Dismantling the Marijuana Dependency Debate
Marijuana has long been in the shadows of the addiction conversation with many misconceptions about cannabis dependence and the impact it can have on a person’s physical and mental well-being. Because the effects of frequent marijuana use are typically milder and less impactful to a person’s life when compared to those of opioids, meth, heroin – and even alcohol – discussions of cannabis, or marijuana, use disorder are often met with skepticism. While many argue for its therapeutic benefits and recreational use, concern is growing about marijuana’s potential for addiction. Surprisingly, marijuana addiction is one of the top three most common addictions in the United States, following alcohol and tobacco.
Today’s Marijuana
Marijuana is the most commonly used illegal substance in the U.S. with overall use growing among all adult age groups and widespread usage among young people. According to a 2019 federal government survey, approximately 31.6 million people age 12 or older used marijuana during the past month, up from 22.2 million five years earlier. With full legalization for both recreational and medicinal use in 23 states, the cannabis industry continues to grow and market to a range of consumers.
While overall use has risen, another notable increase has occurred: an increase in potency. Today’s marijuana is different from the marijuana of the past. In the 1990s, THC levels were around 4%. By 2015, levels increased 212% in the marijuana flower. And currently, some concentrated THC products like oil, shatter, dab, and edibles can have THC concentrations nearing 95%. This combination of increased use, potency, and availability raises concerns about the impacts on individuals, especially those who are susceptible to addiction or those who begin using marijuana before the age of 21, as they have a higher risk of developing marijuana use disorder.
What is Marijuana Addiction?
Long-term, regular use of marijuana can lead to physical and psychological dependence – approximately 3 in 10 people who use cannabis have marijuana use disorder. Marijuana use disorder is the continued use of cannabis despite impairment in psychological, physical, or social functioning. For some, this looks like a disruption in their social and professional lives, interfering with interactions with family and friends and impacting work- or school-related duties. Unsuccessful attempts to quit using and/or a strong desire or urge to use cannabis throughout the day are also signs of potential dependency.
The Link Between Marijuana Addiction, Mental Health, and Psychosis
A psychiatric diagnosis – such as anxiety, depression, post-traumatic stress disorder, schizophrenia, or attention deficit hyperactivity disorder – is associated with an increased risk of marijuana addiction. One possible reason for the connection is that some individuals self-medicate with cannabis, and the heavier a person’s use, the more likely they are to develop physical dependence. People may also turn to marijuana to treat issues like sleep disorders, nausea, and chronic pain without consulting their primary care physicians. While many people can use marijuana without significant negative consequences, others are struggling with the drastic impacts on their lives.
A recent study published in The Lancet Psychiatry shows that consuming marijuana daily, especially products with high potency, increases the chance of having a psychotic episode – a disconnection from reality, often leading to hallucinations, delusions, and impaired thinking. Individuals who used marijuana daily were three times more likely to have a psychotic episode compared with someone who never used the drug. Studies suggest that heavy marijuana use, especially during adolescence when the brain is still developing, can increase the risk of developing schizophrenia spectrum disorders, with an increased rate of 2-4 times what is typical. Another study published in JAMA Psychiatry found that cannabis use disorder was associated with an increased risk of both psychotic and nonpsychotic bipolar disorder and major depressive episodes. Additional research needs to be done in this area to determine the extent to which cannabis use impacts mental health outcomes.
The Path Forward
While marijuana may offer potential therapeutic benefits, acknowledging and understanding the associated risks, especially concerning addiction, is essential. If those struggling with marijuana addiction are dismissed and disregarded, they may feel that their experience and struggles aren’t valid, causing them to avoid seeking treatment that could greatly improve their well-being. If you or someone you know is struggling with marijuana addiction, know there are resources and supports available! Visit us at Safer Sacramento for help.
References:
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Hasin, D.S., Saha, T.D., Kerridge, B.T., et al. Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013. JAMA Psychiatry. 2015;72(12):1235–1242. doi:10.1001/jamapsychiatry.2015.1858
Jefsen, O.H, Erlangsen, A., Nordentoft, M., Hjorthøj, C. Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder. JAMA Psychiatry. 2023;80(8):803–810. doi:10.1001/jamapsychiatry.2023.1256
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SAMHSA. (2020). Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Samosa.gov. https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR1PDFW090120.pdf
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