Is Marijuana Addictive?

Is Marijuana Addictive?
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The evidence clearly indicates that long-term marijuana use can lead to addiction, but are there negative consequences?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“[T]he evidence,” evidently, “clearly indicates that long-term marijuana use can lead to addiction.” “[A]pproximately 9% of those who experiment with marijuana will become addicted,” and that “number goes up to about 1 in 6 among those who start…marijuana as teenagers and to 25 to 50% among those who smoke marijuana daily.”

By addiction, what they’re talking about is like the colloquial definition: “an acquired, chronic, relapsing disorder that is characterized by a powerful motivation to continually engage in an activity despite persistent negative consequences.” You may want to stop, but when you try, you may suffer withdrawal symptoms that make it hard to quit.

This “withdrawal syndrome…affects around 50% of daily users,” and “typically begins 1 to 2 days after [stopping], peaks at 2 to 6 days.” But the “craving[s], sleep[ing] problems, nightmares, anger, irritability, [unease], and nausea” goes away after one or two weeks.

Marijuana now has this “reputation…as being benign, non–habit-forming”—and that may be true “[f]or most users.” Certainly less addictive than many other drugs, like alcohol, only about half the dependence risk compared to heroin or cocaine, less than a third as habit-forming as tobacco, but 9%, “One in 11 users—1 in 6 for those starting in their early teens—is hardly an inconsequential percentage…”—given that about 20 million Americans actively use the stuff.

“However, not all varieties of cannabis” are equally addictive. “[H]igh potency strains have been associated with a greater severity of dependence,” but that’s the stuff people prefer.

This is not your grandmother’s grass. Based on 38,000 samples of marijuana confiscated by the DEA, the potency has tripled in recent years, from 4% THC up to around 12%, with Denver and California now up around 15%, and Seattle pushing 20%. That’s 15 times more powerful than pot from the 70s, so like 15 joints all rolled up into one.

Yeah, but don’t users know this, and “titrate their dose…” accordingly, using “less of the more potent” pot? Yes, but they don’t compensate fully, and so do end up getting higher doses—perhaps reflected in the increase in emergency room visits in Colorado for marijuana intoxication after legalization.

Parallels have been drawn with the tobacco industry intentionally boosting nicotine levels of their products to make them more addictive, but where that analogy breaks down is in the consequences of that addiction. Every year, tobacco kills 25 times more people worldwide than all illicit drugs combined. Alcohol kills about 10 times more, and “cannabis [alone probably] contributes little to [overall] mortality,” at least.

So, one has to consider the outcomes of substance dependence. Caffeine can be addictive, too. But if it gets you to drink more green tea, then great. The consequences of consuming this leaf, as opposed to this leaf, depends on the health consequences, which we’ll cover next.

Please consider volunteering to help out on the site.

  • Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219-27.
  • Curran HV, Freeman TP, Mokrysz C, Lewis DA, Morgan CJ, Parsons LH. Keep off the grass? Cannabis, cognition and addiction. Nat Rev Neurosci. 2016;17(5):293-306.
  • Bostwick JM. Blurred boundaries: the therapeutics and politics of medical marijuana. Mayo Clin Proc. 2012;87(2):172-86.
  • Azofeifa A, Mattson ME, Schauer G, Mcafee T, Grant A, Lyerla R. National Estimates of Marijuana Use and Related Indicators - National Survey on Drug Use and Health, United States, 2002-2014. MMWR Surveill Summ. 2016;65(11):1-28.
  • Englund A, Freeman TP, Murray RM, Mcguire P. Can we make cannabis safer?. Lancet Psychiatry. 2017;4(8):643-648.
  • Elsohly MA, Mehmedic Z, Foster S, Gon C, Chandra S, Church JC. Changes in Cannabis Potency Over the Last 2 Decades (1995-2014): Analysis of Current Data in the United States. Biol Psychiatry. 2016;79(7):613-9.
  • Degenhardt L, Hall W. Extent of illicit drug use and dependence, and their contribution to the global burden of disease. Lancet. 2012;379(9810):55-70.
  • Hom L, Gannon R. Non-Psychological Consequences of Chronic Marijuana Inhalation. Conn Med. 2015 Aug;79(7):423-8.
  • Hall W. Alcohol and cannabis: Comparing their adverse health effects and regulatory regimes. Int J Drug Policy. 2017;42:57-62.
  • Balon R. The madness of medical marijuana and marijuana legalization. Ann Clin Psychiatry. 2016;28(4):229-230.

Image credit: Get Budding via unsplash. Image has been modified.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

“[T]he evidence,” evidently, “clearly indicates that long-term marijuana use can lead to addiction.” “[A]pproximately 9% of those who experiment with marijuana will become addicted,” and that “number goes up to about 1 in 6 among those who start…marijuana as teenagers and to 25 to 50% among those who smoke marijuana daily.”

By addiction, what they’re talking about is like the colloquial definition: “an acquired, chronic, relapsing disorder that is characterized by a powerful motivation to continually engage in an activity despite persistent negative consequences.” You may want to stop, but when you try, you may suffer withdrawal symptoms that make it hard to quit.

This “withdrawal syndrome…affects around 50% of daily users,” and “typically begins 1 to 2 days after [stopping], peaks at 2 to 6 days.” But the “craving[s], sleep[ing] problems, nightmares, anger, irritability, [unease], and nausea” goes away after one or two weeks.

Marijuana now has this “reputation…as being benign, non–habit-forming”—and that may be true “[f]or most users.” Certainly less addictive than many other drugs, like alcohol, only about half the dependence risk compared to heroin or cocaine, less than a third as habit-forming as tobacco, but 9%, “One in 11 users—1 in 6 for those starting in their early teens—is hardly an inconsequential percentage…”—given that about 20 million Americans actively use the stuff.

“However, not all varieties of cannabis” are equally addictive. “[H]igh potency strains have been associated with a greater severity of dependence,” but that’s the stuff people prefer.

This is not your grandmother’s grass. Based on 38,000 samples of marijuana confiscated by the DEA, the potency has tripled in recent years, from 4% THC up to around 12%, with Denver and California now up around 15%, and Seattle pushing 20%. That’s 15 times more powerful than pot from the 70s, so like 15 joints all rolled up into one.

Yeah, but don’t users know this, and “titrate their dose…” accordingly, using “less of the more potent” pot? Yes, but they don’t compensate fully, and so do end up getting higher doses—perhaps reflected in the increase in emergency room visits in Colorado for marijuana intoxication after legalization.

Parallels have been drawn with the tobacco industry intentionally boosting nicotine levels of their products to make them more addictive, but where that analogy breaks down is in the consequences of that addiction. Every year, tobacco kills 25 times more people worldwide than all illicit drugs combined. Alcohol kills about 10 times more, and “cannabis [alone probably] contributes little to [overall] mortality,” at least.

So, one has to consider the outcomes of substance dependence. Caffeine can be addictive, too. But if it gets you to drink more green tea, then great. The consequences of consuming this leaf, as opposed to this leaf, depends on the health consequences, which we’ll cover next.

Please consider volunteering to help out on the site.

  • Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219-27.
  • Curran HV, Freeman TP, Mokrysz C, Lewis DA, Morgan CJ, Parsons LH. Keep off the grass? Cannabis, cognition and addiction. Nat Rev Neurosci. 2016;17(5):293-306.
  • Bostwick JM. Blurred boundaries: the therapeutics and politics of medical marijuana. Mayo Clin Proc. 2012;87(2):172-86.
  • Azofeifa A, Mattson ME, Schauer G, Mcafee T, Grant A, Lyerla R. National Estimates of Marijuana Use and Related Indicators - National Survey on Drug Use and Health, United States, 2002-2014. MMWR Surveill Summ. 2016;65(11):1-28.
  • Englund A, Freeman TP, Murray RM, Mcguire P. Can we make cannabis safer?. Lancet Psychiatry. 2017;4(8):643-648.
  • Elsohly MA, Mehmedic Z, Foster S, Gon C, Chandra S, Church JC. Changes in Cannabis Potency Over the Last 2 Decades (1995-2014): Analysis of Current Data in the United States. Biol Psychiatry. 2016;79(7):613-9.
  • Degenhardt L, Hall W. Extent of illicit drug use and dependence, and their contribution to the global burden of disease. Lancet. 2012;379(9810):55-70.
  • Hom L, Gannon R. Non-Psychological Consequences of Chronic Marijuana Inhalation. Conn Med. 2015 Aug;79(7):423-8.
  • Hall W. Alcohol and cannabis: Comparing their adverse health effects and regulatory regimes. Int J Drug Policy. 2017;42:57-62.
  • Balon R. The madness of medical marijuana and marijuana legalization. Ann Clin Psychiatry. 2016;28(4):229-230.

Image credit: Get Budding via unsplash. Image has been modified.

Motion graphics by Avocado Video.

Doctor's Note

I have a whole treasure chest of cannabis videos that are going to be dribbling every month or so until the end of 2019. If you want to see them all now, I put them all in a DVD download. 

Check out all of the videos currently posted: 

And more are coming, so visit the marijuana topic page to see all of the latest. 

Speaking of parallels with the tobacco industry, check out:

If you haven’t yet, you can to my videos for free by clicking here.

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