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Marijuana Addiction and Treatment Options Available
Marijuana is the most commonly used illicit substance in the United States,1 and recent measures to legalize the drug for both medicinal and recreational use have resulted in a booming industry surrounding the cultivation, distribution, and sale of marijuana products in those states.
However, despite the perceived safety and therapeutic value, millions of people struggle with substance use disorders stemming from their marijuana abuse. Heavy users face the risk of accidents—especially if driving under the influence of marijuana—and may be more likely to experience psychological problems. Professional treatment is an option for those who are unable to quit using marijuana on their own.
What Is Marijuana?
The scientific name for marijuana is cannabis sativa, and the plant has 2 other subspecies varieties: cannabis ruderalis and cannabis indica. There are numerous slang terms for marijuana, including:4
- Mary Jane.
The marijuana plant originated in central Asia but grows wild in parts of the United States as well as most regions of the world. The cannabis plant has a tough stem that is harvested to make hemp oil, hemp seed, and hemp rope. The leaves and resinous flowering tops contain delta 9-tetrahydrocannabinol (THC), the main chemical responsible for the “high” produced when the plant is smoked or ingested.
In a study of high school students, researchers found that nearly 1 in 5 e-cigarette users put cannabis or hash oil into their pens. Marijuana is often encountered as a dried greenish or brownish leaf and can have a skunk-like odor.
It may be sold as whole buds or cut/ground into smaller pieces. People typically grind marijuana up and roll it into a cigarette, cigar, or pipe to smoke it. Marijuana can also be mixed into food and teas.
More recently, people vaporize the plant using an e-cigarette pen. In a study of high school students, researchers found that nearly 1 in 5 e-cigarette users put cannabis or hash oil into their pens. E-cigarette use among teenagers has been increasing nationally, and 27.9% of high school students reported using e-cigarettes. Of those users, 18.7% say they have smoked marijuana using an e-cigarette.3
Additional cannabis paraphernalia can include:4
- Water pipes (bongs).
- Glass pipes.
- Cigars (blunts).
- Rolling papers.
Marijuana is classified as a Schedule I drug, alongside heroin and cocaine, meaning it has no accepted medical use and a high potential for abuse.2
How Does Marijuana Affect the Brain?
As more and more people use cannabis, the science surrounding the effects and benefits of the drug continue to emerge. THC is the primary compound responsible for marijuana’s mind-altering effects.
THC works by interacting with cannabinoid receptors located throughout the central nervous system, predominantly on cells in the brain and spinal cord.5 Cannabinoid receptors are also located in the immune system, which could help explain marijuana’s observed therapeutic effects on inflammation and immune cell mediated pain processes.5
Cannabidiol (CBD) is another chemical compound in marijuana. CBD does not contain the psychoactive properties of THC and does not produce the same high.6
The way CBD works is still not completely understood by the medical community, but many studies have shown its effectiveness at reducing anxiety, seizures, depression, and inflammation.6 Because of this, CBD is being increasingly accepted in the medical community as a therapeutic approach to treating a wide range of conditions such as post-traumatic stress disorder (PTSD), dementia, schizophrenia, and osteoporosis.
While recreational marijuana use is now legal in 8 states and the District of Columbia, selling, growing, or transporting marijuana remains a federal offense.
States that have legalized recreational use differ widely in their specific regulations. For example, in California, an adult cannot carry more than 1 ounce of marijuana on their person. In Maine, however, residents can carry almost twice that amount—up to 2.5 ounces of marijuana.
In all 8 states where recreational marijuana use is legal, it is still against the law to consume marijuana in public. For more information about your state’s marijuana policies and laws, visit your local government website.
States that have legalized recreational marijuana are:
Colorado, Washington, Alaska, Oregon, California, Maine, Massachusetts, Nevada
As of 2017, medical marijuana is legal in 29 states and Washington, D.C., Puerto Rico, and Guam. States, where medical marijuana is legal, are:
Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, D.C., West Virginia.
Even in states that have legalized marijuana use for medical and recreational purposes, the drug remains illegal at the national level and certain crimes, such as driving under the influence, will still be prosecuted even with patients who hold a doctor’s prescription for medical marijuana.
The Business of Weed
The cannabis industry is one of the fastest growing industries in the United States. In 2015, Colorado’s marijuana industry created more than 18,000 new jobs and brought in more than $2.4 billion dollars.7 The legalization of marijuana led to an increase in demand for local goods, such as warehouse space for growers and lighting and watering equipment for new plants.
By 2020, the cannabis industry is expected to create more than a quarter of a million new jobs.8 This data could be good news for many, as it corresponds with a report from the federal Bureau of Labor Statistics that predicts steep declines in manufacturing, utilities, and government jobs by 2024.9 Recent data suggests that the market for legal marijuana was $6.6 billion in 2016, and it is expected to grow to over $24 billion by 2025.10
Businesses that grow and sell marijuana in states where recreational marijuana is legal must pay taxes, and recreational marijuana is heavily taxed. In Washington, the tax is 37%. In Colorado, weed is taxed at 28%,11 and in Oregon the tax rate is 17%.12 In the first 3 months of 2016, Oregon sold roughly 11,000 pounds of marijuana, and from February to November 2016 the state brought in $54 million in marijuana tax revenue.12
New dispensary companies are entering the market and innovating the cannabis scene to keep up and stand out. Some dispensaries offer free grams of weed for patient referrals, discounts for veterans or individuals with PTSD, and daily deals on products such as pre-rolled joints and edibles. In response to the growing marijuana sector, businesses, entrepreneurs, and venture capitalists are investing in new ways to reach customers. For example, new smartphone apps allow you to order medical marijuana, edibles, and oils from your phone and have them delivered to your doorstep.
With the influx of companies joining the cannabis scene, the number and size of marijuana-focused events and expos has also exploded. These events aim to bring together leaders in the cannabis community so that people can network, share ideas, and market new approaches and products.
What Are the Medicinal Uses of Marijuana?
Some doctors are experimenting with medical marijuana to treat patients with a range of health issues, including:13
- Chronic pain.
- Neuropathic pain.
- Multiple sclerosis.
Limited research studies have found that marijuana may have health benefits for those with the following conditions:14
- Glaucoma: Glaucoma is a condition of increased eye pressure and the potential for resulting optic nerve damage. In animal studies, there is evidence that THC can help decrease eye pressure.
- Nausea: One of the first medical uses for THC was the treatment of vomiting and nausea that results from chemotherapy.
- AIDS: Studies show that smoking or ingesting cannabis can help patients with AIDS gain weight, improve mood, and increase quality of life.
- Inflammation: THC and CBD can work as anti-inflammatory agents in the body. Studies have shown their efficacy in treating arthritis and gastrointestinal inflammation associated with Crohn’s disease and ulcerative colitis. Given CBD’s non-psychoactive effects, it is of particular interest in the medical community as an anti-inflammatory.
- Epilepsy: A handful of studies demonstrate marijuana and CBD’s potential to treat epileptic seizures in children. However, more studies on marijuana’s efficacy in treating seizures is needed.
Marijuana has also been reported to benefit patients by helping manage both the disease symptoms and the side effects associated with the treatment of the following conditions:13
- Alzheimer’s disease
- Hepatitis C
- Lou Gehrig’s disease (ALS)
- Tourette syndrome
- Spinal cord damage
- Parkinson’s disease
- Huntington’s disease
Additionally, some doctors who prescribe medical marijuana see it as a viable form of harm reduction in patients with alcoholism, drug addiction, or physical dependence on prescription drugs. In a study preformed at a medical cannabis dispensary, researchers found that 40% of survey respondents reported using cannabis as a substitute for alcohol, 26% as a substitute for illicit drugs, and nearly 66% as a substitute for prescription drugs because it gave them fewer adverse side effects and better symptoms management.15
There is evidence that marijuana can help people manage chronic pain as an alternative to opioids.16 According to the U.S. Centers for Disease Control and Prevention (CDC), 91 people die every day from an opioid overdose.17 In states that have legalized marijuana, researchers have noted significant reductions in opioid-related deaths. In fact, one study found a 25% reduction in opioid overdose mortality rates in states that legalized medical marijuana.18
Certain conditions can be exacerbated by marijuana use, and people who do use cannabis products either recreationally or medicinally should consult their doctor if they notice any worsening of symptoms. Examples of such conditions include:13
- Anxiety disorders.
- Mood disorders.
- Psychotic disorders.
- Substance use disorders.
It is important to note that the Food and Drug Administration (FDA) has not approved marijuana as a treatment for any disease or medical condition.19 The FDA requires rigorous clinical trials before approving any drug, and without those clinical trials, the agency warns that a drug that is not FDA-approved may have unknown consequences. The FDA has said it is working with states that have legalized marijuana for medicinal purposes and is considering future support of medical research to ensure these states can meet federal drug requirements and scientific standards.19
Side Effects and Consequences of Marijuana
Despite state-level legalizations and favorable attention in the medical community, long-term marijuana use can negatively impact an individual’s health and wellbeing in a number of ways, including:20,21
- Addiction: Long-term marijuana use can lead to addiction. Studies indicate that 9% of those who use marijuana will become addicted.
- Impaired brain development: Exposure to THC can potentially alter the brain’s reward system and how it reacts to other types of drugs. Young people may suffer from long-term effects such as lower IQ in adulthood.
- Reduced lung health: Inhaling marijuana smoke can be harmful as it can contain many of the same toxins, irritants, and carcinogens as cigarette smoke. This can lead to an increased risk of bronchitis, phlegm, and cough.
- Mental health problems: More research is needed on the subject, but studies indicate that people who use marijuana may be more likely than non-marijuana users to develop mental disorders such as schizophrenia. Marijuana use has also been associated with psychosis, delusions, depression, anxiety, and suicidal thoughts.
- Impaired driving ability: Marijuana can affect a person’s ability to drive. In fact, it is the most commonly cited drug reported in car accidents and fatalities.
- Dependence: Long-term marijuana use can lead to the development of psychological dependence to the drug.
In the short term, marijuana use can lead to the following negative effects:22
- Memory loss
- Loss of coordination and motor skills
- Increased heart rate
- Dry mouth (“cottonmouth”)
- Disinterest in other activities
Marijuana is a drug that is frequently used in combination with other drugs, especially alcohol.15 This can create what is called a synergistic effect—magnifying the effects of both substances to potentially dangerous levels. Mixing marijuana and alcohol can lead to dizziness and dramatically reduced motor control (some users call this “the spins”), extreme paranoia, and heavy vomiting.23
Sometimes marijuana is mixed with other substances such as cocaine, PCP, crack, heroin, or other contaminants.22 While some users lace marijuana themselves by sprinkling cocaine or crack into joints, users also run the risk of buying drugs laced with unknown substances.
How to Tell if Someone Is Using Marijuana
If you suspect that someone close to you has a problem with marijuana, be aware of any changes in their behavior. Every individual is different, but below are some common signs of marijuana use that may help confirm your suspicion:24
- Red, bloodshot eyes
- Acting unusually giddy: Laughing inappropriately or uncontrollably
- Poor coordination
- Difficulty remembering things that just happened
- Neglecting hygiene: not showering or brushing hair and teeth
- Sudden mood changes
- Unexplained changes in performance at school or work
- Loss of interest in sports or other activities they once enjoyed
- Drug paraphernalia such as rolling papers, bongs, cigar paper, or e-cigarettes
The individual may also exhibit more serious behavioral signs of substance abuse, including:25
- Secretive behavior.
- Withdrawing from normal activities.
- Loss of motivation.
- Stealing or borrowing money.
- Financial problems.
- New friend groups.
- Unsuccessful attempts to cut down on marijuana use.
- Skipping class or neglecting work duties.
- Difficulty concentrating.
- Social isolation.
- Lying about drug use.
- Suicidal thoughts.
Marijuana use can affect a person’s life in many ways. Some people may feel hesitant to admit that they have a problem and ask for help. If you are close to someone who is struggling with marijuana or other drug use, reaching out could make an incredible impact on their life. Having the support of someone who cares can help them seek treatment and change habits that are harming their mental or physical health.
If your spouse, friend, co-worker, or child is abusing marijuana and you are concerned about their health and wellbeing, don’t be afraid to speak up and reach out. You should only approach the individual about your concerns when they are sober. Try to avoid using any language that is accusatory, blaming, or patronizing. You want to encourage the person to seek treatment while also offering your support.
If you suspect that the person is in physical danger, having health issues, or exposing themselves to physical danger or possible legal or financial consequences, there are additional free resources that can provide you with information and advice on next steps:
- Substance Abuse and Mental Health Services Administration (SAMHSA): This national helpline provides information to individuals and families who are struggling with substance abuse and mental health issues. 1-800-622-4357
- Marijuana Anonymous (MA): This 12-step group offers free support to those struggling with marijuana addition. MA also offers a mobile recovery app that you can download on your phone. 1-800-766-6779
Can You Overdose on Marijuana?
There have not been any reports of death from marijuana overdose alone.26 However, smoking or ingesting large quantities of marijuana can be problematic. It can cause an individual to experience panic attacks, psychotic episodes, and extreme loss of judgment or coordination (increasing your chances for injury in an accident, especially while driving).27
If you fear that someone near you is in danger due to excessive marijuana use, you can call 911. While you are waiting for help to arrive, try to calm the person down and monitor their heart rate and breathing. If the person mixed marijuana with alcohol or other drugs, try to figure out what substances they took and how much so you can share this information with emergency responders.
Is Marijuana Addictive?
Although pot is generally thought to be less addictive than other illicit drugs, problem use has been reported to develop into an addiction in extreme cases.28 One study found that nearly 30% of marijuana users meet the criteria for a diagnosis of a marijuana use disorder, a percentage that might translate into a growing number of individuals as more states legalize marijuana use for medical and recreational purposes.29
Nearly 30% of marijuana users meet the criteria for the diagnosis of marijuana use disorder. Regular marijuana users can develop a tolerance to its effects. Once tolerance develops, it takes larger amounts of marijuana to achieve the same desired effects, and this can develop into dependence—meaning users need marijuana in their system in order to function normally.
Marijuana dependence occurs when your brain adapts to the presence of the drug. People who have developed marijuana dependence and then stop using the drug will likely experience withdrawal symptoms. Although cannabis withdrawal can be uncomfortable, it is not dangerous and is considered mild compared to withdrawal from other substances like opioids, alcohol, or benzodiazepines.
A person who feels they are having trouble quitting marijuana, despite it interfering with their daily life, would likely benefit from some form of substance abuse treatment. According to the National Survey on Drug Use and Health (NSDUH), about 4 million people met the criteria for a marijuana use disorder in 2015 and of these people, only 138,000 sought treatment for their disorder.30
It’s natural to feel cravings when you stop using the drug. Thankfully, there are many ways to manage cravings. Try these strategies and see if one works best for you.
- Change your routine: If marijuana was an important part of your daily routine, you will need to switch things up. Try to change simple things in your schedule like when you wake up, or where you sit in a classroom or at work. This will help your brain re-orient and train itself not to associate marijuana use with certain times of the day or place.
- Throw away all your drug paraphernalia: Having pipes, bongs, rolling papers, or lighters in your home or personal space may trigger a desire to use the drug again. When these items are out of sight, you will be less likely to experience cravings.
- Stay active: Get involved in activities that stimulate your interest. Try a new hobby, exercise schedule, meditation practice, or sign up for a course in a subject you’ve always wanted to learn more about. When you are doing something you enjoy or gaining new skills, you will be less likely to turn to marijuana in your downtime.
- Practice deep breathing: Focusing on your breath can have tremendous benefits in helping you manage cravings. When you get a craving for marijuana, practice inhaling and exhaling slowly for 1-2 minutes. If that feels good, you can go for another 1-2 minutes. Pay attention to what thoughts are entering your mind. After a few minutes of deep breathing, you will likely feel a sense of relaxation and clarity.
- Take care of yourself: Make sure to drink enough water, eat foods that are nutritious, exercise, and get enough sleep. When you are not feeling healthy, you may feel triggered to use drugs to make you feel better. Cravings can be especially intense when you haven’t eaten or you’re tired. It’s important that you take care of yourself during this time.
Detox and Rehab
Cannabis withdrawal is not life-threatening. Researchers estimate that at least 1 out of every 6 marijuana users experiences withdrawal symptoms (some estimates are closer to half of all users).31 Despite this, cannabis withdrawal can be uncomfortable, so choosing to detox in a professional rehab center may be beneficial for your long-term sobriety.
Common symptoms of marijuana withdrawal include:31
- Strange dreams.
- Trouble sleeping.
- Decreased appetite.
- Weight loss.
The professional treatment of marijuana abuse typically involves behavioral and psychological therapy. Commonly used methods include:32
- Motivational enhancement therapy (MET): Typically consists of 1–4 sessions that last 45-90 minutes each. Therapists will work with you to reflect on your addiction as well as the pros and cons of your marijuana use.
- Cognitive-behavioral therapy (CBT): Typically consists of 6–14 sessions delivered weekly in individual or group sessions. Sessions usually last 45 to 90 minutes. CBT teaches you how to manage cravings and triggers, and cope with stress.
- Contingency management (CM): This approach uses an abstinence-based voucher system to reward you for not using marijuana. Producing negative drug tests will earn you vouchers that you can exchange for small rewards.
- 12-step or non-12-step support groups: Attending support groups meetings like Marijuana Anonymous (MA) before, during, or after treatment can also make a huge difference in your progress.
The cannabis withdrawal timeline typically lasts up to 5 days. People feel the peak of discomfort sometime during day 2 or 3. Some people, however, experience protracted withdrawal, with sleep difficulties and strange dreams lasting 45 days after stopping drug use.33
There are no approved medications to treat marijuana dependence and withdrawal, but treatment providers may prescribe medications to help ease withdrawal symptoms during the detox period.31
Marijuana abuse and dependence are typically treated in an outpatient setting, though if you are abusing other drugs in addition to marijuana, or suffer from a mental health disorder, you may consider entering a higher level of care.
- Inpatient rehab: Inpatient programs typically last 30 to 90 days. These programs offer 24-hour support and medical supervision while you are in treatment. If you have a severe addiction or psychiatric condition such as PTSD, depression, or schizophrenia, this could be a great option. In an inpatient program you will participate in individual therapy, group counseling, and relapse prevention.
- Outpatient rehab: Outpatient programs can help you reduce your marijuana consumption and teach you ways to stay drug-free in your day-to-day life. These programs are flexible and offer therapy sessions in the day and evening to accommodate your schedule. You may participate in individual therapy, group therapy sessions, and family therapy.
Recovering from Marijuana Abuse
After completing treatment, you may ask yourself, what’s next? As you return to daily life, it’s important that you stay engaged in care, as it can be easy to slip back into drug-using behaviors. During treatment, you will work with a therapist to develop an aftercare plan. This may include attending 12-step meetings, helping another person in recovery as a sponsor, or seeing a therapist regularly. The key to recovering from marijuana abuse is finding a system that works for you.
- National Institute on Drug Abuse. (2017). What is the scope of marijuana use in the United States?
- U.S. Drug Enforcement Administration. (n.d.) Drug Scheduling.
- Morean, M., Kong, G., Camenga, D., et. al. (2015). High School Students’ Use of Electronic Cigarettes to Vaporize Cannabis. Pediatrics.
- National Institute on Drug Abuse. (2017). What is marijuana?
- Hill, K., Palastro, M., Johnson, B., et. al. (2017). Cannabis and Pain: A Clinical Review. Cannabis and Cannabinoid Research. 2(1):96-104.
- Zlebnik, N., Cheer, J. (2016). Beyond the CB1 Receptor: Is Cannabidiol the Answer for Disorders of Motivation? Annual Review of Neuroscience. 39:1–17.
- Light, M., Orens, A., Rowberry, J., et. al. (2016). The Economic Impact of Marijuana Legalization in Colorado. Marijuana Policy Group Market Intelligence Report.
- New Frontier Data. (2017). The Cannabis Industry Annual Report: 2017 Legal Marijuana Outlook Executive Summary.
- U.S. Dept. of Labor, Bureau of Labor Statistics. (2015). Projections of industry employment, 2014–24.
- New Frontier Data. (2017). New Frontier Data Projects U.S. Legal Cannabis Market to Grow to $24.1 Billion by 2025.
- Dept. of Revenue, Washington State. (2016). Taxes due on marijuana.
- Oregon Dept. of Revenue Research Section. (2016). Oregon Marijuana Tax Statistical Report: January–March 2016.
- Hill, K. (2015). Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: a clinical review.JAMA.313(24):2474–2483.
- Volkow, N., Baler, R., Compton, W., et. al. (2014). Adverse Health Effects of Marijuana Use.New England Journal of Medicine.370(23):2219–2227.
- Reiman, A. (2009). Cannabis as a substitute for alcohol and other drugs.Harm Reduction Journal.6(1):35.
- National Institute on Drug Abuse. (2016). Study Links Medical Marijuana Dispensaries to Reduced Mortality From Opioid Overdose.
- Centers for Disease Control and Prevention. (2016). Understanding the Epidemic: Drug overdose deaths in the United States continue to increase in 2015.
- Bachhuber, M., Saloner, B., Cunningham, C., et. al. (2014). Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010. JAMA Internal Medicine. 174(10):1668–1673.
- U.S. Food & Drug Administration. (2017). FDA and Marijuana.
- Volkow, N., Baler, R., Compton, W., et. al. (2014). Adverse health effects of marijuana use.New England Journal of Medicine.370(23):2219–2227.
- Centers for Disease Control and Prevention. (2017). Marijuana and Public Heath: Health Effects.
- University of Maryland Center for Substance Abuse Research. (n.d.). Marijuana.
- University of California, Santa Cruz. (n.d.). Common Alcohol & Drug Combinations.
- National Institute on Drug Abuse. (2016). Marijuana: Facts Parents Need to Know.
- University of Notre Dame. (n.d.). Quitting Marijuana a 30 Day Self Help Guide.
- Drug Enforcement Agency. (n.d.) Drug Fact Sheet: Marijuana.
- National Institute on Drug Abuse for Teachers. (2017). Drug Facts Chat Day: Marijuana.
- National Institute on Drug Abuse. (2017). Is marijuana addictive?
- Hasin, D., Saha, T., Kerridge, B., et. al. (2015). Prevalence of Marijuana Use Disorders in the United States Between 2001–2002 and 2012–2013. JAMA Psychiatry. 72(12):1235–1242.
- Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health. (HHS Publication No. SMA 16-4984, NSDUH Series H-51).
- Ramesh, D., Schlosburg, J., Wiebelhaus, J., et. al. (2011). Marijuana dependence: not just smoke and mirrors.ILAR Journal. 52(3):295–308.
- Budney, A., Roffman, R., Stephens, R., et. al. (2007). Marijuana Dependence and Its Treatment.Addiction Science & Clinical Practice.4(1):4–16.
- Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal. Substance Abuse Treatment Advisory. 9(1):1–8.