Is Marijuana Addiction Real?

Is marijuana addiction a possibility? Studies point to some interesting findings. Back in early 2018, National Institute on Drug Abuse released findings that suggest 30 percent of those who use marijuana may have some degree of “marijuana use disorder.” The study also suggested that who use marijuana before age 18 are four to seven times more likely to develop a disorder than adults. Overall, researchers estimate that somewhere around 4 million people in the United States meet the criteria for marijuana use disorder as of 2015. Of them, nearly 140,000 eventually sought some form of treatment. The researchers report the use disorder can morph into an addiction when the person can’t stop using the drug even when it interferes with their daily activities. Most people know someone who is using marijuana. Marijuana is viewed differently than other drugs, especially with recent research showing its medicinal value, but is it any less dangerous than hardcore narcotics? Like any other addiction, there are signs that you are becoming or have become addicted. Among the signals is a growing tolerance for the drug’s effects as well as using more marijuana than you initially intended to use.

Marijuana Addiction: Who’s Addicted?

While marijuana use isn’t going away, it certainly isn’t decreasing. In fact, a 2013 study concluded that 6,600 people in the United States start using marijuana every day. The number might even be higher now because move to legalize cannabis in recent years. Even in seniors is marijuana use is rising. All of this begs the question “who is getting addicted to marijuana and how is it happening?’ While genetics play a role as a strong predictor of addiction (the nurture vs. nature debate applies), addiction is caused by many other factors ranging from influence by peer groups, underlying emotional or mental health issues and problems managing stress. “When we look at the criteria for addiction, it has a lot to do with people tempering their behavior,” explained Carl Hart, PhD, an associate professor of psychology at Columbia University in New York and author of “High Price,” in a 2016 interview with Healthline. “It has a lot to do with responsibility skills. It’s not perfect, but when you look at the people who are addicted, and you look at people who have jobs and families, they have responsibilities, they’re plugged into their societies, they have a social network, the addiction rates within those kind of groups are dramatically decreased from people who are not plugged in with jobs, families, social networks.” “Most of us have a lot of choice in life of things that make us feel good,” said Gantt Galloway, PharmD, executive and research director of the New Leaf Treatment Center and senior scientist at the California Pacific Medical Center Research Institute, in a 2016 interview with Healthline. “Those who have fewer choices, who perhaps don’t have as rich a set of social interactions because their family life is difficult or because they have emotional problems that are stopping them from forming close friendships. Those people may find drugs such as marijuana more attractive and be at greater risk for addiction.” “Mental health is a huge risk factor for marijuana addiction,” said Stalcup. Co-occurring disorders complicate every form of addiction and influence tendencies toward addiction. “Drugs work very well, at first, for mentally ill people. If you’re anxious, it’ll go away with a couple of hits, a beer. It’s like magic. But then, the tolerance sets in. So, not only do they need to drink more to relieve the anxiety, but every single time they try to stop, the underlying anxiety comes back worse. We conceptualize it as a biological trap. It works at first, it turns on you, it stops working, and then you still have a problem.” Stalcup estimates that 50 to 60 percent of the people addicted to marijuana his clinic treats have some sort of underlying mental illness. The majority he sees have depression, anxiety, post-traumatic stress disorder (PTSD), or schizophrenia. At first, marijuana offers a benefit to each of them. It makes the world more interesting to counteract the loss of pleasure in depression. It soothes anxiety. For those with PTSD who experience nightmares, it shuts down the process by which dreams form in the brain.

Building up a tolerance

The conversation around marijuana addiction use has become more nuanced since the World War II era film “Reefer Madness” portrayed the drug as destructive and dangerous. However, the pain-relieving properties of the drug make it a potential replacement for pain medication. States that had legalized medical marijuana reported in 2014 a 25 percent drop in overdose deaths from pain pills. Dependence on marijuana happens when users build up a tolerance for the substance and need more and more of it to experience the same effect. When a drug enters the brain, it overrides the brain’s natural processes, boosting a specific function far above, or below, normal levels. The brain may become resistant to the effects of the drug in an effort to protect itself, so that next time the person uses the drug, it doesn’t have as strong an effect. In order to feel the same high, the person has to take larger and larger doses. Over time, users may graduate from smoking marijuana to using it in high-dosage edible forms, or propane-extracted concentrates called dabs. One study found that people who use marijuana have “fewer receptors in their brain for endogenous cannabinoids, the signaling molecules that marijuana’s active component, THC, mimics.” THC also affects the brain’s reward system and the release of the “pleasure hormone” dopamine. “It is very well known that dopamine is one of the most important neurotransmitters that regulates reward, motivation, and self-control,” said Dr. Nora Volkow, director of NIDA and one of the authors of the study. “All of the drugs, whether legal or illegal, that can cause addiction apparently can stimulate dopamine signaling in the main pleasure center of the brain.… By stimulating dopamine, they activate the main reward centers of the brain. This is why when someone takes a drug, it is pleasurable.” “The problem isn’t that they are releasing less dopamine, but that the dopamine stimulation in the brain is having a very attenuated effect,” Volkow said. “The brain doesn’t know what to do with the dopamine. The dopamine signal is not being heard, not communicating properly downstream.” There are certainly other ways to raise dopamine levels, but many people just don’t pursue that course of action. Boredom is another influencer. “I smoke just to get through the boring parts of my day: grunt tasks like making breakfast, showering, running errands, and walking to work,” one research subject reported. In this subject’s case, her habit had increased from once to at least three times a day, smoking “between one and infinity joints at night, depending on how much weed I have.”Once tolerance sets in, dependence can form. If someone uses a drug often enough, the brain will become accustomed to it. At this point, it feels like addiction and it looks like addiction.

Is Abuse Addiction?

Most marijuana users never let their use become a problem and they certainly don’t think they have a marijuana addiction problem. They’re not driving high or getting high at work. They don’t get caught with marijuana and never enter the legal system. Some are even dependent on the drug, using it daily and suffering withdrawal if they try to quit, but still remain functional. But for some people, their use of marijuana gets out of control causes problems. “Marijuana-addicted people rarely present for treatment,” said one doctor. “As such, it’s difficult to discern the impact and growth of use among certain age groups accurately.” “If you are getting in trouble because you are using or going after an illegal drug, the illegality, and the fact that you don’t stop, and the fact that you keep getting in trouble over it, says that you have a high degree of a substance use disorder, and that you need treatment,” said Michael Kuhar, PhD, a professor of neuropharmacology at Emory University’s School of Medicine, and author of “The Addicted Brain: Why We Abuse Drugs, Alcohol and Nicotine,” in an interview with Healthline. “If you’re doing something that’s wreaking havoc in your life, you need help. Don’t focus on semantics – just get help.”

The cycle of addiction

Unlike opiate misuse, which can set in fairly quickly with heavy use, marijuana addiction can take months or even years to develop. A user might not immediately realize that they’ve crossed the line into addiction. For many, it’s difficult to imagine a life in which doing drugs is more important than spending time with friends or doing favorite hobbies. It’s certainly difficult to imagine doing drugs despite major consequences, such as a suspended driver’s license or prison time. There’s a simple test for marijuana addiction according to one doctor, “To make the diagnosis, we propose an experiment. In the experiment, we ask you for a defined period of time not to use. The basic question that we ask is, ‘OK, so you smoke pot, that’s not the issue. Can you not smoke pot?’ Someone who’s not an addict, that’s not a problem. Being unable to not smoke it when you’re trying not to smoke it defines addiction. I encourage anyone who’s using any substance to do this experiment from time to time.”