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Is Marijuana Really Addictive?

Written By Aaron Weiner, PhD on March 9, 2021. Reprinted here with permission.

OK, let’s be real: is marijuana addictive in the first place?

Absolutely, yes, marijuana is physiologically addictive - you develop tolerance when using and, once addicted, experience withdrawal when you try to stop. There is actually no debate about this fact, despite what you may hear from pro-marijuana politicians, businesspeople (these two may actually be one and the same…), or current users.

For one of the foundational studies establishing this fact, please see here, and for a recent validation, see here. With today’s current high-potency THC flower and concentrates, the CDC tells us 10% of adult users develop a dependency, and 16% of adolescents.

What are the long-term side effects of marijuana use?

The severity of long-term marijuana use depends in large part on the age of the user and the potency of the marijuana being used - the younger someone is when they start the greater the negative consequences, and the more THC taken at once the worse the consequences. Related to the latter point, today's marijuana is much, much stronger than in the past: a recent study found that an average joint of recreational marijuana in legal dispensaries has a THC content of 21.5%. The THC content of marijuana at Woodstock, and even as late as 1995, was 3-4%. THC concentrates are incredibly strong, in some cases well over 90%.

The severity of long-term side effects also vary greatly by age: the younger you are (particularly under 25) the more severe the possible long-term side effects. Some of the most concerning, however, relate to permanent physical changes in the structure of your brain and associated cognitive deficits. When using THC products as a teenager and young adult, the hippocampus (central to learning and memory) and prefrontal cortex (related to personality, motivation, abstract thought, planning, and other executive functions) are particularly vulnerable to these structural changes. The impact also applies to adults - a recent meta analysis found deficits in general functioning, decision-making, executive functioning, learning, and memory. THC has also been linked to accelerated brain aging and decay, as well as to the development of acute and/or persistent psychosis, anxiety, and suicide.

If someone is detoxing from marijuana, what can they expect?

If you have been using marijuana frequently for a prolonged period of time, you should expect to have physiological withdrawal symptoms, just like with any other addictive substance. As delineated by the DSM-5, symptoms of marijuana withdrawal include:

  1. Irritability, anger, or aggression

  2. Nervousness or anxiety

  3. Sleep difficulty (insomnia or vivid dreams)

  4. Decreased appetite or weight loss

  5. Restlessness

  6. Depressed mood

And at least one of the following physical symptoms:

  1. Abdominal pain

  2. Shakiness/tremors

  3. Sweating

  4. Fever

  5. Chills

  6. Headache

Someone can also expect to have marijuana cravings, or an intense psychological and physiological urge to use THC products. These cravings will likely continue long after withdrawal symptoms have ceased, although they do tend to fade with time.

Do any medications exist for treating marijuana addiction?

As of right now we do not have any FDA-approved medications for the treatment of marijuana withdrawal or addiction, although there are some medications that show promise, such as gabapentin and N-acetylcysteine. If someone is trying to quit marijuana and struggling to do so, I would absolutely recommend working with a physician trained in addiction medicine and a therapist trained in addiction psychology, in order to explore the medical and psychosocial options available for treatment.

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