During the past few decades, there have been a lot of changes in the way people perceive cannabis in the United States. Decriminalization, medical dispensaries and even legalization of marijuana in several states have resulted in a more relaxed view toward cannabis use. However, it’s very important to note that cannabis use has been shown to impair cognitive functions on a number of levels, leaving users with both acute and long-term effects.
You never hear of any dying from daily pot use. You certainly don’t hear about it in the same way you hear about deaths and other tragedies caused by alcohol and other “harder” drugs. And, there are some serious medical conditions for which marijuana is now believed to be an effective treatment. Additionally, the movement to legalize marijuana seems to be growing—25 states have legalized medical marijuana, while four states plus Washington, D.C. have gone even further and legalized recreational use of pot.
So, what’s the big deal?
Well…The big deal is that like any substance or activity that has the ability to alter your mood or neurological responses, marijuana can be addictive. And, like all other addictions, it can have a devastating impact on your life.
When people do start to feel that their marijuana use is interfering with their lives and relationships in a negative way, they often have trouble asking for and getting the support they need. Molly Hankins, in a personal essay for Nylon magazine, put it like this: “Being a junkie or an alcoholic who turns themselves over to a 12-step program, the sober lifestyle, God, whatever, registers at the David Bowie end of the addiction spectrum. Being addicted to weed barely registers as laughable and there’s no one in my life I feel comfortable talking to about it. As the era of marijuana prohibition in this country seems to finally be coming to an end, what is the popular discussion surrounding appropriate use? How much is too much? How do I stop if I want to but can’t?
Among the many excellent pointsMolly makes in her essay, her point about the need for a discussion around marijuana and addiction really hits home. The low rate of fatalities directly related to marijuana use, as opposed to heroin or alcohol use, for example, may have contributed to a general societal complacency around Marijuana addiction.
It’s important to note that even though weed may not be as fatal, statistically speaking, as heroin or alcohol, depression is often co-occurring condition that goes along with marijuana addiction. And, withdrawal from marijuana can exacerbate symptoms of depression and anxiety. Many people—like “Jake” who wrote a letter to Scientific American in 2012 describing his marijuana addiction—often end up having suicidal thoughts.
This means that the drug can, in a way, be indirectly tied to some fatalities. The drug may not be directly responsible for deaths related to suicide, but it certainly doesn’t help to prevent them. Here’s how Jake describes his experience:
“Over time, the proportion of high time to clean time became steadily more heavy on the high side. I went through several periods of suicidally. During my last six months of use the possible necessity to kill myself always seemed just a week or two away. My plan while I was at school was to jump off of a nearby parking garage. At home, I would use my dad's shotgun to shoot myself in the head. I didn't want to feel what I felt when I wasn't high. Luckily, I always got high before I was ready to actually kill myself.”
For those who become addicted to marijuana, "recreational use" of the drug slowly stops being fun or relaxing. The need to smoke in order to cope with life’s ups and downs and the need to hide how much you’re smoking (or ingesting) from others can have the same isolating and disruptive effects on a person’s life as any other addiction. Here are a few of the signs that someone may be dependent on the drug:
People who are addicted to pot often think that they aren’t "really addicted" if they don't smoke it every day. While it’s true that marijuana addicts can go a few days between smoking again before they suffer any symptoms, it’s important to note that that’s because the chemicals in marijuana can stay in a person’s system for days. Once all of those chemicals are out of their system, subtle but serious withdrawal symptoms can start to set in. The first sign is a craving powerful enough to drive the addict to use the drug again.
2. Irritability and Depression
People who are addicted to marijuana find themselves becoming increasingly irritable and depressed if they go many hours without another hit. Often they don’t recognize the connection between their mood changes and the drug. After several days without the drug addicts can begin to develop severe depression accompanied by frequent crying spells. Many in recovery from marijuana addiction say the experienced a rapid and immense drop in self-confidence and self-esteem along with intense feelings of worthless and anxiety. Some even developed suicidal thoughts.
3. Loss of Ambition
While some pot users may continue to function at their jobs and their personal lives, addicts may end up accomplishing a lot less than would if they were not addicted to the drug. People who were once active and ambitious may stop participating in work, school or social functions, and lower their ambitions or drop them altogether.
4. Physical Changes
Withdrawal from marijuana can also include physical symptoms like nausea and loss of appetite. People in withdrawal often also report having sleep disturbances and nightmares that can continue over a period of months.
Many people with addiction and substance use problems are afraid to ask for help because of the stigma associated with the disorder. This can especially be true for those struggling with marijuana addiction. Since many harbor the belief that marijuana is a completely harmless drug, many addicts might assume that their friends and or family members will dismiss their concerns, especially if they are marijuana users too who don’t feel that they have experienced any ill effects from the drug.
So, it’s especially important for those who fear that they may be dependent on pot to know that they are not alone - many people struggle with this particular drug in the same ways that they do. They are not imagining things—marijuana addiction is real and it can be treated. And, They are not weak - anyone can become addicted to marijuana.
If you think that you or a loved might have a problem with marijuana, reach out for help from a therapist and a local Marijuana Anonymous (MA) group.
If the addiction is severe and is accompanied by other disorders such as depression, anxiety, or bipolar disorder—and it often is— inpatient or intensive outpatient treatment may be needed. If so, look for a program that provides treatments that can begin to heal both the emotional and neurological aspects of addiction through trauma work, experiential therapies like equine therapy and art therapy, and brain-based therapies like biofeedback and neurofeedback.
Our specialists at The Meadows would be happy to answer any questions you might have about addiction treatment. Please call us anytime at 800-244-4949 or chat with us through our website.
Evidence is mounting that regular marijuana use increases the chance that a teenager will develop psychosis, schizophrenia or a pattern of unusual thoughts or perceptions, earlier than they might have had they not used cannabis. Heavy marijuana use between the ages of 15 and 17, a critical period for brain development, could result in the onset of psychosis in those prone to the disorder, new research suggests (1).
“With several states easing marijuana laws or even legalizing the drug altogether, both adolescents and parents might pay heed to this warning about the potential for the earlier onset of psychotic illness in regular marijuana users,” says Dr. Stephen Brockway, The Meadows Psychiatrist.
It’s important to keep in mind that this research does not mean marijuana can cause psychosis. It only shows a relation between smoking pot and developing psychosis or schizophrenia earlier than one otherwise might have. Data from the Allied Cohort on the Early course of Schizophrenia (ACES) II project, a secondary analysis of ACES, showed those who regularly smoked marijuana (at least more than twice a week) aged 15-17 years experienced first episode psychosis an average of almost 4 years earlier than their counterparts with first episode psychosis who did not use cannabis (1).
Predictors that cannot be modified regarding the age of onset for development of psychosis are male sex and family history of psychosis. Young adults with a parent or sibling affected by psychosis have a roughly one in 10 chance of developing the condition, whether or not they smoke marijuana (2).
The study included 247 hospitalized patients who had experienced first episode psychosis. Most study participants were single, male and African American. Nearly half of the patients had not graduated from high school, and almost 60% had been incarcerated. It was discovered that the average age of prodromal symptoms was 19 years, age at onset of psychotic symptoms was 21 and age of hospitalization was 23 (1).
Researchers asked the patients’ detailed questions about their individual marijuana use and just fewer than 80% reported having used the drug. The average age of psychosis onset was 21 years in those who used cannabis between the ages of 15 and 17, compared to those with no cannabis use during that time period, which were roughly 23 to 24 years of age. The amount of marijuana smoked was also a predictor of age of onset for those under 18 years old.
Teen use of marijuana may be particularly harmful because the teenage brain is still a work in progress. Areas of the brain responsible for judgment and problem solving are still making connections with the emotional centers of the brain. It is possible that smoking marijuana could derail the natural process of brain growth, which in turn could increase a young person’s vulnerability to psychotic thinking.
Delay in psychosis onset is important because it improves outcomes in the severity of symptoms and disability level. The later in life psychosis symptoms arise, the more one has been able to accomplish, such as graduate from high school. This in and of itself is associated with better physical health, better mental health and better social outcomes over the course of a life span (1). Despite the growing evidence of the relationship between marijuana and psychosis, further research is needed to determine causality.
Many doctors explain how the link between marijuana and psychotic disorders is important to be aware of for patients with a family history of schizophrenia or other psychotic disorders, but there is no evidence in regards to marijuana being a cause for these disorders. It is most plausible to conclude that cannabis use precipitates schizophrenia or other psychotic disorders in individuals who are already vulnerable because of family history (3).
LEGALIZATION OF MARIJUANA IN ARIZONA
by Jerry Boriskin, PhD
Arizona Legalizes Medical Marijuana: www.cbsnews.com/8301-504763_162-20022928-10391704.html
The following Time Magazine article, "How Marijuana Got Mainstreamed" looks at the issue from a national perspective: http://www.time.com/time/nation/article/0,8599,2030768,00.html
As a professional who treats individuals with PTSD and other co-occurring conditions, I want to encourage you to be careful in separating hype, culture, science, and fact in making decisions about using marijuana as a tool, distraction, or method of coping with emotional and/or physical discomfort. Perhaps the most important thing to know is the difference between a drug and a medicine. Cannabis may in fact have some medicinal ingredients; separating the medicine from cannabis" 400 other chemicals will require additional science, some of which is already under way. I list below my key concerns:
1. You might feel mellow when you smoke or consume cannabis, but your ability to learn, drive a car, or function in a relationship may become more impaired than you would ever dream. There is evidence that young brains, not fully developed, may be permanently injured or altered by marijuana use.
2. Self-medicating with drugs, alcohol, and/or marijuana can make things much worse, not better. We know that alcohol increases depression and the risk of violence. The negative impact of cannabis is more subtle for most, and dramatic for a few. For some individuals, anxiety is relieved temporarily but increases over time. Some long-term users develop full-blown panic attacks.
3. Regular use of cannabis can increase the risk of schizophrenia, a serious psychiatric disorder. Modern marijuana tends to contain higher levels of hallucinogens than did the pot of the 1960s. We also believe that marijuana increases the risk of the onset of bipolar disorder. We do not fully understand all the causative factors for these serious illnesses, but genetic and environmental risk factors do exist. The use of marijuana appears to increase the risks.
4. Cannabis is addictive. There are some disputes regarding the formal definition of "addiction," but recent evidence indicates that cannabis meets the criteria of an addictive substance. Those of us who treat addictions have seen many older and sober patients who have been addicted to marijuana for decades; one of the most common observations is "I don't know how I lost the last 20 years. I got nothing done."
5. Smoking marijuana may mask symptoms of PTSD - delaying treatment, recovery, and natural mastery of powerful symptoms.
6. Self-medicating is not the same as treatment. When you self-medicate, you cannot control the content, quality, or dose of what you consume, and you are at great risk of becoming impaired, addicted, or out of control in ways you might not see for a long time.
Bottom line: If you are a trauma survivor, you should be aware that self-medicating for PTSD and other psychiatric disorders is risky. I am an advocate of your good physical, emotional, and interpersonal health. I urge you to avoid self-medicating with alcohol as well as cannabis; staying sober and clear-headed will help you recover from the symptoms that bring you to our doors.