Marijuana addiction, clinically referred to as cannabis use disorder, is a pervasive medical condition in which one becomes reliant upon marijuana. Addicted individuals continue to use despite physical, cognitive, emotional, social, and legal consequences. Despite societal debate as to whether marijuana is addictive, statistics strongly support that it is. It is treatable, and there are many available treatment options.
What Is Marijuana Addiction?
Marijuana addiction, which is clinically referred to as cannabis user disorder,6 is a diagnosable medical condition that necessitates treatment. Recent numbers have estimated about 4 million Americans meeting the diagnostic criteria for cannabis use disorder,7 with nearly 138,000 seeking treatment voluntarily.8,9 Given the numbers, this is a relatively common condition that warrants appropriate attention.
Marijuana is the most commonly used illicit substance in the United States and Europe.1 55 million American adults (16.9% of the population) acknowledge being current users or having used at least once in the past year.2 Like alcohol or any other drug, it is possible to become addicted to marijuana.3 In fact, about 1 in 10 marijuana users will become addicted while for individuals who begin under age 18 that number increases to 1 in 6.3
To address the argument that marijuana is not as addictive as other drugs, a study determined that of the major medically classified drugs (including alcohol), that marijuana was ranked number 11.4,5 Heroin and cocaine rated highest; however, alcohol and tobacco rated higher than marijuana as well.5
How Is Marijuana Addiction Diagnosed?
Marijuana use must meet several diagnostic criteria in order to be considered an addiction.
Clinical criteria for cannabis use disorder are as follows:
A problematic pattern of cannabis use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:6
- Cannabis is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts 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 results in failure to fulfill 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 in which it is physically hazardous.
- Cannabis use continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
- Tolerance, as defined by either: (1) a need for markedly increased cannabis to achieve intoxication or desired effect or (2) a markedly diminished effect with continued use of the same amount of the substance.
- Withdrawal, as manifested by either (1) the characteristic withdrawal syndrome for cannabis or (2) cannabis is taken to relieve or avoid withdrawal symptoms.
Severity is rated among mild, moderate, or severe if 2-3, 4-5, or 6+ of the above criteria are met. Note that one need not consume marijuana daily to be addicted. Marijuana associated thoughts, cravings, and withdrawal are still associated with the addiction even if not consumed daily.
Who Is at Risk of Becoming Addicted?
Anyone who consumes marijuana and does not take proper precautions is at risk of becoming addicted. As the alcohol advertisements on television remind consumers to “drink responsibly,” the same applies here. The game has changed a bit now, as 15 states in addition to Washington D.C. have legalized marijuana for adults 21 and older. Many other states have mixed laws regarding use as well. In either respect, the pathway to addiction tends to begin with increased consumption.
Although anyone can ultimately become addicted, there are certain factors that may increase the likelihood of it happening. Such factors may include but are not limited to:10
- Genetic predisposition
- Availability of marijuana
- Potency of marijuana
- Vulnerability to drug addiction
- Past history or current experience of trauma
- Chronic pain or illness
- Mental health or other substance use disorder (potentially developing a cross addiction)
Those impacted by any of the above are at higher risk for developing marijuana addiction and should consult a professional if either taking or considering taking for recreational or medicinal purposes.
How Marijuana Affects the Brain
The active agent within marijuana that creates the euphoric high is tetrahydrocannabinol (THC). THC has a similar structure to a natural chemical, anandamide, in the brain.11 This allows it to act like a neurotransmitter, which sends chemical messages throughout the nervous system.11 Areas of the brain affected include those that influence pleasure, memory, thinking, concentration, movement, coordination, and sensory and time perception.11
Upon consumption, the pleasure pathway is activated in the brain, and users experience an elated state. People are hardwired to gravitate toward those things that bring them pleasure. This is a natural survival trait that ensures we eat food and drink water but also crosses over to substances and other behaviors that are addictive.
Signs of Marijuana Addiction
As with most any other addiction, signs of marijuana addiction oftentimes manifest through gradual but drastic behavioral changes. For children and teens this may include acting out, becoming withdrawn, sleeping odd hours, refusing to answer questions, being secretive, hanging out with new people, struggling with school, not completing household chores, changes in eating habits, etc.
For adults and seniors, similar signs may present themselves, however, the changes may also include relationship and/or marriage issues, struggles with meeting parental obligations, decline in work performance, loss of interest in sex and/or decline in performance, and financial issues.
Regardless of age, the signs of someone currently intoxicated are similar, including the following:6
- Recent use of cannabis
- Clinically significant problematic behavioral or psychological changes (e.g., impaired motor coordination, euphoria, anxiety, a sensation of slowed time, impaired judgment, social withdrawal) that developed during, or shortly after, cannabis use
- At least two of the following signs, developing within 2 hours of cannabis use: red eyes, increased appetite, dry mouth, tachycardia
- Symptoms not due to a general medical condition and not better accounted for by another mental disorder
- Specify if perceptual disturbances are present: hallucinations with intact reality testing or auditory, visual, or tactile illusions occur in the absence of delirium
These signs are important to recognize, as individuals struggling with marijuana addiction will continue to use more frequently and perhaps in higher potency. This is consequent to the cycle of cravings and withdrawal. When use increases, it is likely that one will notice these signs as well as others which may include noticing the smell of marijuana, finding marijuana paraphernalia, hearing one talk about marijuana more frequently, issues with short-term memory, and partaking in more activities that one tends to enjoy more while high.
Symptoms of Marijuana Addiction
The symptoms of marijuana addiction vary by individual and extent to which one uses. Note that many of the common symptoms are similar to those experienced while intoxicated. With addiction, however, these symptoms may become more pervasive and severe in intensity.
Some of the symptoms of marijuana addiction are as follows:12
- Anxiety
- Bloodshot eyes
- Distorted perception
- Dizziness
- Dry mouth
- Feeling “high” or euphoria
- Impaired coordination
- Impair judgment
- Increased appetite
- Lack of motivation
- Memory impairment
- Nervous or paranoid behavior
- Relaxed state, sleepiness
- Slowed or poor coordination
- Slowed reaction time
- Weight gain
The more symptoms present, especially while not actively using, the greater likelihood that one is struggling with marijuana addiction.
When Does Marijuana Use Become Addiction?
Marijuana becomes an addiction when it gets to a point where it is not only consuming one’s life, but use continues despite the consequences. It is no longer something used casually and becomes a necessity. Note that this distinction does differ from medicinal use.
For medicinal users, addiction is primarily indicated by misuse of the drug. In the case of prescribed medical use, there is a likelihood of one developing dependence. For more information regarding addiction versus dependence, please see the article Addiction vs Dependence: Understanding the Differences.
For both recreational and medicinal marijuana users, the shift from appropriate use to an addiction is indicated by the following:13
- Continuing to take a drug when it is no longer medically necessary
- Requiring increased amounts of a substance to achieve the desired effect
- Experiencing emotional instability, lethargy, or physical discomfort when the effect wears off
- Regardless of a desire to stop one continues using despite the consequences
- Much time is spent thinking about and acquiring the substance of choice
- Boundaries consistently become blurred and broken, which includes using increased amounts of a substance over longer periods of time than intended
- Engaging in physically hazardous activities to self or others while under the influence
- Stealing or borrowing money to pay for the substance
- Becoming distant from and struggling to get along with loved ones and friends
- Getting too much or too little sleep
- Eating too much or too little
- Beginning to physically change in appearance
- Surrounding oneself by only those who engage in the same problematic behavior
- Doctor shopping for prescription drugs or stealing them from others
- Combining prescription drugs with alcohol and recreational drugs
Health Risks of Marijuana Addiction
Although medicinal use of marijuana has proven medical benefits, recreational use or abuse of medical marijuana that leads toward addiction may include a number of short- and long-term associated health risks. Some of these risks include a negative impact on brain health, mental health, athletic performance, driving, baby’s health and development, and daily life.14 The more one consumes, the higher the risk of associated health risks.
Short-Term Health Risks
Short-term health risks are those that tend to occur during use and shortly thereafter. The risks are acute but may impair an individual to the extent that additional hazards are possible. For instance, troubles with thinking combined with an altered sense of time make it difficult to functionally operate a vehicle. Problems with body movement may increase the likelihood of trips, falls, and other bodily injury.
Common short-term health risks of marijuana use are as follows:9
- Altered senses, such as seeing brighter colors
- Altered sense of time, such as minutes seeming like hours
- Changes in mood
- Problems with body movement
- Trouble with thinking, problem-solving, and memory
- Increased appetite
Long-Term Health Risks
Unlike short-term health risks that occur while intoxicated or shortly thereafter, these have lasting effects that extend well beyond use. For those who are using while experiencing long-term health risks, the impact is compounded further.
Long-term health risks of marijuana use are as follows:9
- Problems with brain development. People who started using marijuana as teenagers may have trouble with thinking, memory, and learning.
- Coughing and breathing problems, if you smoke marijuana frequently
- Problems with child development during and after pregnancy, if a woman smokes marijuana while pregnant
Causes & Triggers of Marijuana Addiction
The causes and triggers of marijuana addiction vary. Again, genetic vulnerability is a significant factor. Many individuals who smoke do so casually and in a safe setting. They do not operate heavy machinery, go to work, or try to care for children. In such cases, chronic use may lead toward addiction over a period of months or years.15 For those with genetic vulnerability, however, the onset of addiction may occur much more rapidly.15
Common causes and triggers of marijuana addiction include:
- Accessibility of the drug
- Addictive personality
- Being bored or alone
- Being in a particularly good or bad mood
- Being in the company of others in which one is uncomfortable
- Celebrating a holiday, major life event, or otherwise
- Concealed and or discrete means of use
- Diagnosable mental health or substance use disorder
- Experiencing acute or chronic pain
- Facing significant loss
- Family history of use
- Genetic vulnerability
- Having undergone trauma
- Peers who use
- Struggling to eat without first consuming marijuana
- Struggling with a major loss
- Wanting to enhance a particular experience through use
- When being reminded of a particularly fond memory of using (romanticizing)
- Winning a major victory
It is important to note that when an individual is actively struggling with marijuana addiction that anything can be a trigger.
Treatment for Marijuana Addiction
Because addiction contributes toward more problems than the addiction itself, a form of treatment that is as comprehensive as possible is recommended. The type of treatment and subsequent setting will vary by need and personal preference. Typical settings include outpatient, intensive outpatient (IOP), inpatient (residential), and group. Common types of therapy include cognitive behavioral therapy (CBT), family counseling, and motivational enhancement therapy (MET).
Common Type of Therapies for Marijuana Addiction
Types of therapy used to treat marijuana addiction include the following:
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy focuses on maladaptive beliefs and values that contribute toward problematic thoughts and subsequent behaviors. For example, a common belief is that marijuana is completely safe. The corresponding thought is that it is okay to use. From there the individual consumes marijuana. With therapy, the therapist and patient may work together to adjust the belief to one that accurately recognizes the risks involved. Thoughts become more discretionary, and use is minimized or discontinued.
Family Counseling
Family counseling is helpful in cases where the family has been impacted by the use of a single member or in which there are multiple users. With the help of a therapist, the family may become properly educated on marijuana, process through emotional disturbance, set boundaries, and work on healthier communication. The benefit here is that everyone may work together to support and hold one another accountable.
Motivational Enhancement Therapy (MET)
Motivational Enhancement Therapy “helps individuals resolve their ambivalence about engaging in treatment and stopping their drug use. This approach aims to evoke rapid and internally motivated change, rather than guide the patient stepwise through the recovery process.”16 Because one must be motivated to change for progress to be made, MET provides a sort of jump start toward the therapeutic process. Not only does one become increasingly motivated toward positive treatment outcomes but also other areas of life.
Intended Treatment Outcome & Timeline
Fortunately, the intended treatment outcome and timeline for recovery is relatively promising for those who are motivated enough to go through the recovery process. Internal (intrinsic) motivation is critical here, as that this the single most determining factor toward success. Although addiction is treatable and not curable, one may progress into a maintenance stage of recovery relatively quickly should one abstain from using while engaging in treatment.
Lifestyle Changes
Many substance use professionals tell patients that they must change their “persons, places and things” for recovery to be possible. This is important, as anything may serve as a trigger in an addicted mind. For those who intend to take recovery seriously, one is encouraged to distance from anything and everything that may trigger use while engaging those that will promote recovery. Otherwise, it is increasingly likely that one will resort back to using thoughts and behaviors, which ultimately continue the cycle.
Medication
At present, there are no FDA approved medications that have demonstrated consistent effective treatment of marijuana addiction.17 One consideration clinically tested in controlled laboratories is buspirone.17 There are medications that reduce symptoms of withdrawal, which are particularly useful coupled with the beginning stages of therapy.17 It is important to consult a medical professional if considering taking any of these medications and to take any other prescription medications as prescribed.
How to Get Help for a Marijuana Addiction
To get help for marijuana addiction, one may start by conducting a web search, calling the local health department, or contacting one’s managed care provider. When options are presented, the next step is to research each one.
Appropriate questions to ask a car provider may include:
- Do you treat marijuana addiction?
- What type of therapy do you use for marijuana addiction?
- What age groups do you serve?
- What have been common treatment outcomes for patients past and present?
- What are your days and hours of availability?
- Do you accept my insurance?
- What are the associated out of pocket costs?
If one is looking for an additional adjunct to therapy or necessitates something lower cost or free, support groups are an appropriate option. Support groups are available both in person and virtually. Within these groups are facilitators and leaders who can answer questions and provide appropriate guidance. Members also rely on one another for support and accountability.
How to Get Help for a Loved One
Becoming informed about marijuana use, addiction, and available treatment options will help you maneuver the process and better support your loved one. When ready to confront your loved one about the addiction, it is recommended to remain as emotionally supportive and objective as possible. Listen to what is said and respond empathically. Roll with any resistance. Be sure to listen but also set boundaries.
Moving forward, be sure to continually remain supportive but maintain boundaries. Any flexibility here may continue to exacerbate the issue. When your loved one is ready for treatment, ask what is needed, provide the requested support, and allow the therapist and your loved one to take over from there. Anything needed from that point onward will be brought to your attention.
Marijuana Addiction Statistics
There are numerous annual studies that explore marijuana addiction in depth. In a compilation of the most noteworthy marijuana statistics in the United States, the National Center for Drug Abuse Statistics reported the following:2
- 55 million adults (16.9% of the population) currently use marijuana
- 45% of the population has tried marijuana at least once
- 72% believe that regular alcohol use is more of a health risk than regular marijuana use.
- 76% believe it is less harmful than tobacco and 67% believe it is less harmful than prescription painkillers.
- 56% believe that marijuana use is socially acceptable.
- 24% of 12th-graders reported using marijuana the past year (2017).
- Approximately 55 million reported using marijuana within the past year, which is higher than the 36.5 million current tobacco smokers.
- Marijuana use exceeded daily cigarette use for 8th, 10th, and 12th graders (2017).
- 53% of adult users (current or past) report first marijuana use between ages 12-17.
- 19% of teen drivers reported driving under the influence of marijuana.
- 13% of young users will become dependent upon marijuana.
For more useful statistics on marijuana and other addictive disorders, one may visit credible resources such as SAMHSA, NIDA, and the CDC.
Living With Marijuana Addiction
Living with a marijuana addiction will present challenges but is manageable so long as one remains intentional and consistent with recovery. During and after treatment one is privy to a host of knowledge, insights, and healthy coping skills to help work through cravings and other triggers. When met with struggle, it is important to reach out for help.
SAMHSA’s eight dimensions of wellness are a great way to conceptualize those activities that support recovery.18 These dimensions are conceptualized across one’s emotional, environmental, financial, intellectual, occupational, physical, social, and spiritual well-being.18 If kept in healthy balance, individuals may find living with marijuana addiction more manageable.
Common strategies to assist one living with marijuana addiction are as follows:
- Attending support groups
- Avoiding activities in which one traditionally uses
- Distancing from triggering persons, places, and things
- Eating healthier and exercising
- Engaging in healthier activities and hobbies
- Journaling or partaking in a healthy creative expression
- Meditating or praying
- Removing marijuana and marijuana paraphernalia from the home
- Seeing a therapist
- Speaking with regular support often and especially when going through a difficult time
This list is by no means all-inclusive but serves as a foundation toward finding ways to distance oneself from use.
Marijuana Addiction Tests, Quizzes, & Self-Assessment Tools
Marijuana addiction tests, quizzes, and self-diagnosis tools are useful toward determining whether one has an issue and to what extent. Some tools are meant for professional use while others are available for self-diagnosis. Note that no one tool is the answer to everything but provides a start toward the recovery process.
Tests Performed by Professionals
Tests performed by professionals are recommended, as these have a strong evidence basis through research. Further, professionals are trained and experienced in their administration. One common test used by professionals is the Cannabis Use Disorder Identification Test – Revised (CUDIT-R).19
Quizzes & Self-Assessment
Quizzes and self-assessment tools are useful toward indicating a potential problem. Proceed with caution while using such tools, however, as some may not prove as credible as others. Further, those not trained in diagnosis should never diagnose. This should always be left to a trained professional. If you do choose to begin with one of these tools and a problem is indicated, the next step is to contact a professional.
For Further Reading
The following are helpful resources for anyone impacted by a marijuana addiction:
