Posted on October 06 2020
Medical and recreational cannabis use is sweeping the nation, and many are impressed and bewildered by some of its effects, especially in managing a range of refractory symptoms related to chronic illness. However, as people explore the potential of cannabis as a medicine, it’s just as important to explore the potential for adverse side effects. Although cannabis is usually considered to carry a lower risk than many prescription medications, exploring the boundaries of cannabis side effects and potential aversions helps medical professionals more accurately recommend cannabis to patients.
One question that stirs a bit of confusion in the medical community is whether cannabis is addictive. Unfortunately, the answer is neither black nor white, but there is a bit of research looming in the grey area that helps us understand the way cannabis affects the brain and the relationship between cannabis use and substance abuse.
Can Cannabis Be Addictive?
If you gather opinions on cannabis and addiction, you’ll see that the medical community and the general population have wildly different ideas on the topic. Likely, this has a bit to do with a difference of perspectives. After a little digging, it’s apparent that most of the confusion comes from the perceived definition of “addiction.”
In short, yes, cannabis can be “addictive.” However, addiction doesn’t necessarily fit the description many people assign to the word. Addiction, which is sometimes characterized by physical dependence, comes in many forms. However, cannabis won’t often cause another commonly associated characteristic, withdrawal. Many people who have stopped using cannabis after a period of time report no symptoms of withdrawal.
Some medications, like opioids, are considered highly addictive because of their ability to quickly form physical dependencies. This physical dependence is apparent in many prescription medications and street drugs, which is why addiction is rampant and users have such a hard time putting the substance down. Their bodies crave it.
On the other hand, cannabis users are much less likely to experience severe symptoms of withdrawal when quitting cannabis. However, experts agree that cannabis can still be addictive, resulting in what has become known as “cannabis use disorder.” To clear the confusion, you need to understand the difference in physical vs psychological dependence, as well as what causes and characterizes cannabis use disorder.
Physical vs Psychological Dependence
Physical dependence, which is what results in the severe withdrawal symptoms that many people associate with addiction, is characterized by a chemical procedure in the body that results in chemical dependence. In this scenario, the substance in question has likely been used repeatedly over a length of time, and the body’s natural chemical balance has changed in response. Then, the body craves the substance to feel “normal.” One common example of this is getting a caffeine headache after missing your daily cup of coffee.
While many medications do have the potential for physical dependence, cannabis is slightly different. As opposed to common symptoms of withdrawal that may be severe and related to bodily illness, cannabis “withdrawal” symptoms seem to affect people differently. One study suggests that anger, irritability, anxiety, nervousness, sleep disruptions, and more could be signs of withdrawal after quitting cannabis.
However, it seems important to note that cannabis has been listed as a treatment for several of these ailments and that feeling “anxious” after quitting anxiety medication would be considered a normal, often expected response. While this study does suggest that cannabis can be physically addicting, many experts agree that the real risk for cannabis addiction lies in psychological dependence instead.
Psychological dependence is characterized by emotional and motivational withdrawal symptoms, like anxiety, depression, or lack of motivation. Experts suggest that while cannabis is unlikely to cause any severe physical dependencies, some people do experience symptoms of a psychological dependence on cannabis. Since cannabis is known for its potential ability to help manage anxiety and depression, these potential effects aren't that abnormal.
Still, quite a bit of grey area exists regarding cannabis and addiction. The resulting condition, cannabis use disorder, varies greatly by severity and symptoms.
What is Cannabis Use Disorder?
Cannabis use disorder is the official name assigned to cannabis dependence, listed in the DSM-5, the official diagnostics manual for psychiatric disorders in the U.S. The disorder manifests differently in different people and has varying levels of severity that make it hard to diagnose. Still, many professionals diagnose cannabis use disorder based on its textbook definition and the guidelines given in the DSM-5. Cannabis Use Disorder is described as “a problematic pattern of cannabis use leading to clinically significant impairment or distress” as manifested by at least 2 out of 11 markers. These markers involve a number of behavioral patterns, such as:
- Strong, frequent desires for cannabis
- Obtaining and using larger amounts of cannabis than needed
- Uncessful efforts to control cannabis use
- Desire for cannabis that outweighs minor responsibilities at work or school
- Lack of social activities or responsibilities due to cannabis use
Diagnosing Cannabis Use Disorder requires a standard psychiatric evaluation and an understanding of the patient’s full relationship with cannabis. Physicians can diagnose based on the level of severity, and there are separate codes and treatment procedures for conditions labeled as “mild” and moderate to severe cases of Cannabis Use Disorder. While Cannabis Use Disorder is nationally recognized as a potential threat to cannabis users, experts do agree that some users are at a higher risk for developing a dependence or substance abuse disorder. The same can be said for cannabis use disorder.
What Causes Psychological Dependence on Weed?
Although many people use cannabis regularly with no adverse reaction, experts suggest that some people may be more likely to abuse substances, including cannabis, than others. Likely, genetics have a lot to do with your potential for developing a substance abuse disorder. This is apparent when looking at a study done on identical twins who were raised separately, but still had a higher chance of addiction co-occurring than fraternal twins.
However, researchers and experts are beginning to uncover other potential factors that may make you more likely to develop a substance abuse disorder. One theory looks at the impact of environmental factors, like trauma, abuse, or isolation. This theory suggests that humans naturally form bonds, usually with those around them. During periods of isolation, whether temporary or long term (caused by some form of trauma) a person may be more likely to form a bond with a substance. This is especially true for substances that will potentially take the edge off of symptoms often co-occurring with trauma, like anxiety, depression, sleeplessness.
Further, there may be an increased risk of developing a substance abuse disorder if you have been diagnosed with other mental illnesses. This is especially true for illnesses that affect relationships or make it difficult for the person to create bonds. For this reason, the idea that the risk of developing cannabis use disorder involves both genetic and environmental factors is commonly accepted among the medical community.
Evaluating the Risks of Cannabis and Addictive Behaviors
Overall, describing the relationship between cannabis and addiction is difficult. The answer to “Is Cannabis Addictive?” depends on who you ask. As medicine, cannabis still compares fairly well to many prescription options. Many people use cannabis to manage pain, and experts suggest that cannabis-based medicines may be an alternative option to opioids. Prescription opioids, which are well-known for being highly addictive, and are often blamed for the national opioid crisis, may provide a much higher threat of substance abuse and dependence than cannabis.
Of course, your risk of developing a substance abuse disorder is unique, and experts seem to suggests that one can be predispositioned (both by genetics and experience) to develop these disorders. Overall, the risk is low, especially if you don’t suffer from other mental illnesses. Still, cannabis use disorder is a medical condition that should be treated by a professional. If you exhibit signs of cannabis use disorder or think you may be predispositioned to developing these disorders, talk to your doctor. For a look at a non-psychoactive option (that may carry a lower chance for addiction), you may be interested in reading “CBD Oil Benefits: Is CBD the Medical Mastermind Behind Cannabis.”