Maybe you’ve heard someone talk about about “jonesing” for weed, or “needing” to smoke, or having a “habit.” Hey, maybe that someone talking was you. The idea that someone has a fever for cannabis that can only be treated with more cannabis implies the dreaded A-word: addiction.
But come on—is that a real thing? Can a pot smoker become addicted to weed the same way as an alcoholic does to booze, or a regular user of opiates, cocaine, or heroin gets hooked on their drug of choice?
Much like a car that’s been hotboxed, the answers are hazy. The term “addiction” has a fairly broad definition, and the differences between someone with a daily habit of consuming cannabis versus a heroin addict are vast.
Merry Jane writer Madison Margolin recently wrote a great piece that breaks down the issue, addressing the categories of addiction, dependence, and disorders and the differences between them. Margolin cites the National Institute of Drug Abuse’s (NIDA) definition of “addiction” as “compulsive drug use despite harmful consequences... characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal.” And NIDA defines “dependence” as “the body [adapting] to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal).” Addiction and dependence often go hand-in-hand, which sometimes makes them difficult to tell apart.
The top-shelf psychiatric reference text Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (often called DSM-5) mentions a “cannabis use disorder,” and Margolin writes, “A person must exhibit two to three of 11 criteria to officially qualify, including symptoms like cravings, developing a tolerance, or spending a lot of time getting, using, or recovering from a given substance.”
So what about a medical patient who has a craving for the pain relief they get from cannabis—someone who has built up a tolerance from regular use and spends a fair amount of time acquiring and consuming their medicine? That checks off three boxes, so... yes? Is wanting to reduce or eliminate physical pain a “disorder”? And wouldn’t substituting opiates for cannabis be more likely to create the same kind of disorder?
In June, the Denver Post published an article with the headline “Marijuana addiction is real, and rising,” stating that it affects 9 percent of cannabis users (and 17 percent of those who start in adolescence). Some attribute that statistic to the increased THC potency of flower and the wider availability of concentrates and extracts. But, as Margolin writes, “Research has found that people who smoke stronger forms of cannabis may tend to smoke less, since they titrate their doses themselves.”
That 9 percent addiction rate compares to 15 percent for alcohol and cocaine and 24 percent for heroin. The differences in how the body responds to withdrawal from each of these drugs is stark—irritability, anxiousness, and a serious case of “cranky pants” are among the symptoms someone quitting cannabis might experience. Heroin users get all that, plus sweating, nausea, depression, pain, and, best of all, up to a week of severe stomach cramping, vomiting, and diarrhea. (You know what might be good for some of those ailments? Just sayin’.)
Prohibitionists point to the increase in admissions at rehab centers for cannabis addiction, but conveniently fail to mention a major undercutting qualifier. According to a 2015 study by the Department of Health and Human Services (as reported by the Washington Post), more than 50 percent of those in rehab for cannabis had been sentenced there by the courts and justice system, and were usually facing jail time as an alternative. In 2013, of the 281,991 people in rehab for cannabis, fewer than 20 percent voluntarily sought out treatment.
Anyone who feels cannabis has become detrimental to their wellbeing should have full access to support and services, but I’d say maybe not at the expense of a bed in a dedicated rehab facility. Those beds are in chronic short supply, and are urgently needed by those being treated for heroin and opiate addiction, as a delay in treatment can prove fatal. A cannabis user most likely won’t smoke themself to death waiting for that same bed.