‘Cannabis use disorder’ is a real thing despite contrary perceptions
The stereotype of a teenage stoner glued to the couch doesn’t represent all cannabis users, but it also isn’t without basis, says Trisha Seastrom. “Marijuana has an impact on motivation that, in the adolescent brain, is particularly insidious,” she said. “Young people often find that they’re not achieving the goals they set for themselves.”
A lack of motivation isn’t the only negative side effect of heavy pot smoking. Many of the young people Seastrom works with as a licensed drug and alcohol counselor reach a point where cannabis impacts their daily functioning. Some “wake and bake”—or use first thing in the morning—to avoid physical and psychological withdrawal symptoms, she said. Others become extremely anxious if they don’t get the right dosage throughout the day.
It’s a pattern of abuse that can negatively affect performance at school and work as well as personal relationships, she added.
Seastrom is the program director of Chico State’s Campus Alcohol and Drug Education Center (CADEC). Speaking generally about attitudes toward marijuana—not just among college students—she says there’s a common perception that there’s no such thing as cannabis addiction, and if there is, it’s not that bad of a condition. However, the scientific and medical communities hold that marijuana addiction exists and causes harm. “Cannabis use disorder” is recognized by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), considered the bible for psychiatrists, as a spectrum that ranges from mild to severe.
“It is a psychoactive drug that leads to tolerance and withdrawal,” Seastrom said, “which are hallmarks of physical dependence.”
Nationally, young people’s attitudes toward marijuana are trending toward greater acceptance, according to the University of Michigan’s annual Monitoring the Future report, which surveys about 50,000 students in eighth, 10th and 12th grades throughout the U.S.
In 2015, the percentage of students who reported using cannabis remained virtually unchanged from the year before—about 24 percent. However, the percentage of students who perceive smoking it to be a “great risk” was the lowest ever recorded in the study: 58 percent in eighth grade; 43 percent in 10th grade; and 32 percent in 12th grade.
Over the last few years, Seastrom says, colleges throughout the U.S. are seeing more young people seek treatment in substance abuse programs for cannabis alone. On top of society’s normalization of the drug, Seastrom attributes this to pot’s increasing potency. Compared with when Seastrom went to high school in the 1970s and ’80s, strains today are much higher in tetrahydrocannabinol (THC), the psychoactive ingredient in cannabis.
“The THC content has become so high and growing techniques have become so sophisticated—all you have to do is Google it—people are developing more profound dependencies,” she said.
Dr. Ruben Baler is a health science administrator with the National Institute on Drug Abuse, a Maryland-based organization dedicated to advancing addiction science. It sponsors research on the health aspects of drug abuse and addiction, including the Monitoring the Future report.
Speaking with the CN&R by phone, Baler said the latest edition of the DSM reflects a shifting paradigm regarding addiction in general. The vagueness of terms such as “physical dependence,” “psychological dependence” and “addiction” only feed confusion.
“DSM moved away from those terms because they don’t mean much,” he said. “Medical professionals and scientists now are recognizing that these disorders are dimensional; they’re spectrum disorders. That means they come in many different flavors with different grades of severity.
“There is a number of criteria to define a person with a substance use disorder, but we will not say you have it/don’t have it,” he continued. “We say to what degree you’re suffering from a substance use disorder.”
Such conditions are defined by the behaviors they entail, Baler said. Users act compulsively despite potentially damaging consequences “but they just can’t control themselves.” In that regard, cannabis is a substance of abuse like any other.
“You definitely can be quote-unquote ‘addicted to cannabis,’ and you definitely can suffer from the use disorder,” he said. “And the proof is in the pudding—you can go to the emergency room because of withdrawal symptoms.
“It’s a myth that cannabis is a benign drug that cannot cause addiction.”
Still, it’s not nearly as addictive as, say, nicotine. Nearly half of U.S. adults have smoked marijuana at some point in their lives, according to a Pew Research Center poll, and about 9 percent of people who try it develop some level of use disorder, Baler said. That’s similar to alcohol, but far below nicotine—about one-third of people who try smoking cigarettes become addicted. As with all substances of abuse, the earlier someone starts, the higher their risk of developing a problem later in life, he said.
The symptoms of withdrawal from cannabis aren’t nearly as bad as from harder drugs such as heroin, cocaine and methamphetamine, Baler said. The most common are lack of appetite, problems sleeping, irritability and anxiety. Depending on the level of use, those symptoms may be magnified, he added.
“If you’re further along in the severity of the disorder,” he said, “you will feel the withdrawal symptoms more severely as well.”
The good news, Baler says, is that all substance use disorders are treatable. “If you feel like you are suffering from a cannabis use disorder—you probably can tell if you are or you’re not—seek professionals trained to help you on the recovery trajectory,” he said.
Relapsing is an expected part of the process, Baler emphasized.
“It is not a sign of failure of treatment,” he said, “it a sign of a condition that is chronic and relapsing, like diabetes or hypertension. You have to stick with it.”