While many cannabis users would probably say that there’s no such thing as a cannabis addiction, many others are adamant that cannabis is an addictive product.
With the global surge of cannabis legalization we’re currently witnessing (and subsequent wider acceptance by society), both the rookies in the cannabis world, and the general public are concerned about the possible addictive traits of pot. This concern is of course completely legitimate, but unfortunately the answer to this question isn’t simple at all.
In medical circles the term “cannabis addiction” is used in extremely rare occasions, while phrases like “cannabis use disorder” and “cannabis dependence” are much more prevalent.
So, is cannabis addictive or not?
It’s very important to point out that cannabis isn’t physically addictive like heroin, cocaine or tobacco. Believe it or not, coffee (precisely caffeine) is actually more addictive than cannabis.
The most important factor in developing an addiction to cannabis is an individual’s biochemistry, and approximately only one out of ten people are prone to become psychologically addicted to the active ingredients in pot (cannabinoids).
For a large percentage of cannabis consumers, a responsible and moderate use of cannabis will not result in any damage to physical and mental health (apart from the obvious harm done by smoking).
Dependence vs addiction
For medical experts, addiction has to cover both the physical and the psychological compulsive need to use a substance (or for instance gambling, which clearly isn’t a substance, but also has an addictive effect), without considering the possible detrimental consequences.
Both of these two characteristics have to exist to consider a person addicted to something.
What differentiates addiction from dependence is that addiction eventually leads to behavioral patterns which become more difficult to resist over time, and accompanying biochemical changes in the brain caused by the abuse of that particular substance.
Another important thing to consider is the difference between physical and psychological addiction.
Substances like alcohol, heroin and cocaine can cause severe physical addiction. People with these kinds of addictions need the substance to function “normally”. If they don’t take the substance, they’ll go through a painful withdrawal phase.
Unlike the physically addicted, people with psychological addictions don’t go through the process of withdrawal once they stop using a substance.
Simply said, people who’re psychologically addicted to something think they need that substance to feel and function better, but they actually don’t.
Dependence, on the other hand, is somewhat similar to addiction and is usually a part of it, but in no way is it the same.
Dependence doesn’t interfere with behavioral patterns, however, by avoiding the substance we have a dependency on we can also cause withdrawal symptoms. In this instance they are much milder than with substances that cause physical addiction.
Dependency is a disorder which is usually associated with prescription medication like painkillers, ADD drugs, antidepressants and other similar narcotics.
Tolerance is a completely different story.
Tolerance is gradually built up when the substance is used continuously. After an extended period of continuous use, our body becomes resistant to that substance (which lessens the effects of it), and because of this we require larger quantities to feel the same effect.
A frequent uninterrupted use of cannabis usually builds up a tolerance quite quickly, but luckily it only takes a few days of abstinence for things to go back to normal.
What’s a cannabis use disorder?
As I previously mentioned, the phrase cannabis addiction isn’t heard that often in the medical community.
Even though there are some slight disagreements in the opinions of experts, most of them agree that a cannabis use disorder would be a much more fitting term for people who overindulge in weed.
In 2013, American Psychiatric Association has issued The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (which is also known as DSM-5). This manual has cannabis use disorder listed among the other disorders.
In the DSM-5, there are 11 differing criteria that precisely describe the cannabis use disorder. In order to be diagnosed, a person would need to meet at least two of the following criteria:
- Cannabis is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control cannabis use.
- A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its effects.
- Craving, or a strong desire or urge to use cannabis.
- Recurrent cannabis use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.
- Important social, occupational, or recreational activities are given up or reduced because of cannabis use.
- Recurrent cannabis use in situations in which it is physically hazardous.
- Cannabis use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
- Tolerance, as defined by either a need for markedly increased cannabis to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount of the substance.
- Withdrawal, as manifested by either the characteristic withdrawal syndrome for cannabis or cannabis is taken to relieve or avoid withdrawal symptoms.
This manual received negative critics from cannabis advocacy groups, as both recreational and medical cannabis consumers weren’t pleased with what constitutes as a cannabis use disorder.
The main reason for the disapproval was because most patients who use cannabis as a medication will probably meet more than two of these criteria.
For example, if a patient is using cannabis for depression, he’ll mostly likely meet criterion number 10, as it’s normal for someone to develop a tolerance when consuming cannabis for depression. He’ll also be easily irritable and probably experience trouble falling asleep without the use of cannabis.
Experts also added that meeting two of these criteria can be just fine, because frequent users can enjoy cannabis on a daily basis, and once they decide to abstain from cannabis they most likely won’t experience any harsh withdrawal symptoms whatsoever.
In 2012, a comparison study was performed on the panel members of DSM-4 and DSM-5. The authors found that 69% of panel members had direct financial ties with the pharmaceutical industry, which had a long history of downplaying cannabis. (1)
Unfortunately this wasn’t an isolated incident regarding DSM panel member and their involvement with Big Pharma, which is quite important when we question the validity of their claims.
To conclude, the majority of both recreational and medicinal cannabis users won’t experience any of the symptoms listed above after quitting cannabis, but around 9% of users will experience some negative symptoms and meet more than two criteria from the DSM manual. (2)
Cannabis is truly a powerful medication, which is a conclusion based on so many scientific studies that confirm this claim, but sometimes it can impact people differently, and usually after long periods of use.
If cannabis consumption starts to negatively impact your quality of your life (or the people around you), or if you feel that you’re unable to stop using it, there’s a good chance that you’re in that small group that’s genuinely addicted to cannabis.
Most cannabis consumers will never experience any withdrawal symptoms. Around 90% of users can stop at any time without any negative consequences.
However, withdrawal from more addictive substances is a completely different story, as it affects a much larger percentage of people and produces extremely unpleasant withdrawal symptoms.
Once someone stops taking an addictive substance they’ve been using regularly, a plethora of unpleasant physical and psychological difficulties start to happen.
Some of the common substance withdrawal symptoms are tremors, vomiting, insomnia, depression, flu-like symptoms and even delirium.
But because cannabis is a completely natural substance, abstinence doesn’t cause severe withdrawal symptoms, unlike addictive drugs like heroin or cocaine.
A small percentage of pot users will feel discomfort, have restless sleep with intense dreams, changes in appetite, and some also may experience anxiety. These symptoms are just temporary and are closely associated with THC.
The duration of these manifestations ranges from a couple of days to two weeks, and only a small portion of cannabis users will go through a withdrawal phase.
These symptoms occur because cannabinoids (like THC) bind to the same cellular receptors as our own internal endocannabinoids. The human body becomes accustomed to an increased volume of cannabinoids, and reduces the number of cannabinoid receptors to maintain balance. Once we stop using cannabis, though, these receptors grow back to normal.
What’s also fascinating is that you can treat THC withdrawal symptoms with the non-psychoactive cannabinoid — CBD. This study from 2013 showed (3) that CBD therapy helped one 19 year old girl tremendously with her cannabis withdrawal.
For most cannabis users, the plant is not considered harmful at all. As a matter of fact, it’s used for treating all sorts of medical conditions and illnesses.
Cannabis is very safe to use, but it can make a small percentage of people struggle with the psychoactive effects that THC produces.
Also, heavy users will most likely have bigger issues when cutting down the amount of weed they use on a daily basis.
If you feel like cannabis has lowered the quality of your life, or that it negatively affects your productivity, worsens your relations with the people around you, perhaps it’s time to get some help and quit using it altogether.
- Cosgrove L, Krimsky S; A comparison of DSM-IV and DSM-5 panel members’ financial associations with industry: a pernicious problem persists; 2012; 9(3):e1001190
- Lopez-Quintero C, Pérez de los Cobos J, Hasin DS, Okuda M, Wang S, Grant BF, Blanco C; Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC); Drug and Alcohol Dependance; May 2011; 115(1-2):120-30
- Crippa JA, Hallak JE, Machado-de-Sousa JP, Queiroz RH, Bergamaschi M, Chagas MH, Zuardi AW; Cannabidiol for the treatment of cannabis withdrawal syndrome: a case report; Journal of clinical pharmacy and therapeutics; April 2013; 38(2):162-4