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Adjusting for Addiction: When Medical Use Becomes Too Much

What’s the difference between a medical marijuana patient and a marijuana addict? The difference is subtle.

Adjusting for Addiction: When Medical Use Becomes Too Much

As a professional cannabis consultant, I think marijuana addiction is an issue and it’s something I’m concerned about. But because cannabis has been illegal for so long it’s hard to know what marijuana addiction is and if everyone’s in the shadows using it. So first I’m going to talk about what marijuana addiction is in comparison with other drugs.

According to the National Institute of Health, Marijuana Use Disorder affects about 2.5% of marijuana users. It’s defined as the continual use of marijuana despite clinical distress and impairment. This isn’t a huge percentage. But if you have millions of users that means a lot of people are addicted to marijuana.

This means somebody continues to use cannabis even though they know marijuana is not ultimately helping them or is making their life worse. That is the definition of addiction. That you can’t stop using something even though it’s bad for you.

Now let’s compare that to alcohol addiction, which affects millions of people at a rate of approximately 6% of adult users. That’s almost three times as high as marijuana addiction, just to give you a comparison. Cocaine is at least twice as addictive as cannabis. Tobacco is about three times more addictive. Opiates are two and a half times more addictive. These are drugs that can and will kill you. So as far as comparing marijuana with other drugs, cannabis is a lot safer in terms of addiction.

When we’re talking about addiction, it’s important to remember that marijuana is not physically addictive. This is hard to define, but essentially, substances such as alcohol, cocaine, tobacco, and opiates actually make your body physically addicted. Once you start using them, if you use them a lot, your body becomes physiologically dependent upon them. And when you stop using them your body has severe side effects.

Cannabis is not physically addictive

Cannabis, however, is not physically addictive. Your body doesn’t physically need cannabis, but that doesn’t mean you can’t be addicted to it. There are plenty of people who have a really hard time stopping their cannabis use. But the withdrawal effects of cannabis are much less severe than other drugs.

That’s also because we have our endocannabinoid system, which is the largest cell feedback system in our body. Our cells use chemicals like endocannabinoids to communicate. These are chemicals that scientists discovered after researching what the cannabis plant does to humans when we ingest it. Our body recognizes the chemicals in cannabis as something natural that the body uses, so it’s harder to get addicted to chemicals that the body uses all the time.

Marijuana Use Disorder has doubled in the last 10 years, and there are several reasons for this. For one, cannabis has gotten a lot stronger and more people are using it. As it becomes legal in states, of course you’re going to have more people using cannabis and hopefully seeking other drugs less. Perhaps people are using cannabis more than alcohol and harder drugs. But cannabis is quite strong. THC, the main ingredient in cannabis, increases tolerance in users. This means if you smoke a joint each day for six months, eventually you’re going to need two joints per day to reach the same level.

But we also lack community support. When you have a drug like cannabis that’s illegal and the laws surrounding it are very draconian, people are not going to readily share their addiction issues. If we can legalize the drug, then we can be more open about when people are addicted because they can express their addiction.

Another issue now, especially with younger people, is this idea that they’re using cannabis as medicine. Let’s say you have anxiety, pain, insomnia, IBS, or mood disorAdjusting for Addiction: When Medical Use Becomes Too Muchders, and you feel that cannabis helps. It’s very easy to say, “Oh, well, it’s my medicine. I have to take this every day.” And for a lot of people, this is a really good point. When we’re talking about medical cannabis use, the FDA has not established dosing so it’s very hard to determine. You may have someone who’s had severe pain after an accident or surgery who needs 100 milligrams of cannabis per day. Yet other people who don’t have such extreme ailments may be more dependent on the drug even though they’re using less of it. So really, it’s subjective.

A great method that I use with clients involves basing your cannabis use on three things:

One, is it reducing harmful medication such as opiates? For example, if you introduce cannabis into your regimen and your opiate use goes down that’s a positive benefit even if you are using cannabis every day because opiates are more dangerous.

Two, is it reducing symptoms? Anxiety is a perfect example. Is it truly reducing anxiety, or is it only when you’re stoned? When you’re not stoned, how bad is your anxiety? This is very subjective. A lot of people get stuck in what I call a medicated loop. Anxiety is very natural, especially in adults who have mouths to feed and bills to pay. We live in a stressful culture. If you smoke pot or consume cannabis in a way that works for you and reduces your anxiety, that’s fine. But some people find that once the THC wears off their anxiety goes up even higher. They need to smoke more until eventually their receptors for THC get inundated, leaving the nervous system worn out and anxious. It’s really just exacerbating their anxiety.

I see this a lot with people who go to dispensaries and aren’t interacting with people who are necessarily aware of their health.

If you’re just using more and more cannabis while it’s ultimately harming your anxiety levels, then this is an indication that you’re using it addictively and you need to back off.

Third, many people get addicted to the ritual of smoking cannabis. It’s satisfying to break up cannabis, put it into a joint, roll it up, go outside, take a few minutes, and smoke it. This is completely reasonable for your average adult who is not abusing the drug. But that ritual can become the addiction. I often ask people who come to me to reduce their cannabis use if they’ve tried oils. “Have you tried ingesting a very boring tasting liquid that you take into your system?” A lot of people have a hard time stopping smoking. Maybe they’re addicted to the ritual of it and the quick high that comes from it.

If we’re truly medicating with cannabis, then we want to make sure that we use as little as possible. The goal is to use as little medical marijuana as possible so that one day we can just use it recreationally.

My book Cannabis Consulting is coming out this summer and is available for pre-order on Amazon.

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