When it comes to cannabis, there’s a lot of contradictory information out there on whether the plant can be addictive or not. On one extreme, there’s the “Reefer Madness” hysteria that claims cannabis is a dangerous and destructive drug. On the other side, there are people that claim cannabis is a perfectly safe medicine that is impossible to get addicted to.
But the truth is that cannabis can be addictive for some, and not at all to others. The majority of people that use marijuana — either recreationally or medicinally — will not become addicted. However, it is absolutely possible for a person to become addicted to using cannabis.
Here’s what the science says.
Does Cannabis Addiction Exist?
Scientific research indicates that, yes, cannabis can be addictive. About one in 10 people that use cannabis will develop an addiction, according to a 2018 study conducted by Columbia University and the New York State Psychiatric Institute.
Cannabis users may develop a physical, psychological, and/or social dependence. Physical symptoms can include discomforts such as weight loss, headaches, and/or abdominal pain when a user stops consuming cannabis regularly. Psychological symptoms may present as irritability, anxiety, insomnia, etc. A social dependence means a user finds difficulty refraining from using marijuana in social settings, while others are partaking around them.
The DSM-5 now recognizes cannabis addiction as a “cannabis use disorder,” defined as “the continued use of cannabis despite impairment in psychological, physical, or social functioning.”
Basically, when someone continues to regularly use cannabis despite its negative consequences on their life, they may have developed a loss of control over their use and could be addicted to cannabis. Those with cannabis use disorder may not be aware that this has happened, and they may not even be aware that their behavior is causing problems for themselves and others.
It is estimated that about 22.1 million people globally (that’s about 0.3% of the world’s population) suffer from a cannabis use disorder.
Is THC Addictive?
THC is the chemical component in cannabis that causes the altered state or feeling of being high. It is this high that those with cannabis use disorder are often chasing. Therefore, yes, THC can be addictive.
According to research conducted by the United States National Institute on Drug Abuse, cannabis strains containing high levels of THC and low levels of CBD have been found to produce stronger reinforcing effects. This means that high-THC cannabis strains cause higher ratings of enjoyment, which could potentially make these strains more addictive.
Is CBD Addictive?
While THC can be addictive, there is no evidence that suggests CBD is addictive.
A 2017 double-blind study published in the Journal of Drug and Alcohol Dependence analyzed the abuse liability profile of CBD by administering various oral dosages of CBD to frequent cannabis users by itself and in combination with smoked cannabis that contained 5.3% to 5.8% THC. The research team concluded that while the THC-containing cannabis did reliably produce abuse-related subjective effects because it produces a “high” that users may become reliant upon, CBD did not display any signs of abuse liability.
However, it is important to note that different CBD products may contain different levels of THC. Hemp-derived CBD products by law must not contain any more than 0.3% THC in the US, or 0.2% THC in the EU.
Interestingly, there is evidence that suggests CBD could be actually used to help combat cannabis use disorders. A 2010 study conducted by University College London examined 94 marijuana users that smoked either low-CBD strains or high-CBD strains of cannabis then tested them on dependence-related measures. The researchers found those that smoked the high-CBD cannabis were less dependent on cannabis than their low-CBD counterparts. As a result, the researchers concluded that CBD has potential as a treatment for cannabis dependence.
Who’s at Risk of Developing a Cannabis Addiction?
There are several factors that may contribute to developing a cannabis use disorder.
Family history of addiction
Scientists have concluded that genetic factors can play a major role in the progression from general drug use to abuse and dependence. Addiction can run in families, so if your family has a history of addiction, this is something to be aware of when using cannabis. It doesn’t mean that you’ll definitely develop a cannabis use disorder — it just means you’re at a higher risk.
Mental health conditions
Mental health is a big fisk factor when it comes to cannabis addiction.
Dr. Alex Stalcup, the medical director of the New Leaf Treatment Center in California, shared in an interview with Healthline that an estimated 50% to 60% of patients that come to treat a cannabis addiction at the treatment center has an underlying mental health condition, such as:
At first, cannabis can serve as a potent medicine to help mitigate the negative effects of a mental health condition. But if high-THC strains are used too frequently, a tolerance can develop and withdrawal symptoms can occur when trying to cut back.
According to scientific research conducted by the University of Minnesota, people who start using cannabis before the age of 18 are four-to-seven times more likely to develop a cannabis use disorder than adults.
Lack of community
When it comes to substance abuse of any kind, addiction rates are dramatically increased among those that lack a good social network, steady job, and family ties. There is evidence that suggests addiction can stem from social and emotional isolation. Therefore, cannabis users that don’t have a healthy community around them could turn to frequently misusing cannabis and, as a result, a cannabis use disorder may form.
Signs of a Cannabis Addiction
According to the DSM-5, a person with a cannabis use disorder will display at least two of the following symptoms within a 12-month period:
- Cannabis is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control cannabis use.
- A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its effects.
- Craving, or a strong desire or urge to use cannabis.
- Recurrent cannabis use results in failure to fulfill role obligations at work, school, or home.
- Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.
- Important social, occupational, or recreational activities are given up or reduced because of cannabis use.
- Recurrent cannabis use in situations in which it is physically hazardous.
- Cannabis use continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
- Tolerance, as defined by either: (1) a need for markedly increased cannabis to achieve intoxication or desired effect or (2) a markedly diminished effect with continued use of the same amount of the substance.
- Withdrawal, as manifested by either (1) the characteristic withdrawal syndrome for cannabis or (2) cannabis is taken to relieve or avoid withdrawal symptoms.
Those that meet two to three of these criteria are diagnosed as having a mild cannabis use disorder. If four to five criteria are met, then it is considered a moderate cannabis use disorder, and if six or more criteria are met, it is a severe cannabis use disorder.
A cannabis use disorder may take months or even years of cannabis use to develop.
Cannabis Addiction Treatment Options
There are several methods to help treat cannabis use disorder.
Going “cold turkey”, or stopping cannabis use completely, is one method. For heavy users, this will mean withdrawal symptoms can occur, including but not limited to:
- Depressed mood
- Loss of appetite
- Intense, vivid dreams
Withdrawal symptoms usually last one to two weeks before subsiding. A gradual decrease as opposed to an abrupt stop of cannabis use altogether is likely to decrease the discomforts of withdrawal. While these withdrawal symptoms can be uncomfortable, they are relatively mild compared to other addictive substances, and most people are able to manage them without intervention.
So far, no medications are approved or have been found effective for the treatment of cannabis use disorders, according to a 2019 Australian study.
The best way to successfully treat a cannabis use disorder is to seek professional help.
Psychological interventions that have been proven to be useful in dealing with cannabis dependence include:
- Motivational Enhancement Therapy (MET)
- Cognitive Behavioral Therapy (CBT)
- Contingency Management (CM)
- Supportive-Expressive Psychotherapy (SEP)
- Family and Systems Interventions
- 12-Step Facilitations, such as Marijuana Anonymous
Is Cannabis a Gateway Drug?
While some studies have shown that cannabis use is likely to precede the use of harder drugs and the development of addictions to other substances, the simple truth is that the vast majority of cannabis users do not go on to become hard drug addicts. This was a scare tactic invented by the Federal Bureau of Narcotics to justify the growing War on Drugs in the 1960s.
In fact, science suggests that the opposite can actually be true. Cannabis has been shown to serve as an “exit drug” — meaning cannabis can be a useful tool for helping people get rid of their addictions to substances ranging from opioids and benzodiazepines to tobacco and alcohol.
A 2017 study published in the Harm Reduction Journal surveyed more than 2,000 Canadian medical cannabis patients about their patterns of medical cannabis use, including questions assessing the impact of cannabis on the use of prescription drugs, illicit substances, alcohol, and tobacco.
Nearly 70% of the respondents reported that they were opting to substitute medical cannabis instead of prescription drugs such as opioid medications and antidepressants. Of the participants that chose to substitute cannabis for opioids, 59% were able to completely cease their opioid use altogether. Medical cannabis also helped 44.5% of patients to stop using alcohol, 31.1% to stop using tobacco, and 26.6% to stop using illicit substances.
As a result, the researchers of this study conclude that “increased regulated access to medical and recreational cannabis can result in a reduction in the use of and subsequent harms associated with opioids, alcohol, tobacco, and other substances.”
The Bottom Line
While the vast majority of cannabis users will not become addicted, it is true that around 9% of people that use cannabis develop a cannabis use disorder.
It is important to be aware that it is possible to become dependent upon cannabis, even if it has been prescribed medically — just as it is possible for patients to become addicted to their prescribed pharmaceuticals.
If you are in the approximately one-tenth of users who have become addicted to cannabis, consider reaching out for help from family and loved ones and seek out a medical professional. There are many different existing psychological interventions these days designed to help those with cannabis use disorder.