Marijuana addiction (cannabis use disorder): Is marijuana addictive?

Is Marijuana Addictive?

Yes, marijuana can be addictive. However, most people who use it do not become addicted to marijuana – instead, they’re able to control where, when, and how often they use it. They also aren’t surprised (or, most importantly, hindered) by the resulting effects.  

Again, though, this substance can be addictive, and some cannabis users do develop a cannabis dependence. This is formally and clinically known as cannabis use disorder (CUD), sometimes referred to as marijuana use disorder and – less often – THC use disorder. According to the CDC, recent research says that around 3 in 10 people who use marijuana have a marijuana addiction. 

What Is Cannabis Use Disorder? DSM-5 Definition

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), cannabis use disorder is characterized by “a problematic pattern of cannabis use leading to clinically significant impairment or distress.” 

For example, those with cannabis use disorder might spend an excessive amount of time obtaining or using marijuana, experience strong urges to use, and fail to follow through on their work duties as a result. 

The buds, stems, and seeds of the cannabis sativa plant contain Delta-9-TetraHydrocannabinol (THC), which is responsible for most of the psychological effects of cannabis (such as hallucinations, disorientation, and depersonalization).

Cannabis Use Disorder Symptoms

As with any form of substance abuse or substance use disorder, a core symptom of cannabis addiction is excessive time and money spent on getting and/or using the substance. That said, the DSM-5 says that for someone to be diagnosed with cannabis use disorder, they must experience at least two of the following symptoms within a year’s time:

• Marijuana use in larger amounts or over a longer time than originally intended
• Repeated unsuccessful attempts to stop or lessen the amount of cannabis used
• A significant amount of time spent trying to get, use, and/or recover from marijuana
• Intense cravings for cannabis
• Recurrent marijuana use resulting in failure to fulfill work responsibilities at work, school, or home
• Continued cannabis use despite its negative consequences (such as being left by a partner or friends, poor job performance, or even criminal charges)
• Important activities (personal or professional) are reduced or given up because of marijuana use.
• Marijuana use in dangerous situations, such as while driving a car
• Continued use despite physical and/or psychological problems it has caused
• Tolerance, in which the cannabis effect diminishes with continued use and/or the individual needs to use larger amounts of marijuana to achieve the desired effect
• Withdrawal, as manifested by typical withdrawal symptoms and/or cannabis use to relieve or avoid withdrawal

The severity of cannabis use disorder is determined by the number of symptoms one displays and divided into three categories:

Mild Cannabis Use Disorder

The disorder is considered mild if an individual displays two or three of the above symptoms.

Moderate Cannabis Use Disorder

For the disorder to be considered moderate, a person must exhibit four or five of the above symptoms.

Severe Cannabis Use Disorder

The diagnosis of severe cannabis use disorder is when an individual shows six or more of the above symptoms.

Risk Factors for Marijuana Addiction

Most people who use cannabis begin in early adolescence or as young adults. Individuals might be more likely to develop cannabis use disorder if they…

• Have family members who smoke cannabis or a family history of substance dependence
• Have a history of tobacco smoking
• Have been diagnosed with conduct disorder or antisocial personality disorder
• Are of low socioeconomic status
• Are abused by family members or have unpredictable family circumstances
• Are easily able to obtain marijuana

Mental and Behavioral Disorders Due to Use of Cannabinoids

Other cannabis-related disorders, as outlined in the DSM-5, are cannabis intoxication, cannabis withdrawal, cannabis-induced psychotic disorder, cannabis-induced anxiety disorder, cannabis-induced sleep disorder, cannabis intoxication delirium, and unspecified cannabis-related disorder (in which symptoms of a cannabis-related disorder are present but the individual does not meet complete criteria). 

Marijuana Addiction Treatment Options: How to Treat CUD

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, they might finish their education, begin a career, and/or start a family. With these responsibilities, the risks often outweigh the rewards of using cannabis – and the result is that they either stop or reduce 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 amotivational syndrome, which is a gradual shift to indifference and apathy – goals remain unmet, no new goals are set, everyday tasks are left unfinished, and responsibilities are neglected. This impact of 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 recovering and stopping marijuana use. It’s often treated with individual therapy and 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 do so.

Psychoeducation is also used, in order 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 one’s marijuana addiction.

Twelve-step groups can also help in recovery by offering support, accounting for one’s 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.