joint in bowl

Introduction

Marijuana has been the target of vicious disinformation campaigns over the past century, making it hard to sort out fact from fiction. Starting with the Marijuana Menace of the early twentieth century and morphing into full-blown Reefer Madness by the 1930s, the dangers of weed have been exaggerated while research into its medical applications has been suppressed for almost the entire history of its recreational consumption in America.

We’ve talked about the dark side of cannabis history before in our post on social justice and cannabis, which explains how most of this demonization was aimed at swaying public opinion with regard to specific ethnic groups, and a lot of misconceptions about our favorite flower still persist today. These include the notion that weed can kill you, make you insane, or turn you into a drug-crazed addict. Modern medical science has revealed that it’s nearly impossible to overdose on marijuana and cannabis-induced psychosis is rare, usually only affecting people with certain genetic predispositions, but the research into cannabis dependence is still relatively new—and worth discussing.

It’s important to be informed about all the pros and cons of marijuana consumption, which is why we’ve posted articles about the potential medical benefits of cannabis as well as why you might want to avoid it. This time, we want to talk about the reality of cannabis dependence for the 10% of users who experience it. What does cannabis dependence feel like, what are the risks, and what should you do if you think you or someone you know might be dependent on cannabis? 

Define “Dependence”

There’s a difference between heavy consumption of cannabis and cannabis dependence. As we mentioned in our guide to THC tolerance, “heavy cannabis use” refers to using cannabis on twenty-one of the last thirty days. This could be a prescribed regimen for pain management, or just an after-work stress reliever, but heavy use in and of itself is not necessarily a bad thing.

Cannabis dependence is a little harder to pin down, but the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders lists eleven key indicators. While it is not the be-all end-all of diagnostic tools, The DSM-V offers helpful perspective to evaluate your own consumption. If you manifest two or more of these symptoms over a twelve month period, you might want to have a conversation with a doctor about your experience:

  • Using cannabis in larger amounts or over a longer period than was prescribed or intended. If you’re prescribed a specific dose and you find it’s not enough, you should talk to your doctor about your treatment plan. If an eighth was supposed to last you two weeks but it’s gone in a weekend, that’s worth talking about too.
  • Making unsuccessful efforts to cut down or control cannabis use. Sometimes, we’ll see the vape pen sitting there and just take a hit because we can, because it’s harmless. If it starts happening every time, you should try taking a tolerance break, just to make sure you’re still dictating the terms.
  • Spending a lot of time in activities necessary to obtain, use, or recover from cannabis effects. Does waking and baking leave you needing to take a lot of afternoon weed naps? Are you picking up extra hours at work because you keep running low on cash for flower? Look at how cannabis affects your schedule to see if it’s keeping you from doing what you want to do.
  • Craving cannabis or feeling an urge to use cannabis. Marijuana is a great stress-reliever, but if it’s the only thing you do to relieve stress then it may be time to look at some other hobbies or activities.
  • Failing to fulfill major life obligations at work, school, or home. Missing deadlines, skipping chores, canceling plans, because you got high is a good indicator that weed is interfering with your life in a negative way.
  • Continuing to use cannabis despite persistent or recurrent social or interpersonal problems. If you’ve already noticed that the herb keeps getting in the way but you keep smoking it anyway, it’s time to re-evalute the relationship. 
  • Giving up or reducing involvement in important social, occupational, or recreational activities. Didn’t apply for the job you really wanted because they urine-test? Always skipping practice because you don’t like to run while you’re high? Is weed keeping you from doing what you really want? 
  • Using cannabis in physically hazardous circumstances. The second rule of staying safe while you smoke weed is don’t drive. If you’re hotboxing your car, operating heavy machinery, or otherwise impairing your reaction time in life-or-death situations, it means your ability to assess risk is impaired. That’s the only time weed really gets dangerous.
  • Continuing to use cannabis despite having a persistent or recurrent physical or psychological problem. We mentioned that some people with psychosis or schizophrenia might have episodes related to their cannabis use, and if that happens to you, you should discontinue use until you can consult with your doctor. 
  • Tolerance, as defined by a need for markedly increased amounts of cannabis or a markedly diminished effect with continued use of the same amount of cannabis. Okay, so the DSM-V considers tolerance to be one potential symptom of cannabis dependence. Cannabis dependence necessarily entails higher tolerance, but that doesn’t mean high tolerance causes dependence.
  • Withdrawal, as manifested by characteristic withdrawal syndrome. Withdrawal symptoms start within forty-eight hours of your last dose and might include irritability, anger, anxiety, difficulty sleeping, abdominal pain, fever, chills, and severe headache.

Now, you might be thinking, “wow, practically everybody I know has at least two of those symptoms!” but the important thing to remember is that this list is simply a diagnostic tool. We’re not doctors, so we’re in no position to diagnose anybody with anything, but if you see yourself in this list, we encourage you to open a dialogue with your doctor about it and maybe take a short tolerance break. If you can’t walk away from it for more than a week without things becoming unbearable, that might be another indication that cannabis dependence is at play.

What You Can Do

Dependency is a scary concept, partly because of how disempowering it is. People don’t like to think that they are not in control of their actions. They tell themselves all kinds of stories, about how they can stop anytime they want (although they rarely choose to,) or how it’s not really interfering with their life as much as it might seem, because they’re worried confronting their dependency would mean losing to it. 

Nobody wants to be seen as a loser, yet that’s how people who experience cannabis dependency are often depicted in media. The truth is, dealing with cannabis dependence isn’t the end of the battle, it’s the start of it, and there are many ways to re-assert yourself over this part of your life.

TRY A TOLERANCE BREAK

If you recognize some of those symptoms of dependence, you can do a little experiment by taking a tolerance break (although consult with your doctor first if you’re taking cannabis under clinical direction). A tolerance break is a fourteen-day vacation from consuming cannabis to give your CB1 receptors a chance to rejuvenate and allow you the time and space you need to see if cannabis is having a negative effect on your life. 

Pick a date on the calendar when you feel confident you wouldn’t want to get stoned for a couple weeks and mark out fourteen days. Tell your friends you’re going to take a break and either get rid of your stash or give it to someone you trust until you’re ready to ask for it back.

During these two weeks, be mindful of things that you usually associate with cannabis and try to find something else to do instead. Maybe you just got home from work and you can pick up a video game to blow off steam instead of a pipe, or maybe you noticed it’s just after 4:00 and you can use this opportunity to take a walk instead of a toke. The more you’ve integrated cannabis into your daily life, the harder it’s going to be to imagine life without it—but you got this.

Even if it seems like it’s totally unmanageable, there are other ways to defeat cannabis dependence.

TALK TO A MEDICAL PROFESSIONAL

Your doctor will have the best perspective on your physiological relationship with cannabis, and they’re bound by stringent laws to keep your conversations with them confidential. Cannabis withdrawal isn’t particularly painful or long-lasting, and there are a lot of ways to treat the unpleasant symptoms.

Or, if you have access to a mental health provider, you can address the deeper causes of cannabis dependency through cognitive-behavioral therapy, which helps you enhance your self-control, or motivational enhancement therapy, which empowers you with tools to effect change.

Millions of Americans experience dependence in one form or another, and it’s important to remember that help is available, treatment works, and people are recovering from dependency every single day. Some people don’t have a current relationship with a medical or mental health provider, but there are other resources out there like FindTreatment.gov or HealthGrades.com. And there’s always the Crisis Text Line if you don’t feel like talking on the phone. 

TALK TO A FRIEND

If you don’t feel comfortable talking with people you don’t know, it’s still important to have a conversation with someone you know and trust about your relationship with weed, if you notice that it might be giving you trouble. It’s hard to see ourselves objectively, and if we’re having difficulty taking a tolerance break, it’s okay to ask for an outside opinion. Friends, family members, even co-workers can be vital assets in figuring out if you have a problem and what you can do to solve it.

Open Dialogue

The most important thing we can do to help people win against cannabis dependence is to talk about it with each other. 10% of adult cannabis users experience dependency at one point or another, so if we’re going to look out for each other, we need to acknowledge that it’s real and that there are real strategies to overcome it. Talking about it openly and often is the best way to safeguard responsible use against the potential for dependence.

In spite of all the disinformation that’s out there, this rumor about marijuana has turned out to be true: it is possible to get addicted to cannabis, just like it’s possible to get addicted to alcohol or World of Warcraft. And, like many other addictions, people recover from it every day and go on to lead happy, healthy, normal lives.


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