Here's one of the most hotly-contested questions from an anti-pot perspective: Is marijuana addictive? A bevy of misguided PSA's and crusty politicians would have you believe that one joint will lead to a deadly spiral of junkie-like addiction and debauchery. Reefer Madness, a 1936 propaganda film, illustrates this mentality to a tee. On the other side of the spectrum, carefree stoners may try to convince you that no one has ever gotten hooked on pot, and it's perfectly safe for anybody to use. As usual, the true answer lies somewhere in between the extremes. Let's take a deeper dive into what we know about marijuana and addiction.
Cannabis Use Disorder
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), marijuana can be addictive. The condition of becoming overly dependent on cannabis is called "cannabis use disorder". Cannabis use disorder as mild, or moderate to severe, and characterized by an apparent inability to slow or stop cannabis use despite the desire to do so.
The DSM-5 also contains criteria for cannabis withdrawal, cementing the addictive potential of cannabis from a clinical standpoint. However, the DSM-5 does not codify the extent of the physical and psychological dependence possible.
Differentiating between physical addiction and psychological addiction is crucial to answering the question "is marijuana addictive". When the average person pictures Addiction with a capital “A”, they're usually envisioning dependence on heroin or meth. Many of us have seen the "Not Even Once" PSA campaign against meth, featuring extremely dark scenes ostensibly derived from real-life, everyday situations faced by those addicted to methamphetamines.
While the disheveled appearances, wild eyes, and missing teeth of the subjects represents the physical degradation caused by meth, this isn't actually what's meant by the term "physical addiction".
Physical addiction actually refers to the material changes addiction causes in the brain. When people say addiction is a disease, this is what they're talking about.
Your Brain on Addiction
Physical addiction is what happens when your brain makes physical changes leading you to be dependent on a substance, rather than just craving it. Continuing with the methamphetamine example, meth produces a huge amount of dopamine in the brain. After chronic use, the brain stops producing as much on its own, and may become unable to produce it in adequate amounts. The symptoms of a serious dopamine deficiency include muscle spasms, hallucinations, and loss of balance – all symptoms of meth withdrawal. In other words, physical addiction is measurable in terms of how unpleasant (or even life-threatening) physical withdrawal symptoms are. In the case of alcoholism, physical addiction is incredibly dangerous, as the symptoms of a cold-turkey withdrawal can actually kill you without medical intervention.
Weed withdrawals are very light on the physical symptoms. People who quit smoking after chronic, heavy consumption may experience some tremors and moderate stomach pains, but that's about it on the physical end of the spectrum. So in the most critical sense, marijuana is not strongly addictive at all.
Psychological Aspects of Addiction
Physical addiction represents the most profound and dangerous aspects of drug dependence, but it can only develop once psychological addiction takes root. As you might guess, psychological addiction is the craving component of drug dependence. This is the most common form of dependence, and the area where marijuana and addiction usually intersect.
Psychological addiction is measurable by emotional and motivational changes upon withdrawal of the substance. Basically anything consumable has addictive potential from a psychological standpoint. Everyday things like coffee can stir up psychological addiction, as evidenced by those who insist they simply can't function without their morning joe. From this standpoint, marijuana can be addictive, especially when used on an everyday basis to self-medicate mood disorders.
What Qualifies as Cannabis Dependence?
The problem is, most people don't have the information they need to know when they're smoking too much weed. Because cannabis doesn't produce the equivalent of a hangover, it's easy to go on consuming it frequently without giving it much thought. After all, what's the harm in a few hours of fun every now and again?
What makes marijuana addictive is how it interacts with your brain's reward system, also known as the endocannabinoid system (ECS). THC artificially stimulates the ECS with rewards including increased dopamine, one of the main chemicals that gives weed its wonderful mood-enhancing properties. The problem is frequent consumption leads to reduced results. When someone consumes more cannabis to get the same effect, or cannot get the desired effect with the same amount they used to smoke, it means they've built up a tolerance.
Some tolerance is inevitable, especially for medical patients who must smoke, vape, or eat edibles to keep their symptoms bearable. But when someone reacts to a growing tolerance by consuming more and more cannabis, there's a problem. In addition to tolerance, the following behaviors occurring over the past 12 months are indicative of cannabis use disorder as defined by the DSM-5:
- Cannabis is often taken in larger amounts over a longer period than was intended.
- There is a persistent desire or insignificant effort to cut down or control cannabis use.
- A great deal of time is spent in activities necessary to obtain cannabis, use cannabis or recover from its effects.
- Craving or a strong desire or urge to use cannabis.
- Recurrent cannabis use resulting in failure to fulfill major role obligations at work, school or home.
- Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.
- Important social, occupational or recreational activities are given up or reduced because of cannabis use.
- Recurrent cannabis use in situations which is physically hazardous.
- Cannabis use is continued despite knowledge of having persistent or recurrent physical or psychological problems that are unlikely to have been caused or exacerbated by cannabis.
Risk Factors for Cannabis Dependence
To recap: Is marijuana addictive? Yes. But the good news is, not for most people. In fact, less than 10 percent of people who try marijuana end up with cannabis use disorder. Age plays a large role in whether someone will develop cannabis dependence, as well. If a person starts during adolescence, their chance of becoming dependent jump up to 17 percent – a significant leap.
Because young brains are still developing until approximately age 25, they are extremely susceptible to interference. While weed is still the least addictive substance they can try, frequent use can still have negative effects. It may not be the massive and permanent IQ loss youngsters are constantly threatened with, but we do know supplying young brains with reward chemicals from THC can cause the ECS to develop improperly, and spur cannabis dependence.
Cannabis as a Treatment
Is marijuana addictive enough to warrant its Schedule I designation? No. For young adults the risks cannot be ignored, but adults should know whether they're predisposed to addictive behaviors and avoid increasing cannabis consumption before addiction even becomes a distant possibility. Tolerance breaks are a must for individuals with a family history of addiction.
Not only is marijuana very unlikely to trigger dependence, CBD has even proved to help those combating addiction to opioids. CBD can actually decrease cravings for both alcohol and opioid painkillers. New York and Philadelphia have already approved opioid addiction as an addition to the qualifying conditions for medical marijuana. Other states, like Arizona, have introduced similar bills in the hopes of getting the opioid crisis under control.
Many people would rather walk into their neighborhood dispensary than deal with the side effects and extreme addictive potential of opioids. Now that the FDA has approved CBD-based drug Epidiolex, more cannabis-based drugs should follow. Hopefully the new wave includes drugs designed to treat addiction and stop pain before addiction can begin. With more exposure to cannabis as medicine, more people will understand why "is marijuana addictive?" is a more complicated question than it seems.