What is Cannabis use disorder (marijuana addiction) and what are its effects?

Also known as weed and pot, marijuana refers to the dried leaves or other parts of the plant Cannabis sativa. It is often smoked, though it can be consumed in other ways too (e.g., in foods). An important chemical in the cannabis plant is tetrahydrocannabinol (THC), which is responsible for the major psychological effects of marijuana.

The short-term effects of consuming marijuana depend on a variety of factors and may include both pleasant and unpleasant psychological and physiological changes, such as distortions in perception (e.g., time slowing down), euphoria (intense feelings of joy), relaxation, increased heart rate, dryness of the mouth and eyes, increased hunger, learning and coordination problems, anxiety, and paranoia. Marijuana is sometimes used for medical purposes—to manage the symptoms of certain painful chronic diseases or side effects of medical treatments (e.g., nausea due to chemotherapy).

Nevertheless, smoking marijuana is associated with a number of long-term physical and mental health consequences. Given that smoking marijuana delivers to the body some of the same harmful substances found in tobacco smoke, it also increases the probability of similar lung and heart conditions. And frequent or long-term use of marijuana has been linked with an increased risk of mental health problems, including psychosis and schizophrenia.

Cannabis use disorder

Over 22 million Americans consume marijuana each month. And one in 10—and for those who started using before age 18, one in six—will become addicted. According to the latest Diagnostic and Statistical Manual of Mental Disorders (DSM–5), the diagnostic criteria for cannabis use disorder (sometimes called marijuana addiction) include:
• Craving for cannabis
• Consuming more or for longer than intended.
• Having trouble controlling one’s drug use.
• Spending much time in getting, using, or trying to recover from the effects of cannabis.
• Failing to fulfill obligations (e.g., at work) due to cannabis consumption.
• Continued use despite worsening interpersonal or social problems.
• Reducing important activities (e.g., socializing) due to consuming cannabis.
• Using the drug in dangerous situations (e.g., while doing manual work).
• Using cannabis despite knowing it has caused or worsened a health condition.
• Experiencing tolerance, such as needing more cannabis to experience a high.
• Experiencing withdrawal symptoms when stopping or significantly reducing drug use.

Common cannabis withdrawal symptoms consist of anger, anxiety, depression, restlessness, sleeplessness, loss of appetite, and a variety of physical symptoms, like shakiness, abdominal discomfort, and headaches.
Many people who regularly consume marijuana do so to cope with physical or mental health problems, like pain, sleep difficulties, and mood problems. Not surprisingly, a large portion of those who have cannabis use disorder also meets the criteria for psychological disorders (e.g., anxiety disorders) and other types of substance abuse conditions.

DSM-5 notes the onset of cannabis use disorder is usually during adolescence or young adulthood. Risk factors include genetics (30-80% of variance), certain mental health issues during childhood and adolescence (e.g., conduct disorder), and environmental factors (e.g., family abuse, family history of drug use, low socioeconomic status).

Because the symptoms of cannabis use disorder may be less severe than certain other substance use disorders, individuals with this disorder may deny having a problem or be reluctant to seek help. Nevertheless, regular and heavy marijuana use is associated with serious adverse effects (e.g., chronic bronchitis, car accidents), and can, over time, cause financial problems, damage relationships, and lower life satisfaction. Therefore, it is essential to bring one’s drug use under control and seek treatment as soon as possible.

This article is provided by Dr. Anthony Mele. Dr. Mele is specialized in the use of dialectical behavior therapy (DBT), motivational interviewing (MI), and attachment theory-based interventions to treat individuals who struggle with multiple addictions, long-standing depression and anxiety, and those who seek to integrate spirituality into their psychological treatment. The most common cannabis use disorder treatment methods are Cognitive-behavioral therapy, Contingency management, and motivational enhancement therapy.