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Can Marijuana Be Abused?

Marijuana has become incredibly popular, and as of 2018, 43.5 million Americans 12 or older used it in the past year, according to the 2018 National Survey on Drug Use and Health. The survey also revealed that approximately 3,700 adolescents try marijuana for the first time each day.2

Misinformation about marijuana can lead people to believe this substance is not dangerous or addictive, but like alcohol, opioids, and other substances of abuse, marijuana use can be reinforcing, and may progress to compulsive levels which can have a profoundly negative impact on a person’s life.1

A 2018 Pew Research study found that 62% of Americans believe that marijuana should be legalized.3 But while several states have legalized its use, the U.S. Drug Enforcement Agency (DEA) still considers marijuana a Schedule 1 substance, and it’s illegal at the federal level.4

Read on to learn about the side effects of marijuana use, how it can be addictive, and the treatment options available for marijuana use disorder—also known as cannabis use disorder.

What is Marijuana?

Smoking MarijuanaMarijuana—also known as weed, pot, cannabis, and a plethora of other names—is a mixture of dried plant materials (commonly flowers or buds, but also leaves and stems in some cases) derived from the cannabis plant. The primary psychoactive chemical in this plant is delta-9-tetrahydrocannabinol, commonly known as THC. THC produces the euphoria, or “high,” people seek when they use marijuana recreationally.5

The cannabis plant also produces more than 100 other compounds related to THC, collectively referred to as cannabinoids. Cannabidiol, commonly known as CBD, is a non-intoxicating cannabinoid that’s often used therapeutically to treat symptoms of various ailments.5

Marijuana can be smoked in joints, pipes, bongs, or blunts; or eaten when mixed into foods (called edibles) like brownies, cookies, or candies. Users can also consume marijuana with a vaporizer, or vape.5

The Legality & Potential Health Benefits of Marijuana

The federal government classifies marijuana as a Schedule I substance per the Controlled Substances Act, and it is therefore illegal at the federal level.4 Schedule 1 substances are defined as those that have a potential for dependency and no accepted medical use.

A majority of states as well as the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands have legalized it for medicinal use in small quantities. “Medicinal use” refers to the marijuana plant as well as its extracts to manage symptoms of illnesses or other maladies.6 Some of these states have approved marijuana for adult use allowing for legal recreational consumption outside of medicinal use. Other states have simply decriminalized marijuana use.7

The U.S. Food and Drug Administration has not approved medical marijuana in plant form for treating or managing health problems or symptoms of illness. The organization has, however, approved three cannabinoids (two of them synthetic) for pharmaceutical use.8

The primary reason that many states have legalized marijuana for medicinal use is because of both perceived and well-documented health benefits. THC and CBD, the two main cannabinoids from the cannabis plant, are specifically being studied for this reason.9

THC, the component of marijuana often used recreationally for its “high,” may:6

  • Increase appetite.
  • Reduce nausea.
  • Decrease pain.
  • Reduce inflammation.
  • Help with muscle control problems.

CBD, the component of marijuana that does not produce a “high,” may:6

  • Reduce pain.
  • Reduce inflammation.
  • Control epileptic seizures.
  • Potentially be used to treat mental illness.

Effects of Recreational Marijuana

Short-term effects of marijuana used for the psychoactive component THC include:10

  • Altered sense of time.
  • Shifts in mood.
  • Slowed body movement.
  • Reduced thinking and learning abilities.
  • Poor memory.
  • Hallucinations (at high doses).
  • Psychosis (at high doses).
  • Delusions (at high doses).

Long-term effects of marijuana may include:10

  • Impaired thinking, memory, and learning functions (in adolescent users).
  • Breathing problems, such as cough and phlegm and risk of lung illness/infection.
  • Increased heart rate, with other potential cardiovascular risks still being studied.
  • Child development issues for pregnant users.
  • Cannabinoid hyperemesis syndrome (regular cycles of intense nausea and vomiting).

People who become addicted to marijuana are at higher risk of poor judgment,11 as well, which puts them at greater risk or becoming addicted to other drugs.12

And, recreational marijuana strains are becoming more potent than ever. THC content of marijuana in the 90s averaged 3.8%—in 2014, it was 12.2%. This means users can get more of a high from using marijuana than those in previous generations did. Research are not sure what high concentrations of THC do to the body and brain.13

Marijuana Overdose

Contrary to popular belief, marijuana overdose is possible. Marijuana overdose symptoms include:14

  • Extreme paranoia or fear
  • Hallucinations
  • Shortness of breath
  • Nausea or vomiting
  • Dilated pupils
  • Rapid heart rate
  • Tremors or shivering without being cold
  • Disorientation

For people who have physical issues like asthma or heart conditions, marijuana overdose can put them at risk of serious health complications, due to changes in respiration and heart rate.

Marijuana Can Be Addictive

In the simplest terms, addiction is a brain disease that shows itself as uncontrollable substance use in the face of adverse repercussions.15

Marijuana is a drug, and people can become addicted to it—in fact, a survey from 2018 found that there was a significant increase in marijuana use disorder among 18- to 25-year olds.2

It’s also worth mentioning that 75% of cannabis users report that their first use of the drug involved co-use of another drug. NIDA researchers are recommending more study of simultaneous use of cannabis and other drugs, as it may increase the likelihood of addiction.1

While this addiction rate is lower than that associated with other drugs like heroin, alcohol, or amphetamines, it’s still a statistically significant portion of people who use marijuana.

Marijuana Addiction Symptoms

Signs of addiction to marijuana may be subtle, but they can pervade every aspect of the person’s life. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, symptoms of abuse—of which at least two need to manifest within a 12-month period—include:14

  • Consuming the drug in larger amounts or for longer than user meant to.
  • A persistent want or inability to control use.
  • Spend a lot of time trying to get marijuana, use it, or recover from using it.
  • Craving marijuana.
  • Failing to perform major obligations at work, school, or home due to use.
  • Use despite having continued social or relationship problems due to marijuana use.
  • Giving up social, job-related, or recreational activities because of use.
  • Continued marijuana use in situations where it could be hazardous to one’s health.
  • Continuing to use despite knowing that a physical or psychological problem may persist or was caused in the first place by use.
  • Tolerance.
  • Withdrawal.

Symptoms of Marijuana Withdrawal

If you’ve used marijuana regularly over a few months, you may experience some symptoms of withdrawal within a week of stopping use, including:14

  • Irritability, anger, or aggression.
  • Nervousness or anxiety.
  • Sleep difficulty, including insomnia or disturbing dreams.
  • Decreased appetite.
  • Weight loss.
  • Restlessness.
  • Depressed mood.
  • Abdominal pain.
  • Shakiness/tremors.
  • Sweating.
  • Fever.
  • Chills.
  • Headache.

Treatment for Marijuana Addiction

Group-TherapyThere are not currently any medications approved by the U.S. Food and Drug Administration (FDA) to help with the treatment of marijuana use disorder. Instead, treatment could include behavioral therapies that are often used to treat other substance use disorder:16,17

  • Cognitive-behavioral therapy helps users pinpoint problematic behavior and correct them. This can help increase a person’s ability for self-control, specifically relating to drug use.
  • Contingency management centers around a rewards-based program—providing a reward when the right behavior occurs and removing such rewards if the behavior doesn’t occur.
  • Motivational enhancement therapy is designed to garner fast change that’s motivated by the user’s own want for change and engagement with treatment.

Quality treatment centers throughout the U.S. offer these behavioral therapies, often in outpatient and inpatient, or residential, capacities. Oxford Treatment Center offers a dedicated treatment track for marijuana use disorder at its facility in Mississippi.

Although public perception of marijuana use continues to edge toward being positive, don’t forget that it is still a drug that’s powerful and can be addictive.

 

References

  1. Panlilio, L.V. & Justinova, Z. (2017). Preclinical studies of cannabinoid reward, treatments for cannabis use disorder, and addiction-related effects of cannabinoid exposure. 43(1), 116-141.
  2. Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indications in the United States: results from the 2018 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  3. Pew Research Center. (2019). 5 facts about marijuana.
  4. United States Drug Enforcement Administration. Drug scheduling.
  5. National Institute on Drug Abuse. (2019). What is marijuana?
  6. National Institute on Drug Abuse. (2019). What is medical marijuana?
  7. National Conference of State Legislatures. (2019). State medical marijuana laws.
  8. National Center for Complementary and Integrative Health. (2018). Marijuana and cannabinoids.
  9. National Academies of Sciences, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. Washington, DC: The National Academies Press.
  10. National Institute on Drug Abuse (2019). Marijuana.
  11. Wesley, M.J., Hanlon, C.A., & Porrino, L.J. (2012). Poor decision-making by chronic marijuana users is associated with decreased functional responsiveness to negative consequences. Psychiatry Research. 191 (1), 51-59.
  12. Secades-Villa, R, Garcia-Rodriguez, O., Jin, C.J., Wang, S., & Blanco, C. (2015). Probability and predictors of the cannabis gateway effect: a national study. International Journal of Drug Policy. 26(2), 135-142.
  13. National Institute on Drug Abuse. (2019). Is marijuana addictive?
  14. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA, US: American Psychiatric Publishing, Inc.
  15. American Psychiatric Association. (2017). What is addiction?
  16. Patel, J. & Marwaha, R. (2019). Cannabis use disorder. Treasure Island, FL: StatPearls Publishing.
  17. National Institute on Drug Abuse (2019). Available treatments for marijuana use disorders.
  18. A 2018 Pew Research study
About The Contributor
Ryan Kelley, NREMT
Medical Editor, American Addiction Centers
Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More