Cannabis use disorder is the continued use of cannabis despite it causing serious distress or impairment. The strong desire to use the drug causes difficulties in controlling its use, and people with the disorder continue to use it even when there are harmful results.

The buds, stems, and seeds of the cannabis sativa plant contain amounts of Delta-9-TetraHydrocannabinol (THC), which is a psychoactive compound found in the plant, according to the National Institute of Drug Abuse. The highest concentrations are found in the bud of the plant.

According to the American Psychiatric Association (APA), most people who use cannabis begin in early adolescence or as young adults.

DSM-5 Symptoms of Cannabis Use Disorder F12.20

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) which is published by the APA, provides the following criteria for cannabis use disorder:

Using cannabis for a minimum of one year with the presence of at least two of the following symptoms accompanied by serious impairment of functioning and agitation.

  • Used in larger amounts over a longer time than what was intended.
  • Repeatedly tried to stop or lessen the amount of cannabis used.
  • Unusual amount of time is spent trying to get, use and/or recover from cannabis effects.
  • Having cravings for cannabis, such as thoughts and images, dreams, and perceiving its smell because of an obsession with it.
  • Keep on using cannabis even in light of the fact that it has negative consequences, such as others warning to leave the relationship or being left by a partner or friends, poor job performance, and criminal charges.
  • Using cannabis is more important than other areas of life—job, school, hygiene, and responsibilities to family members and friends.
  • Using cannabis and taking dangerous risks, such as driving a car.
  • Using cannabis even though the person is aware of the physical and psychological problems they have because of it (lack of motivation, chronic cough).
  • Builds a tolerance to cannabis—taking larger amounts to get the psychoactive effect experienced when it was first used.
  • Cannabis is used to halt the symptoms of withdrawal.

The severity of cannabis use disorder is separated into three categories depending on the number of symptoms the person displays, according to the APA.

Mild cannabis use disorder DSM-5 (305.20 F12.10) 
The disorder is considered mild if an individual displays two or three of the above symptoms.

Moderate cannabis use disorder DSM-5 (304.30 F12.20) 
For the disorder to be considered moderate, a person must exhibit four or five of the above symptoms.

Severe cannabis use disorder DSM-5 (304.30 F12.20) 
The diagnosis of severe Cannabis Use Disorder is when an individual shows six or more of the above symptoms.

DSM-5 Risk Factors of Cannabis Use Disorder

There are several risk factors for cannabis use disorder, according to the DSM-5, including:

  • Family history of chemical dependence
  • History of conduct disorder or antisocial personality disorder
  • Low socioeconomic status
  • History of tobacco smoking
  • Abusive family
  • Unpredictable family circumstances
  • Family members who smoke cannabis
  • Poor performance in school
  • Easy to get cannabis
  • Drug-tolerant culture

DSM-5 Health Risks Associated with Cannabis Use Disorder

Several long-term health risks are related to cannabis use disorder, including:

  • Chronic obstructive pulmonary disease (COPD)
  • Chronic inflammation of the upper respiratory tract and bronchitis
  • Damage to the cilia (slim protuberances that project from the larger cell body), which can cause frequent and serious upper respiratory infections, such as influenza and rhinovirus
  • Raised heart rate and blood pressure that can harm people with pre-existing heart disease
  • Damage to male and female reproductive system (clinical research is being done, and the impact is not completely understood)
  • Increased risk of cancers, such as lung, oral cavity, and esophagus

What is the Treatment for DSM-5 Cannabis Use Disorder?*

Many people won’t go beyond the mild form of cannabis use disorder and will commonly use cannabis in their teens and early 20s. As they get older, someone might finish their education, begin a career, and/or start a family. With these responsibilities, the risks might seem to outweigh the rewards of using cannabis. The result is either stopping or reducing the use of cannabis with no impact on functioning.

However, others will continue to use cannabis frequently and in large amounts. Long-term use of cannabis is related to amotivation syndrome, which is a gradual shift into indifference and apathy—goals will be unmet, no new goals will be set, everyday tasks will be left unfinished and responsibilities will slowly be neglected. The impact of the long-term use may cause the quality of the person’s life to be debilitated, and they may not reach their full potential.

When a person seeks treatment for cannabis use disorder, they have a great chance of stopping its use. Many people realize that using cannabis is hindering them in achieving success, but they’ve been unable to stop on their own. They either enter treatment because of the criminal justice system or family members are pressuring them. A serious roadblock to finding treatment may be that someone needs to be convinced that their drug use is causing problems. Often, the tolerant culture that accepts the use of cannabis, false information on the Internet and with other users, as well as indifference to cannabis use can create barriers for the person to seek treatment.

Cannabis use disorder is often treated with individual or group therapy following the rational emotive behavior therapy model, which can help the person with the disorder realize the dysfunctional thought patterns from its use and replace them with adaptive thinking. People with the disorder learn to recognize, tolerate, and manage their emotions instead of using cannabis to help manage their moods.

Psychoeducation is used to challenge the false beliefs individuals have about cannabis use, such as thinking its use causes no harm. This type of education provides factual information about the addiction.

Twelve-step groups can also help in recovery in offering support, accounting for the behavior, and motivating the individual to stop cannabis use. In addition, attending 12-step groups can be helpful in replacing the relationships that are harmful (people who continue to use cannabis that the individual used to spend time with) with healthier relationships. The connections with sober, responsible individuals can model healthy behavior and offer incentive and encouragement to help the individual remain free of cannabis.

*The DSM-5 doesn’t give specific treatment options for cannabis use disorder.

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