The question of whether marijuana is addictive has been widely debated. While marijuana is commonly perceived as less addictive than substances such as nicotine or opioids, it can lead to cannabis use disorder (CUD) in some individuals. This article explores the addictive potential of marijuana, the signs of dependence, and the psychological and physical effects associated with frequent use.

Keywords: Is marijuana addictive, Cannabis use disorder (CUD), Psychological dependence on marijuana, Marijuana addiction treatment, Physical vs. psychological addiction, Risks of marijuana use, Effects of cannabis

Addiction is characterised by compulsive substance use despite harmful consequences and a loss of control over consumption. In the case of marijuana, not everyone who uses the drug will develop an addiction, but research shows that it can lead to dependence for some individuals, particularly those who use it frequently over long periods (Budney et al. 2007). According to the National Institute on Drug Abuse (NIDA), approximately 9% of people who use marijuana develop a form of addiction, a figure that rises to about 17% for those who start using in adolescence (NIDA 2020).

Cannabis use disorder (CUD) is a clinical diagnosis used to describe problematic marijuana use. People with CUD may experience cravings, withdrawal symptoms when not using the drug, and continued use despite negative impacts on their life. CUD is more likely to develop in individuals who use marijuana regularly and over long periods. It is recognised as a substance use disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (Hasin et al. 2016).

The main signs of marijuana dependence include:

• Increased tolerance, meaning more of the drug is needed to achieve the same effects.
• Difficulty in reducing or controlling use despite attempts to cut back.
• Spending excessive time obtaining or using marijuana, and neglecting important activities in favour of drug use.
• Withdrawal symptoms when not using, such as irritability, insomnia, decreased appetite, and anxiety (Budney & Hughes 2006).

While withdrawal from marijuana is not as severe as with other substances like alcohol or opioids, it can still cause discomfort and lead to relapse in individuals trying to quit.

Certain factors increase the likelihood of developing a marijuana addiction. Age of onset is one of the strongest predictors; individuals who start using marijuana during adolescence are more likely to develop CUD than those who begin in adulthood (Volkow et al. 2014). Other factors include genetic predisposition, mental health issues, and environmental influences, such as peer pressure and the availability of the drug.

Unlike substances such as opioids or alcohol, marijuana is not generally considered physically addictive in the same way. Physical dependence involves the body adapting to a substance and experiencing significant withdrawal symptoms when use is discontinued. While marijuana withdrawal symptoms can occur, they are typically milder compared to drugs like nicotine or heroin. These symptoms are largely psychological in nature, though some users may experience physical discomfort such as headaches or stomach pain (Budney & Hughes 2006).

While the physical dependence associated with marijuana is less intense than with other substances, psychological dependence is a significant factor. Psychological addiction occurs when a person feels the need to use marijuana to cope with stress, anxiety, or boredom. This can lead to frequent use and difficulty quitting even when the person recognises the negative effects on their life (Hasin et al. 2016).

Treatment for CUD can include both psychological therapies and pharmacological approaches. Cognitive-behavioural therapy (CBT) is often used to help individuals change their thinking patterns and develop healthier coping mechanisms for stress and anxiety. Motivational enhancement therapy (MET) and contingency management are also effective in helping individuals reduce or quit marijuana use (Winters et al. 2011).

Pharmacological treatments for marijuana addiction are still being researched, and no specific medications have been approved for treating CUD. However, ongoing studies are investigating the potential of drugs like N-acetylcysteine and gabapentin to reduce cravings and withdrawal symptoms (Gray et al. 2010).

While marijuana is less likely to lead to addiction compared to substances like opioids or alcohol, it is still possible to develop a dependence on the drug, particularly for regular users. Understanding the signs of cannabis use disorder and seeking appropriate treatment is essential for individuals struggling with marijuana addiction. By focusing on both psychological and physical dependence, we can better address the challenges of marijuana use and promote healthier habits.

• Budney, AJ & Hughes, JR 2006, ‘The cannabis withdrawal syndrome’, Current Opinion in Psychiatry, vol. 19, no. 3, pp. 233-238.
• Budney, AJ, Roffman, R, Stephens, RS & Walker, D 2007, ‘Marijuana dependence and its treatment’, Addiction Science & Clinical Practice, vol. 4, no. 1, pp. 4-16.
• Gray, KM, Carpenter, MJ, Baker, NL, DeSantis, SM, Kryway, E, Hartwell, KJ & Upadhyaya, HP 2010, ‘A double-blind randomized controlled trial of N-acetylcysteine in cannabis-dependent adolescents’, American Journal of Psychiatry, vol. 167, no. 6, pp. 761-768.
• Hasin, DS, Kerridge, BT, Saha, TD, Huang, B, Pickering, RP, Smith, SM, … & Grant, BF 2016, ‘Prevalence of marijuana use disorders in the United States between 2001-2002 and 2012-2013’, JAMA Psychiatry, vol. 73, no. 12, pp. 1235-1242.
• National Institute on Drug Abuse (NIDA) 2020, Marijuana Research Report: Is Marijuana Addictive?, NIDA, viewed 18 October 2024, https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive.
• Volkow, ND, Baler, RD, Compton, WM & Weiss, SR 2014, ‘Adverse health effects of marijuana use’, New England Journal of Medicine, vol. 370, no. 23, pp. 2219-2227.
• Winters, KC, Botzet, AM & Fahnhorst, T 2011, ‘Advances in adolescent substance abuse treatment’, Current Psychiatry Reports, vol. 13, no. 5, pp. 416-421.

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