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As more people around the world are prescribed (and self-prescribe) cannabis, there is a pressing question deserving of deeper analysis: Is cannabis addictive?

It’s a complicated question because addiction can be physical or psychological, or both. Although only affecting a minority of users, cannabis has long been known to be more psychologically addictive than physically addictive. 

Clinical psychologist Jonathan N. Stea summed up the oft-cited data in a recent article when he stated: “Approximately one out of 10 people who ever try cannabis at least once during their lifetime will likely become addicted1.” He goes on to say, “Put another way, this means that about 90 percent of people who try cannabis do not become addicted. While the chances of becoming addicted to other drugs can be higher, such as to alcohol, cocaine, heroin, and nicotine, the story is similar with cannabis: The majority of people who try these drugs do not become addicted.

”While Stea didn’t clarify if he meant psychologically addicted or physically addicted, it’s important to clarify the distinction between the two: First, as UCLA’s Adi Jaffe points out2, “addiction is as both a psychological addiction AND a physical addiction that are inextricably linked through our psyche's presence in the brain.” 

With physical addiction the body grows accustomed to regularly hosting a drug that provides certain functions and will cease to provide those functions once the cue from the drug is removed. For example, an opioid-dependent brain will not produce endorphins, its natural painkiller, without opioids3

While all addictions are, in some part, psychological, a more mental addiction is closer to the practice of habit-forming, whereupon the user develop a psychological desire for the substance, which could affect their lives in negative ways.

It’s also critical to differentiate between addiction and dependence. As this article highlights4, “physical dependence is not the same as addiction. Physical dependence occurs when the brain adapts to the effects of a drug and develops tolerance. In other words, an individual will require more and more of the drug to achieve the initial positive effect and will rely on continued use of the drug to prevent painful and uncomfortable withdrawal symptoms."

The same article outlines the definition of addiction: “On the other hand, a person who has addiction no longer takes a drug just to feel its effects, but rather to escape withdrawal and simply feel closer to normal. Addiction affects the parts of the brain responsible for decision-making and self-control."

”Other questions worthy of further exploration are whether or not cannabis users go through withdrawal, and if they do, what symptoms of withdrawal do they exhibit."

Research has shown that cannabis withdrawal is similar to nicotine withdrawal. As the CBC reports5: The DSM-5 includes diagnostic criteria for cannabis withdrawal and lists possible signs as including irritability, anger, aggression, nervousness, anxiety, sleep difficulty, decreased appetite, restlessness, depressed mood and some other possible physical symptoms (e.g., abdominal pain, shakiness, sweating, fever, chills, and headache).”  

It is interesting to note that cannabis withdrawal symptoms encompass both the physical and psychological spheres.

British psychology professor Alan J. Budney adds6: “Heavy cannabis users who stop experience withdrawal symptoms that may be somewhat similar to tobacco withdrawal symptoms, but they do not approach the severity nor have the clinical implications of the withdrawal experience by many opiate users.

”Cannabis withdrawal is much more akin to the experience of coffee withdrawal, definitely a very frustrating and uncomfortable experience, but one that luckily is short-lived.

Due to the habit-forming nature of cannabis usage, a consumer could rely on cannabis beyond its medical effects. Some physicians have noticed7 how problematic cannabis users will make statements in surveys such as, “I have trouble quitting. I think a lot about quitting and I can’t do it. I smoked more than I intended to. I neglect responsibilities.”  

Stea found that the more heavy cannabis users may self-prescribe in order “to escape from their emotions.”  Stea believes that such usage is detrimental because it robs their brain of the opportunity to practice coping with emotions in healthy ways.  

Stea further explains, “As a consequence, the brain becomes classically conditioned or trained to respond to difficult emotions by using cannabis. It is as if your brain salivates for cannabis every time you feel anxious, or sad, or angry, just like a dog might salivate when it hears a bell that signifies food."

A commonly quoted reason why cannabis could be more addictive to users today than in the 70s is due to THC potency. In 1995, the average potency of cannabis had a peak of about 4 percent, then reached 12 percent in 2014. THC levels have soared since and as of 2018, average potency reached 20 percent. That potency can even be higher among marijuana extracts, known as “dabs,” which can include anywhere from 40 to 80 percent THC, a Drug Enforcement Administration report stated, according to media reports8.

What is also concerning is that for those who are dependent on cannabis, no effective medications are available to assist these cannabis users. Also, as Leslie L. Iversen writes in The Science of Marijuana9: “Unfortunately there have been very few controlled trials to assess treatment methods, which remain mainly focused on group counseling.

”Understanding the difference between mental and physical addictions, and how dependence varies from addiction, is important for cannabis users to identify, lest they confuse the conditions and either place unfortunate stigmas on themselves or those around them.

  1. https://www.cbc.ca/news/opinion/cannabis-addiction-1.4789187
  2. https://www.psychologytoday.com/ca/blog/all-about-addiction/201007/physical-addiction-or-psychological-addiction-is-there-real
  3. https://www.ashwoodrecovery.com/blog/physical-addiction-versus-psychological-addiction/
  4. https://www.centeronaddiction.org/the-buzz-blog/understanding-difference-between-physical-dependence-and-addiction
  5. https://www.centeronaddiction.org/the-buzz-blog/understanding-difference-between-physical-dependence-and-addiction
  6. Alan J Budney, from Cannabis and Cannabinoid Research, pg 48
  7. https://www.theatlantic.com/health/archive/2018/08/americas-invisible-pot-addicts/567886/
  8. https://www.newsweek.com/marijuana-addiction-teens-risk-health-officials-994531
  9. Via The Science of Marijuana by Leslie Iversen (Oxford University Press)

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