Understanding Weed Use: Is Marijuana Addictive?

Last Updated: December 23, 2020

Reviewed by Michael Espelin APRN

Marijuana(weed, pot) is the usual name for a crude drug made from the plant cannabis. However, it contains components that are prone to addiction. Smoking weed can result in a gradual appearance of problem use, often referred to as marijuana addiction or cannabis use disorder. So, why is weed addictive? Is marijuana a gateway drug?

What Is Marijuana

Marijuana is a drug used as a medication for different health purposes. It is made from the cannabis plant. Just like any other drug, marijuana can lead to addiction. It contains a chemical substance that can depress the central nervous system, thus enabling addiction.

Cannabis consists of more than 120 cannabinoids. Notably, no expert is sure of what each cannabinoid is capable of. However, several theories show an excellent understanding of two components in particular. These components are tetrahydrocannabinol (THC) and cannabidiol (CBD).

Even though most people are aware that marijuana causes a high-feeling, only a few people understand how weed affects the body and what causes the effects. The effects of marijuana are mainly caused by the reaction of THC on the central nervous system. This is because THC has a similar chemical structure to the natural chemicals present in the body—such as anandamide.

Marijuana joint near a jar.

When a person smokes weed, THC enters the bloodstream through the lungs. It then moves through the bloodstream directly to the heart and thus circulates throughout the body. Hence, it binds with the CB1 receptors located in the brain, specific organs, and central nervous system. It also binds well with the CB2 receptors in the spleen and immune system. This way, THC gets circulated throughout the body system.

The area where this reception of THC molecules occurs is the cannabinoid receptors located within neurons. When the THC attaches to these receptors, it activates them. Because the endocannabinoid system is crucial to the nervous system’s proper functioning, THC’s action causes profound effects, ranging from relaxation to hallucinations in the short-term and from impaired function to addiction in the long-term use.

With the appearance of various marijuana strains, new ways of consumption also become more popular. For example, marijuana can be used in brewing tea and, especially when it is sold or consumed for medicinal purposes. It is often mixed into foods (edibles) such as candies, cookies, or brownies. Vaporizers are also becoming popularly used to consume marijuana.

However, most people smoke marijuana in blunts (weed rolled in cigar wraps), pipes (also known as bongs), or hand-rolled cigarettes known as joints.

Marijuana for medicinal use is gaining more recognition in the United States over the years. The medicinal or recreational use of cannabis is now legal in some states. However, the fact that the drug is legal does not mean it is safe for consumption.

Changes in weed protocols across different states legalizing the use of marijuana for recreational or medical use indicates that the drug is gaining significant acceptance in society. Therefore, people need to understand what is known regarding the potential therapeutic benefits and the adverse health effects of marijuana.

Recently, the U.N. commission agreed to exclude cannabis for recreational and medicinal purposes from the world’s most harmful drugs’ category. This highly anticipated decision may be responsible for the expansion of marijuana for medical and research use expansion.

 

Marijuana leaves and judging mallets.

In 2019, the World Health Organization made recommendations for reclassifying cannabis. However, the United Nations’ vote was delayed till 2020 because the decision was politically divisive.

The vote by the U.N. Commission for Narcotic Drugs on changing the classification of cannabis and its derivatives was made. However, attention was centered on a significant recommendation to exclude cannabis from Schedule IV of the 1961 Single Convention on Narcotic Drugs — where it was listed among the dangerous and highly addictive drugs like heroin. In December 2020, the House of Representatives, controlled by the Democratic, passed a bill legalizing marijuana use at the federal level.

The History of Marijuana in the U.S.

The history of marijuana in the U.S. is a complicated one. Outside the U.S., the oldest known record of cannabis cultivation dates back to 2727 B.C. Within the U.S., its use dates back to the colonial era. The use of weed as a drug began in the 19th century, during which time it was marketed as medicine, though advertisements tended to focus on recreational effects.

The use of the drug was unchecked until the early 20th century. The first legislation regulating weed came in 1906—the Pure Food and Drug Act. However, this law required companies to disclose the inclusion of cannabis in their products to customers. After the Mexican Revolution in 1910, many Mexican immigrants moved to the United States, bringing their approach to cannabis use with them. Rather than consuming it in drinks and tinctures, these immigrants tended to smoke the drug. Due to anti-Mexican sentiment, cannabis became seen as something dirty and even dangerous, leading states to prohibit the cannabis plant starting in 1914.

At the federal level, the use of cannabis—at least for medical purposes—remained legal until 1970. This is when the Comprehensive Drug Abuse Prevention and Control Act—now called the Federal Controlled Substance Act—was passed. This law created the drug schedule system.

This is perhaps the most significant event in the history of weed in the U.S.

The history of medical marijuana in the post-prohibition era started in California in the early 1990s. At that time, the state legislature began considering medical cannabis laws, even passing bills legalizing its use. However, the governor vetoed them, preventing them from becoming law. Seeking to get around the governor’s veto power, activists worked to get a proposition on the ballot. In 1996, they succeeded, passing the Compassionate Use Act with 56 percent of California voters giving their approval.

Since then, numerous other states have enacted medical cannabis laws either through legislation or popular vote.

Doctor prescribing marijuana for medical use.

While there is an apparent movement towards legalization, there are also many fighting against it, concerned that open access to cannabis could lead to marijuana use disorder and addiction. There is also a concern about weed abuse amongst teens. However, under even the most liberal laws currently in effect in the United States, kids smoking weed remains illegal.

Given that weed use—either medicinal or recreational—is lawful at the state level in certain jurisdictions, users often assume that they are safe from legal ramifications.

In other words, no matter what the state laws say, there is still a significant legal risk for all involved.

Is Marijuana Addictive?

A question that arises often is: is marijuana addictive? It is common for cannabis proponents to claim that pot is not addictive at all. However, the truth is that while marijuana overdose is essentially unheard of, weed addiction is not.

Because addiction to weed is generally not as severe as addiction to harder drugs, it is not always labeled explicitly as addiction. Sometimes it is called cannabis dependence rather than addiction, or it is put under the umbrella term cannabis use disorder, which includes addiction in severe cases. However, it is possible to become physically and psychologically addicted to cannabis.

Marijuana Addiction Risk Groups

Not every pot user is at high risk of developing an addiction. However, the possibility is always there. With that said, certain groups are at a greater risk of becoming addicted to cannabis.

They Include:

  • Those taking large doses of the drug, as this builds tolerance
  • Those who use the drug habitually, as this also makes tolerance
  • Those with underlying mental disorders, as this sets them up for psychological dependence
  • Those who are underage, as taking the drug can alter the brain to not produce the correct chemicals on its own
  • Those with a family history of addiction, as this indicates genetic predisposal
  • Those with a lack of family involvement, as this indicates a lack of support

It must be understood that no one is immune to the possibility of addiction. Not being part of the groups mentioned above does not mean an individual cannot become addicted.

Physical Addiction

Understanding physical addiction to marijuana requires understanding physical dependence in general. Physical addiction to any substance is characterized by at least one of three things: an inability to stop due to a physical compulsion to use, developing a tolerance to the drug, and experiencing physical withdrawal symptoms when stopping use. The most common symptom of addiction seen with cannabis use is tolerance, wherein the user must use weed more frequently or in larger or more concentrated amounts to achieve the same state.

There is a certain amount of controversy over the idea of marijuana addiction. It’s often argued that cannabis is not physically addictive at all, while others may say that it is not an addiction but dependence that is the issue. However, the evidence makes it clear that the body does respond to the drug in a way that can drive continued use.

Man suffering from marijuana addiction with a joint.

Many misunderstand physical addiction to cannabis because they associate physical dependence with other drugs. Quitting weed may not produce the shakes, sweats, and hallucinations that come with stopping harder drugs, but the symptoms are still there. Marijuana withdrawal impacts the nervous system, as that is where the cannabinoid receptors are, meaning that is where weed has been acting on the body. Common symptoms of withdrawal from pot are irritability, anger, depression, sleep disturbance, and decreased appetite. The symptoms start as soon as 24 hours of last use and can remain for up to 3 weeks, with the most significant risk of weed relapse in the first 6 days after stopping use.

Psychological Addiction

More common than a physical addiction to weed is psychological dependence. With a psychological addiction, the drug’s use becomes central to the user’s thoughts and actions. They might organize their day around partaking in it, fret over getting access to it, or even treat it like a hobby, collecting related paraphernalia like pipes and bongs. That psychological addiction to cannabis is possible is evidenced throughout the United States, from stoner films to the head shops that dot cities across the country.

While there may not be physical symptoms, the idea of not using weed is distressing to someone with a psychological addiction, preventing them from quitting even if they believe that would be best for their health. It can also lead them to act in ways that damage their social and familial relationships; for example, they might change social groups to be around others who use weed more often. Often, the psychologically addicted have trouble at work and school and struggle to show up, meet deadlines, and invest more mental energy into their work than their habit.

In many ways, psychological addiction can be more devastating for the addict and their loved ones than a physical addiction to cannabis. As such, cannabis rehabilitation programs often focus on this aspect.

Is Marijuana a Gateway Drug?

Perhaps the most significant concern with weed is that it could be a gateway drug. A gateway drug is a substance that is believed to encourage the use of harder drugs by normalizing the act of getting high both physically and psychologically. According to numerous studies, users of harder drugs often started using drugs with cannabis.

However, it is not the only gateway drug. The use of nicotine is more common amongst users of hard drugs than cannabis. Alcohol is likewise associated with the help of harder drugs. In other words, what makes pot a gateway drug is not something unique to the plant itself, but rather the fact that it can alter the way a user thinks and feels.

Signs Of Marijuana Use And Abuse

Signs that a person is abusing marijuana can be difficult to detect initially, but physical and behavioral changes start cropping out as days go by. One must be attentive in identifying cannabis abuse signs in loved ones, especially if they are expecting a baby, as marijuana during pregnancy poses a risk to the unborn child.

Physical Signs of Marijuana Use

Sobriety is the norm, whether at home or work. Individuals who are high on cannabis can be a risk to those around them, and, therefore, it is crucial to identify them so that they can get help positively.

The Following Are Some Of The Physical Marijuana Symptoms Abusers Display:

  • Red Eyes: Bloodshot marijuana eyes are a tell-tale giveaway that someone has taken weed. That is because weed can cause blood pressure to come down, consequently dilating blood vessels and increasing blood flow, hence the red eyes.
  • Dilated Pupils: Studies have shown that regular use of pot causes a condition known as mydriasis. This is the activation of the iris dilator and sphincter muscles. The result is dilated pupils as the parasympathetic nervous system gets triggered.
  • Fast Heart Rate: Most pot users experience increased heart rate with their hearts making extra 20 to 50 beats per minute compared to those not using weed. This results from the activation of CB1 receptors around the heart muscle. The trigger is autonomic and happens to compensate for the blood pressure reduction caused by pot.
  • Lack of Coordination: The corticostriatal networks are essential areas of the brain connected to motor learning and control. A close examination of the brain of a marijuana user shows differences in this area of the brain. These affect their reaction time, ability to switch from one task to another, and even memory.
  • Sleepy and Lethargic: This is one of the easy ways to identify signs of marijuana use. The interaction between the pot and the dopamine neurotransmitter causes users to be lazy or lethargic. This affects even medicinal cannabis users and hence the need for close monitoring that they do not overdose.
  • Cannabis Odor: Marijuana smells like a skunk, and any person taking it bears the characteristic smell. Even though some use marijuana odor eliminators, they cannot hide this smell forever. Marijuana odor is a strong lead that can help in the identification of those abusing pot.

Behavioral Signs of Cannabis Use Disorder

Apart from the physical signs above, there are behavioral marijuana signs as well as noticeable among users. However, due to the hideous nature of abusers, some of the signs require attentive observation.

  • Increased Food Cravings: Cannabis contains an active ingredient known as tetrahydrocannabinol, abbreviated as THC. Several studies have been conducted, and articles written on how long THC stays in the system. This is the ingredient behind the food cravings, one of the common behavioral symptoms of marijuana. THC stimulates the area of the brain responsible for mood and revitalizes euphoria. This stimulation influences appetite for food.
  • Confusion: Also known as delirium, mental confusion is often accompanied by feelings of grogginess and lack of focus.
  • Unusual Talkativeness: This could be one of the wax weed dabbing signs where excessive weed intake occurs, causing cannabis users to become abnormally talkative. Most of the time, they either repeat themselves or talk about nonsensical things. This could be a result of euphoria.
  • Giggling without a Reason: This is one of the symptoms of marijuana use present in several drug-addicted individuals. However, when a person notices giggly behaviors accompanied by physical signs such as red eyes and persistent coughs, weed abuse chances are high.
  • Misjudging Time: Pot use has been found to give the affected a subjective perception of time. This causes them to overestimate the passage of time and think of the future as though it is the present. This is associated with the effect of weed on cerebellar blood flow that may require drug dependence treatment to kick it out of the system.
  • Neglecting Responsibilities: As one of the signs of marijuana, people who rely on pot tend to exhibit a general lack of responsibility for raising kids, holding onto jobs, and keeping relationships going. A few of them, if any, are go-getters.
  • Disregard for Personal Hygiene: Even though some abusers know how to get rid of marijuana smell, hiding it thoroughly, especially in personal hygiene, is difficult. Basic life maintenance issues all of a sudden become a burden. For instance, they will not brush their teeth, comb their hair, and from a close range, one can even smell their marijuana smell.

Furthermore, physical and behavioral signs such as marijuana dilated pupils may indicate a higher level of addiction. However, people who do not occasionally use cannabis could be hiding some severe problems related to the drug that requires help. Noticing these signs early could help them from tipping over into total addiction.

Marijuana Facts And Statistics

Marijuana statistics show the popularity of this drug is increasing, both recreationally and medically. However, the adverse effects are becoming more common, among the little-known facts about marijuana. Extensive research shows that it is the most commonly used illegal drug, with tens of millions using it every month.

Marijuana use is most common among adolescents and young adults. The annual Monitoring the Future survey portrays a seemingly immutable connection between weed and teens. Adolescents’ perceptions of the risks of use of this drug have steadily declined over the past ten years, possibly due to increasing public debate about loosening restrictions or legalizing marijuana for medicinal and recreational use.

Person holding marijuana in hands.

In 2019, 11.8 percent of 8th graders reported having smoked in the past year and 6.6 percent in the past month. Among 10th graders, 28.80 percent had smoked in the past year and 18.40 percent in the past month. Rates of use among 12th graders were even more impressive: 35.70 percent had used pot during the year before the survey, and 22.30 percent used in the past month.

Statistics of 2017 (July) published by Statista indicate 18 percent of individuals aged 18 and 29 use pot. For the 30-49 age group, the number of marijuana users is 10%. It is 8% in the 50 – 65 age group. Use declines with age: only 3% of those over 65 smoke.

Marijuana Deaths

Cannabis-related deaths include driving under the influence of weed, weed-induced suicides, and poisoning, among others. The prevalence of cannabis use and the high morbidity associated with car crashes have led to much research on their connection.

DUI

Many motor vehicle fatalities involve drivers who test positive for cannabis. Marijuana acutely impairs several driving-related skills depending on the dose, but its effects vary more between people due to tolerance and differences in use techniques.

Suicide

One study showed a link between heavy cannabis use and suicidal thoughts. Apparently, this isn’t just another one of those marijuana myths. Researchers at Louisiana State University found that people who smoke weed daily had more suicidal thoughts than less frequent users based on data from 209 undergraduates who had used weed in the past month and participated in the research.

It is impossible to give exact data on marijuana deaths per year because there is no direct link between them. Yet, facts do speak for the possibility of death from marijuana.

Cannabis Business in the U.S.

According to Marijuana Business factbook exclusive projection, retail sales of recreational and medical cannabis in the U.S. are on pace to reach $15 billion by the end of 2020, a significant increase of approximately 40% compared to the 2019 sales figures. Cannabis sales reached $6.7 billion in North America in 2016, representing 30% y/y growth. According to data from G.Q. magazine, it was the second-largest cash crop in the U.S. after corn in 2019 and is worth more than $40 billion. The non-psychoactive, natural hemp market was worth $600 million in 2015. The industry’s most significant producers were Scotts Miracle-Gro Co. with a market cap of $6.15 billion, CBIS with $253 million, and MJNA with $480 million in the middle of 2017.

Cannabis plant and money.

According to New Frontier Data, the cannabis industry market value in the U.S. is expected to reach an annual landmark of $30 billion by 2025. This is a projection that comes when marijuana is still considered illegal federally despite the legalization of recreational and medical use by several states, including Washington, D.C.

As marijuana legalization movements extend into new states, and several Congress members advocate for reform and federal legalization, the cannabis industry may soon break into new markets. Notably, cannabis sales have increased significantly over the years, but so has the competition with more retailers, growers, including entrepreneurs vying for a stake in the “green rush.”

Marijuana Addiction Treatment

Marijuana addiction treatment involves behavioral therapy techniques that help a user change drug-seeking habits and build coping skills to lead a drug-free life. Treatment for pot abuse is mainly necessary for users who have developed a dependence on the substance, which impairs such an individual’s quality of life.

Is It Necessary To Treat Weed Addiction?

Weed is one of the most common substances adults use. Although cannabis is believed to be a relatively safe drug, it can still lead to substance abuse in some instances, which is characterized by addiction and dependence. At this point, marijuana abuse treatment becomes necessary.

Therapy for cannabis addiction becomes necessary when the individual cannot stop using the substance despite its apparent adverse effects. Adults who seek marijuana addiction treatments usually average more than ten years of daily use with several quitting attempts.

People who use weed before the age of 18 are up to 7 times more likely to develop pot addiction, and, thus, the therapy for weed abuse is even more necessary for adolescents.

Moreover, taking too much of the substance is likely to result in an overdose on weed, placing the person at risk of poisoning and injuries. This is another reason to seek marijuana addiction help.

What Do Marijuana Addiction Treatment Programs Look Like?

Weed rehabilitation is similar in a lot of ways to the treatment for other drug addictions. Treatment mostly involves behavioral therapy sessions held in a comfortable, non-confrontational environment to enable them to detoxify safely.

The facility may also administer medicines to reduce withdrawal symptoms that occur during detox. Following detox, the addiction therapist provides follow up care and rehabilitation services to prevent pot relapse. These programs are scheduled in marijuana anonymous meetings and rehab centers.

Types Of Marijuana Addiction Therapies

The main types of weed addiction treatment include cognitive-behavioral therapy (CBT), contingency management (CM), and motivational enhancement therapy (MET). These treatment options may be used singly or in combinations. The approach that integrates all three types produces the best outcomes.

Types Of Therapies:

  • Motivational Enhancement Therapy. MET addresses a user's ambivalence about quitting. This technique aims to strengthen an individual's motivation to change. A typical session of MET comprises one to four 45 to 90-minute individual therapy sessions. The weed addiction therapist typically uses a non-confrontational approach to help the user decide to change.
  • Cognitive Behavioral Therapy. CBT focuses on helping the patient gain requisite skills to quit the substance and avoid factors that can interfere with a successful cannabis detox. The user learns how to prevent or cope with pot cravings and drug use triggers and builds drug refusal and problem-solving skills. CBT is typically delivered in weekly marijuana clinics in 45-60 minute individual or group therapy sessions. A user can have as many as 16 sessions to learn the relevant coping skills thoroughly.
  • Contingency Management. Contingency management is focused on frequent monitoring of the drug use behavior using positive reinforcements to increase motivation for reduced drug intake. It adopts an abstinence-based voucher system in which vouchers are contingent on abstinence. In this case, the marijuana addiction test is done twice weekly, with the voucher's value increasing with each subsequent negative testing. The patients then exchange these vouchers for prosocial retail items, which are intended to serve as alternatives to smoking marijuana.

Weed Relapse

A 2012 study published in the Public Library of Science found that heavy users were more prone to a marijuana relapse. Also, they experienced withdrawal symptoms more intensely, and weed stayed in their systems for a longer time. The people who had these symptoms were more likely to fall into marijuana relapse.

The  Items Causing the Most Impairment to Normal Daily Functioning Were: 

  • trouble getting to sleep
  • angry outbursts
  • imagining being stoned (cravings)
  • loss of appetite
  • feeling easily irritated
  • nightmares or strange dreams

In addition to the above, common symptoms included depression and mood swings. However, less common symptoms include fatigue, night sweats, and hot flashes. No matter the promises one makes to oneself, a marijuana relapse can always occur, be it a usual joint or another consumption way like a marijuana shot.

Aftercare: The Key to Sustainable Recovery

Timely help is crucial to attaining sobriety whether the person is part of the family or a friend. In recent days, teens and weed abuse cases have become a concern to all parents and guardians. This calls for active intervention.

There Are Several Steps to Take to Bring the Situation Under Control:

  • Approaching pot users with empathy and show of compassion: When discussing the abuse problem with marijuana users, don't heap blame on them, rather be specific and ask for permission to pursue treatment.
  • Talk therapy interventions and psychoeducation: This could be in a group or one-on-one sessions. Cannabis users are educated on the effects of cannabis abuse and how to get out of addictions.
  • Supportfor weed addicts and creating a safe environment for the affected
  • Referral to rehab centers: Here, abusers get professional support and counseling in addition to specialized therapy to enhance their recovery rates.

For individuals who use pot and wish to stop, going at it alone may not be the best option. Instead, it is recommended that they seek assistance either through a drug rehabilitation facility or support groups. Rehabilitation facilities are best for those with severe marijuana addiction, while support groups are suitable for those who just need that extra push. Narcotics Anonymous and Marijuana Anonymous are two groups that help those attempting to quit cannabis. Ultimately, the user must find the right place for them. There are numerous addiction treatment options available.

Finally, aftercare remains the key to entirely abstaining from this substance. It involves a series of interventions offered after the initial treatment phase, intending to help the individual achieve a drug-free life and prevent a relapse. A huge factor of aftercare is emotional support: Patients need a lot of support from friends and family to help them achieve this goal and stay drug-free again. The absence of this increases the risk of pot relapse.


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Published on: December 23rd, 2020

Updated on: December 23rd, 2020

About Author

Peter J. Grinspoon, MD

Dr. Peter Grinspoon is an experienced physician with long-term clinical practice experience. As a former analgesic addict, Dr. Grinspoon knows precisely how important it is to provide patients with effective treatment and support. Medical writing for him is the way to communicate with people and inform them about their health.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.