Cannabis Addiction Facts and How to get Treatment
So many people get cannabis wrong. For decades, society has been at loggerheads over the drug, with one side exaggerating its dangers (remember ‘Reefer Madness’, the US public health film where a young cannabis smoker kills his entire family with an axe?), and the other promoting it as the ‘holy herb’, – the answer to the world’s problems.
But maybe the biggest myth of all is that cannabis is not addictive. In reality, cannabis use can cause dependency in much the same way as other drugs such as cocaine or alcohol, both on a chemical and behavioural level. Research shows that cannabis addiction shares many of the characteristics of other addictions; withdrawal symptoms, deep cravings for the drug, behavioural change and recurring relapse.
Cannabis is by far the most widely used illicit drug in the UK.
Most users would argue that it is completely harmless, a benign way of relaxing, letting go of the stress of daily life and adopting a different perspective. But the United Nations Office on Drugs and Crime report that 1 in 9 cannabis users overall will develop an addiction to the drug. That risk rises to 1 in 6 for those who begin using the drug in their teens.
The media would have us believe that the characteristic cannabis user is very much of a type – laid back, vaguely philosophical and prone to fits of giggles. But cannabis affects different people in different ways. Some do indeed get giggly and relaxed, others get talkative, become more aware of their senses or feel as if time has slowed down. Cannabis can also have a number of negative effects, and users often report feeling anxious, lethargic, sick or confused when under the influence.
All of these diverse effects spring from the same mechanism. The active ingredient of cannabis is a chemical called THC, which is similar to chemicals that occur naturally in the brain. These natural chemicals are called endogenous cannabinoids and they affect brain areas that influence pleasure, memory, concentration, movement, coordination and sensory and time perception. Together, these brain areas are called the endocannabinoid system, and they play a critical role in the nervous system’s normal functioning and development.
When cannabis is used, the active ingredient of the drug – a chemical called THC – travels up the bloodstream and into the brain.
Once in the brain, it mimics the endogenous cannabinoids, disrupting brain function across the endocannabinoid system. Because this system is involved in the many different parts of the brains function, cannabis can cause many different symptoms. For example, THC can interfere with the hippocampus, the brain area that enables a person to make new memories and shift perspective. At the same time, it may disrupt the functioning of the cerebellum, which is responsible for regulating balance and reaction times. But as the effects of THC are considerably stronger and longer lasting that those of the naturally occurring cannabinoids, the effects can be significantly stronger than anything experienced naturally.
How cannabis use becomes addiction
The same mechanism described above can lead to addiction. Over time, the brain adapts to the drug by reducing the production of and sensitivity to its own naturally occurring endogenous cannabinoids. As this happens, tolerance to the drug increases and the users becomes dependent on the drug just to feel normal. This means that when they attempt to stop using the drug, thy will experience a number of psychological withdrawal effects as the brain struggles to make vital chemicals naturally.
Psychological symptoms of cannabis withdrawal may include:
- Insomnia which last for anywhere between a few nights to months
- Nightmares and vivid dreams
- Anger and irritability
- Loss of sex drive
These symptoms will usually fade within three months. Meanwhile, a number of physical symptoms may be present, including:
- Night sweats
- Loss of appetite
- Coughing up Phlegm
“Skunk” and High Potency Cannabis
Cannabis production has changed greatly over the past three decades, and there are varieties of cannabis available on the market today that are many times stronger than those available to the previous generation. Twenty years ago, the majority of cannabis available in the UK was grown abroad, normally on low intensity outdoor farms. THC levels in cannabis were low, averaging just over 3%. Now, almost all cannabis in the UK is grown indoors from special, high potency strains. A study by The Journal for Forensic Sciences found that the average THC concentrations in 2008 were around 9%, almost three times higher than those found in the early 1990’s.
The effects of this increase in potency are enormous. A number of studies have found higher strength cannabis to dramatically increase chances of users developing addictions and mental health disorders. Of these disorders, the most common are psychosis, characterized by an increased inability to separate reality from fiction, as well as depression and anxiety. Age plays a part, with users under 25 at an increased risk of mental health disorders from high grade cannabis.
In the last ten years, admissions to treatment services for cannabis addiction have increased by 55%, even though overall use has dropped. Scientists believe that this can be explained in part by the increase in high-strength cannabis, due to the simple fact that the disruptive effects of THC on the brain increase correspondingly with the levels of THC in the drug.
How modern cannabis is engineered to cause dependence and mental health disorders THC may be cannabis’s most famous ingredient, but naturally grown cannabis contains large amounts of another important chemical – CBD. CBD moderates the effects of THC by reducing the anxiety and paranoia that THC can induce. CBD has also been shown to reduce the addictive qualities of THC, as well as long term mental health risks. However, modern, high strength cannabis is explicitly bred to contain very little or zero CBD, and the highest levels of THC possible. This makes it considerably more dangerous.
Risk Factors for Cannabis Addiction
There are a number of factors that might put an individual at increased risk of developing an addiction to cannabis. These include:
Associating with cannabis using peers is one of the most salient risks for youth drug use. For example, research shows that crucial periods for developing a drug addiction occur during important life transitions, such as moving house or changing school, because it is in these times that individuals are most likely to come into contact with new, drug using peers.
Research has shown that teenagers who feel disengaged from school have a higher risk of using cannabis. Reasons for this disengagement can vary; some students may struggle to keep up, others may find school particularly easy, while some may be poorly suited to mainstream curriculums.
An unstable family environment is a risk factor for all types of drug use, and cannabis is no different. Parents or other family members who have problems with drugs or alcohol are particular pose particular risks, as the model drug use for their children, struggle to monitor their behaviour or provide exposure and access to drugs.
Cannabis is relatively cheap in comparison to alcohol or other drugs, and synthetic cannabis is even cheaper. It is also an easy form of distraction and provides an immediate escape from the mundane. Poverty is by no means the only cause of these conditions, but research has shown that cannabis use is particularly prevalent in poor communities and among the unemployed.
Is cannabis really a gateway drug?
The discussion of whether cannabis acts as a ‘gateway’ to harder drugs has been raging for many years, and there is little sign of it abating any time soon. The evidence shows that cannabis use almost always precedes the use of other drugs, although it is more likely to lead onto the use of other ‘soft drugs’, such as hallucinogens and ecstasy, than harder drugs such as cocaine and heroin. However, limited evidence suggests that the alterations of brain chemistry caused by cannabis could make users more responsive to other drugs, and thus increase their chances of developing addictions to harder drugs.
Long Term Health Effects
Cannabis has a unique influence on memory and learning, different from all other drugs. In both the short term and long term, cannabis damages the ability to form new short term memories. This in turn reduces the brain’s learning capacity, and has negative impacts on concentration, decision making and coping skills. Among regular users, these defecits continue long after abstinence, suggesting that cannabis use can cause semi-permanent damage to the brain.
Research shows that cannabis use can dramatically increase the chances of developing psychological disorders, incuding psychosis, anxiety depression and schizophrenia. This risk increases both with the strength of cannabis used, and the age that use is started. When compared with people who have never used cannabis, those who started at the age of 15 or before are twice as likely to develop psychosis and more than 4 times as likely to experience symptoms of delusion. According to The Official Journal of World Psychiatry, cannabis use is directly responsible for 13% of cases of cases of schizophrenia.
The American National Institute on Drug Abuse suggests that a person’s risk of a heart attack may be five times higher during the first hour after smoking cannabis. This could be explained by the fact that cannabis increases heart rate by up nearly 100%, raises blood pressure and reduces the bloods ability to carry oxygen. Cannabis smoke also contains many of the same harmful ingredients that are present in tobacco smoke, such as carbon monoxide and cyanide. However, as users tend to inhale deeper on cannabis than tobacco, the damages the drug can cause to the respiratory and cardiovascular systems are amplified. Because of this, cannabis smoke deposits four times the amount of tar in the respiratory tract as tobacco, and causes the build-up of twice as many immune cells. This can lead to immunological problems throughout the body.
Cannabis use and pregnancy
Studies on rats show that cannabis use when pregnant affects the structure and functioning of the brain of foetuses and cause learning and memory difficulties in later life. Carbon monoxide from cannabis smoke can led to decreased birth weight and developmental difficulties, in a similar way to tobacco smoke. However, unlike tobacco, cannabis can also cause developmental delays I the visual system and tremors, though these often subside within a month after birth.
Cannabis users are often more reluctant to accept treatment than people with other addictions; not because the drug is more addictive than other addictive substances or behaviours, but because users are often very reluctant to let it go, often referring to it as their ‘last vice’ or ‘not a real drug’. Even when the effects of addiction start creeping across different parts of their life, cannabis abusers will often not class themselves as addicts, at least not in the same way that those struggling with alcoholism or substance abuse.
The first step of recovery for all addicts is the acknowledgement that they are powerless over their addiction, and that change doesn’t happen on its own.
This often takes the support of friends and family, who can be the best source of information for a loved one struggling with addiction. It is only by the user coming to understand the damage that addiction does to their life and the life of those around them, that they can start on the path towards recovery.
Rehab offers a framework for the next stages of recovery, and a safe, supportive environment in which the process can begin. Due to the effects of long-term cannabis use on the brain, as well as the psychological problems abuse can cause, the rehab process is built around group and individual therapy sessions. One form of therapy that studies have consistently shown to be useful for treating cannabis addictions and preventing relapse is Cognitive Behavioural Therapy (CBT). Learning process play an important role in addiction, as the user’s brain adapts to the drug and creates new cognitive pathways which alter the way they think about it. But these same learning processes can be harnessed in a positive way, and used to help support abstinence form the drug and prevent relapse. CBT helps users to recognise the patterns that have led them to use cannabis in the past, and cope with the cravings that are a part of recovery.
Another important aspect of treatment can be Group Therapy, where participants benefit from the fellowship of the group and peer support.
Group therapy can be extremely effective in helping the patient come to understand some of the essential truths about their addiction, as members of the group work together to overcome the same issues. In the group, members exchange stories, coping strategies, hopes and difficulties. With the structure of the 12 steps program, these groups can help patients work through the process of recovery in an atmosphere of mutual respect and support.