not established the full consequences of exposing the body to high concentrations of THC, or whether recent increases in concentration change the risk of developing cannabis use disorder.
How Does Marijuana Use Change Education and Work?
Marijuana use reduces educational performance and the chance of graduating, and heavy use tracks with lower income, higher unemployment and greater dependence on welfare services.
The National Institute on Drug Abuse records that the effects of marijuana on learning, attention and memory persist long after the acute effects of the drug wear off. A review of 48 relevant studies found marijuana use tracking with reduced educational performance and reduced chances of graduating. An analysis of three studies in Australia and New Zealand found that younger people who used marijuana regularly were significantly less likely than their non-using peers to finish high school or obtain a degree.
There are 5 further outcomes recorded alongside heavy marijuana use:
- Lower income
- Higher unemployment rates
- Increased risk of criminal behavior
- Greater dependence on welfare services
- Lower satisfaction with life
Workplace studies record a link between marijuana use and the risk of injury or accident. One study found that postal workers who tested positive for marijuana on a pre-employment urine test had 55% more industrial accidents, 85% more injuries and 75% greater absenteeism than workers who tested negative.
How Is Cannabis Use Disorder Treated?
Behavioral therapy treats cannabis use disorder. No FDA-approved medication for it exists, and cognitive behavioral therapy, contingency management and motivational enhancement therapy are the 3 treatments NIDA identifies as effective.
Yale Medicine records that behavioral therapy treats cannabis addiction, and that cognitive behavioral therapy identifies and modifies damaging thinking and behavior. Yale Medicine psychiatrist Deepak Cyril D’Souza, MD, records that drugs to lessen marijuana cravings have proved unsuccessful, and names an urgent need for more effective behavioral and pharmacological treatment options.
The National Institute on Drug Abuse records that adults seeking treatment for cannabis use disorder have used marijuana nearly every day for more than 10 years, and have attempted to quit more than six times.
NIDA identifies 3 effective behavioral treatments:
- Cognitive behavioral therapy, a form of psychotherapy that teaches strategies for identifying and correcting problematic behaviors
- Contingency management, a therapeutic approach that monitors a target behavior and provides positive rewards when that behavior occurs or does not occur
- Motivational enhancement therapy, an intervention that mobilizes a person’s own internal resources for change and engagement in treatment rather than treating the person directly
To learn more about marijuana addiction and the treatment options available for cannabis use disorder, reach out to our admissions team today.
Sources
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NIH, National Institute on Drug Abuse–Is marijuana addictive? , References, How does marijuana use affect school, work, and social life?
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Centers for Disease Control and Prevention, National Center for Injury Prevention and Control–Marijuana and Public Health Data and Statistics, Addiction (Marijuana or Cannabis Use Disorder)
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Substance Abuse and Mental Health Services Administration–Know the Risks of Marijuana
- Yale Medicine–Cannabis/Marijuana Use Disorder