Marijuana and alcohol continue to be the two most abused psychoactive drugs in America. Chronic marijuana use results in significant health hazards, with significantly harmful short and long-term consequences. The marijuana drug user runs significant risk to harming his/her psychosocial, physiological, cognitive, and emotional health. The highly addictive active ingredients in marijuana (cannabis) will continue to cause the heavy (chronic) and addicted (dependent) marijuana user severe health consequences that will negatively affect relationships, learning, memory, tasks and achieving goals.
Marijuana has been used around the world for thousands of years. Recently, Americans have become more accepting of cannabis use. Increasingly, states have begun legalizing possession and sale of cannabis:
Cannabis is by far the most widely cultivated, trafficked and abused illicit drug…About 147 million people, 2.5% of the world population, consume cannabis (annual prevalence) compared with 0.2 consuming cocaine and 0.2% consuming opiates (World Health Organization, n.d.).
Advertisements for marijuana delivery services, vacation tours of marijuana shops, and frequent references of heavy marijuana use have become a norm more visible in our culture. Unfortunately, the perspective that cannabis use comes with little or no immediate and long-term health risks is growing. Parental support of cannabis use, a very significant increase in college age cannabis use, etc. have suggested to teens and adolescents that cannabis use is safe:
Although the perception persists that marijuana use is innocuous and lacks dependence liability . . . the medical community is now beginning to accept the idea that cannabis-related disorders represents a clinically significant public health problem. According to the Drug Abuse Warning Network, marijuana was involved in 374,435 hospital emergency department visits or 37.7% of all such visits involving an illicit drug in 2008, and marijuana users accounted for 18.5% of the 177,879 drug-related emergency department visits that year by patients seeking detoxification or substance abuse treatment services (Ramesh, et al., 2011).
The addictive properties of THC have proven to bring health risks during clinical trials:
Preclinical studies in a variety of laboratory animals show that repeated admission of THC or other cannabinoid agonists result in dependence. Animal models for assessing dependence also measure reinforcing and rewarding properties – such as self-administration, conditioned place preference, and intracranial self-stimulation as well as withdrawal signs, which can include both physiological symptoms and indicators of emotional state (Panagis et al. 2008).
America’s growing perception that today’s cannabis use is safe has resulted in a resurgence of cannabis use for medicinal purposes. Advocates of medical marijuana and cannabinoids argue that there is a powerful opportunity to provide safe, cheap, and highly effective treatment for many diseases. Significant research is increasingly being done to measure the costs and benefits to the human brain, nervous system, and pulmonary system and the pain and suffering that Cannabis Use Disorder brings. Presently, individuals and health care workers are left weighing the pros and cons of medical marijuana use with conflicting published research.
Scientific Research on THC
Marijuana’s THC is a risk to one’s health and it is addictive; “Prolonged use of marijuana or repeated administration of its primary psychoactive constituent, THC, can lead to physical dependence in humans and laboratory animals,”(Ramesh, et al., 2011). And, the negative health consequences are becoming more and more obvious; “The changes that occur with repeated cannabis use include alterations in behavioral, physiological, and biochemical responses,” (Ramesh, et al., 2011).
Research has proven that with chronic and addictive use comes a host of painful withdrawal responses, very similar to withdrawal from other narcotics (alcohol, cigarettes, methamphetamines): “Anger, aggression, irritability, anxiety and nervousness, decreased appetite or weight loss, restlessness, and sleep difficulties with strange dreams,” (Ramesh, et al., 2011).
In short, due to increasing powerful THC levels, today’s marijuana consumption has generated a new DSM classification in conjunction with Cannabis Use Disorder, due to the effects of cannabis dependency; “cannabinoid withdrawal syndrome.” While affected by additional health risks, the Cannabis Use Disorder individual suffering from the pain of cannabinoid withdrawal “may continue to use marijuana to avoid these and other withdrawal symptoms,”(Ramesh, et al., 2011).
Scientific research reports have not only identified the addictive nature of marijuana but also the clinical diagnosis of acute withdrawal-related symptoms. Teen marijuana users, for example, have also been found in one study to have at least one comorbid diagnosis of anxiety or depression, and anxiety and depression-like symptoms. “Chronic cannabis use is associated with an increased risk of developing substance use disorders; about 9% of those who use cannabis present with characteristic symptoms of dependence according to DSM I criteria,” (Volkow et al. 2014).
Additionally, “A clinical diagnosis of cannabis withdrawal includes: irritability, anger or aggression, nervousness or anxiety, sleep difficulty, decreased appetite or weight loss, restlessness, depressed mood and physical symptoms causing significant discomfort such as shakiness or tremors, sweating, fever, chills, and headache.” Researchers have also found that the “severity of withdrawal symptoms associated with greater negative impact on normal, daily activities, suggesting that the effects of cannabis withdrawal seem to parallel withdrawal in other drugs of abuse,” (Davis et al., 2016).
The percentage of Cannabis Use Disorder users is now mirroring the same addictive rates of other drugs of abuse. Other similarities between marijuana abuse and the health consequences of alcohol, tobacco, methamphetamine, and cocaine abuse include the phenomena of craving, obsession, and withdrawal. The dramatic increase of cannabis use and its increased social acceptance has generated more misunderstanding about its negative health consequences. “Cannabis is the most commonly used illicit drug worldwide. In the United States approximately 56% of young adults (19-28 years old) have at least tried cannabis. This high prevalence allows for many people to have personal or anecdotal experience without necessarily having personal interactions with dependent users. Although only about 3-4% of individuals who have ever tried cannabis meet the criteria for Cannabis Use Disorder (compared with 15-25% for cocaine), the total number of Americans classified with such disorders is 4.3 million more than twice that of cocaine and heroin combined,” (Ramesh, et al., 2011).
With greater social acceptance of cannabis use, coupled with the rapidly increasing amounts of THC used in cannabis products, comes the ability to study the consequences of Cannabis Use Disorder and the severity of cannabis withdrawal:
Only a subset of regular marijuana users experience a clustering of symptoms upon cessation of use; estimates range from 1 in 6 to half of all such users . . . Although the immediate physical impact of the [symptoms of cannabis withdrawal] is mild when compared with certain other drugs of abuse . . . the comprehensive impact of cannabis withdrawal syndrome is being better understood( Ramesh, et al., 2011).
Most Current Research
Let’s take a look at the most current research available on Cannabis Use Disorder and Cannabis Use Withdrawal Syndrome. Perhaps the most poignant finding is that cannabis use, like all other drugs of abuse, creates the withdrawal cravings that most often result in the cannabis user choosing to continue cannabis use, not for fun or enjoyment, but to seemingly bring an end to the freshly generated feelings that accompany cannabis withdrawal syndrome. Again, these include: “anger, aggression, irritability, anxiety and nervousness, decreased appetite or weight loss, restlessness, and sleep difficulties with strange dreams” and “the exact timeline and symptoms of cannabis withdrawal syndrome vary across studies, but the growing consensus is that cannabis withdrawal symptoms contribute to continued drug use. Cannabis withdrawal is comparable in severity and scope to tobacco withdrawal and contributes to relapse to only a slight lesser extent,” (Ramesh, et al., 2011).
For the marijuana user with Cannabis Use Disorder, this continued and frequent cannabis use will result in damaging health risks. Cross addiction – the use and abuse other forms of drugs of abuse – are one. “Cannabis users often differentially use alcohol, tobacco, or cannabis to reduce the severity of specific symptoms. Taken together, the evidence shows that withdrawal from cannabis use produces a distinct syndrome that increases drug cravings and use,” (Ramesh, et al., 2011).
At AToN Center, we treat Cannabis Use Disorder as well as other substances of abuse. If you or a loved one have further questions, please feel free to contact us.
Davis, J.P., Smith, D.C., Morphew, J.W., Lei, S., Zhang, S. (2016). Cannabis Withdrawal, Posttreatment Abstinence, and Days to First Cannabis Use Among Emerging Adults in Substance Use Treatment. Journal of Drug Issues, 46, 64-83.
Karila, L., Roux, P., Rolland, B., Benyamina, A., Reynaud, M., Aubin, H.J., Lancon, C. (2014). Acute and Long Term Effects of Cannabis Use: A Review. Current Pharmaceutical Design, 20, 4112 – 4118.
Panagis, G., Vlachou, S., Nomikos, G.G. (2008). Behavioral Pharmacology of Cannabinoids with a Focus on Preclinical Models for Studying Reinforcing and Dependence-Producing Properties. Current Drug Abuse Review, 2008(1), 350-374.
Ramesh, D., Schlosburg, J.E., Wiebehaus, J.M., Lichtman A.H. (2011). Marijuaja Dependence: Not Just Smoke and Mirrors. Institute for Laboratory Animal Research, (52) 3, 295-308.