Is Marijuana Addictive?

By Andrew Ward Updated June 11th

New consumer trends like global wellness and the anticipation of cannabis becoming federally legal have prompted questions regarding marijuana consumption and its safety. This is especially true for recreational use, where fears of addiction remain.

Inaccuracies persist, and a need for additional data continues. All the while its popularity continues to grow. Marijuana has become one of the most preferred options for alternative treatments. At the same time, it serves as a recreational option just like alcohol or tobacco.

Yet, the question remains--can marijuana be addictive?

Pro- and anti-addiction evidence exists. In this article, the noise will be set aside so the available facts can be laid out. Here's what you need to know.

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Let's Start By Answering the Question

Cannabis, like any other compound we consume, affects everyone differently. The chemical combinations of cannabinoids, terpenoids, and flavonoids present in the cannabis plant affect each individual's endocannabinoid system uniquely. Thus, two people can take the same amount of weed in the same way and have different experiences.

According to NCBI, the concept of marijuana dependence or addiction as a condition exists. However, few who use will develop an addiction.

Cannabis can be as addictive as alcohol, cigarettes, sex, food or anything else. The symptoms are often similar as well, with cannabis typically less severe.

Each produces pleasurable responses in the brain. Just because you overindulge one day in chocolate doesn't necessarily mean you need to treat a chocolate addiction. The same goes for cannabis. But when does casual use become something more?

Although rare, some users do appear to become dependent on cannabis.

According to the National Institute on Drug Abuse (NIDA), only a small percentage of cannabis users will develop cannabis use disorder. Not all cannabis use disorder patients will experience symptoms like dependence or withdrawal. However, patients may notice a decline in productivity and performance.

In a 2002 review, cannabis ranked eleventh in dependency potential after heroin, cocaine, tobacco, methadone, barbiturates, alcohol, benzodiazepines, amphetamines, buprenorphine, and ketamine.

So in short, yes cannabis can become addictive, but the addiction is rare and withdrawal is typically less severe than with traditionally addictive substances.

Why is Cannabis Considered Safe?

Over-the-counter (OTC) medicines like aspirin are considered one of the safest medicines available. Yet complications associated with aspirin's use have been linked with over 3,000 deaths per year. (Huang et al., 2018). Cannabis is frequently argued to be safer than other medications for the following reasons:

  1. Few cannabinoid receptors exist in areas of the brain that control breathing or heartbeat. Opiates and many other drugs suppress heartbeat and/or breathing.
  2. Cannabis has an extremely low toxicity rate.
  3. No known deaths have been conclusively reported connected with overconsumption of cannabis.*

Nevertheless, there are still risks and side effects associated with its consumption.

* A 39 year old woman is said to have died from excessive THC consumption by vaping, but this conclusion is highly debated by medical professionals. 

Unlike cannabis overdose, which is difficult, opiate overdose is common and results in over 40,000 deaths per year.

Cannabis Use Disorder (CUD)

Cannabis Use Disorder is the medical term used for patterns of cannabis use leading to significant impairment or distress, including health problems, persistent or increasing use, and failure to meet major responsibilities at work, school, or home, without necessarily being addicted. However, it also has room to include addiction if it occurs.

Users may develop CUD without ever having physical problems like dependence or withdrawal. For example, CUD may start to cause problems at school or work, reduce motivation, but they don't usually suffer a physical withdrawal if they stop.

Introduced in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), problematic cannabis use was separated into two disorders, covering abuse and dependence.

While often less severe, cannabis withdrawal symptoms appear to mirror other drugs. According to reviewed studies by Dr. Alan Budney, physical withdrawal syndrome patterns in cannabis users appeared just as they had in harder drugs. Symptoms appeared within 24 to 48 hours and lasted for one to three weeks.

Cannabis use is recognized by the DSM-5.

DSM-5 vs DSM-IV-TR: A change in how we evaluate these addiction-related disorders

Significant changes have come about in how we evaluate addiction-related disorders. The previously used DSM-IV-TR separated problematic use into the previously mentioned two categories. However, the currently used DSM-5 combined the two categories into one.
Notable changes have occurred on various levels:

  1. Class (specific disorders considered in the overall group)
  2. Substance (which substances get marked as “drugs of abuse”)
  3. Disorder (the template of criteria applied, across all substances, deviations included)
  4. Individual criteria (the number and symptom types needed to meet the criteria for disorder distinction)

While the definition basically remains the same we now consider CUD differently than before. While the changes don't invalidate old studies, it does make data comparisons with certain accuracy, as each used differing statistics. That said, the previous data remains available and necessary to research outside of statistics comparison.

Who can become addicted to marijuana?

According to the American Addiction Centers, a user who has developed tolerance or dependence is not enough to diagnose addiction. Yet, it does indicate problematic behavior is underway that might ultimately lead to the development of cannabis use disorder.

According to the American Addiction Centers, a user who has developed tolerance or dependence is not enough to diagnose addiction.

Research shows that adults seeking treatment for marijuana abuse or dependence average more than ten years of near-daily use and more than six serious attempts at quitting. Half of the individuals who enter treatment for marijuana use are under 25 years of age. They report a distinctive profile of associated problems, perhaps due to their age and involvement in other risky behaviors.

Only nine percent of those who try marijuana develop dependence. However, because so many people use marijuana, cannabis dependence is twice as prevalent as other illicit psychoactive substances.

Signs of Cannabis Use Disorder

According to DSM-5 criteria, a person is perceived to have a cannabis user disorder if two of the following symptoms are indicated:

  • Craving cannabis
  • Consume more than intended
  • Difficulty controlling or cutting down cannabis use
  • Spending too much time on the cannabis consumption
  • Problems at work, school, and home
  • Social or relationship problems due to consumption
  • Stop or reducing other activities due to cannabis use
  • Taking cannabis in high-risk situations
  • Continuing to use cannabis despite physical or psychological problems
  • Tolerance to cannabis
  • Withdrawal when discontinuing cannabis

Relationship Between Legalization and Cannabis

Cannabis use has increased as more states legalize. Legalization has increased cultivation demand, and more potent strains are bred to compete for consumer demand.

As such, potency has increased over the past years. In the early 1990s, the average THC content in confiscated marijuana samples was less than 4%. In 2018, it was more than 15%. Some fear that the current increasing potency might lead to higher use and problematic consumption, especially in young people whose brains are still developing.

There is no current supporting data on the consequences of significantly high concentrations of THC. Recent studies suggest that experienced users may adjust the amount they smoke and how much they inhale based on the believed strength of the marijuana they are using. Still, they are not able to fully compensate for potency variations.

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Bottom Line

Marijuana isn't typically addictive. However, over-use might indicate other illnesses such as depression, anxiety and psychosis, among others.

Individuals who become addicted will likely give cannabis a high priority in their lives, even though doing so may lead to personal conflicts and inability to fulfill obligations. There is still a need for more research and information to determine the extent of it.

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