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The dried leaves, stems, and flowers from the plant Cannabis sativa are more commonly known as marijuana. Marijuana, while it is legal in some states, is still classified as a Schedule I controlled substance by the United States Drug Enforcement Administration. As such, it is the most commonly used illicit drug in the United States. The major active ingredient in cannabis is delta-9-tetrahydrocannabinol (THC), although there other related compounds.
In 2014, the Substance Abuse and Mental Health Services Administration issued a report on a national survey on drug abuse and use that indicated the following:
While there are a number of potential medical uses for marijuana, this does not make its recreational use legitimate. In this country, there is currently quite a bit of controversy over the legalization of marijuana, especially in the light of the legal status of drugs that may be physically more addictive and dangerous, such as alcohol. There are questions regarding marijuana’s potential to result in the development of physical dependence, abuse, and potential addiction. These questions have been addressed by the development of a formal clinical diagnosis.
The notion of a substance use disorder is the new clinical terminology for the former terms substance abuse and substance dependence (addiction). The notions of abuse and addiction are combined into one singular disorder. Individuals displaying fewer symptoms of the substance use disorder are considered to be more in the abuse end of the spectrum, whereas individuals displaying more symptoms are located on the dependence or addiction end of the spectrum. The term for both marijuana abuse and addiction is now cannabis use disorder.
The National Institute of Drug Abuse and the American Psychiatric Association both consider marijuana to be a psychoactive substance that can be abused and lead to addiction. The American Psychiatric Association clearly lays out the symptoms for a cannabis use disorder, which have been developed based on the research associated with individuals who have serious issues related to abusing marijuana.
The National Institute on Drug Abuse similarly reports that marijuana is addictive due to both to the physiological changes that occur in the brain as a result of chronic marijuana usage and psychological changes that also occur due to chronic use. Individuals who begin smoking marijuana at younger ages or who use marijuana daily are at increased risk to develop the symptoms.
The symptoms of a cannabis use disorder include the clinical diagnostic symptoms reported by the American Psychiatric Association that can only be professionally applied by licensed mental health care workers. In addition, symptoms of a cannabis use disorder include:
In addition, individuals who begin to use more and more marijuana to achieve the same effects that they achieved at lower doses previously, and who develop mild withdrawal symptoms when they stop using marijuana, are displaying signs of physical dependence on marijuana. Withdrawal symptoms from cannabis typically include severe irritability, restlessness, decreased appetite, mood swings, difficulty sleeping, and strong cravings to use marijuana. Thus, the physical dependence that develops on marijuana is relatively mild. The National Institute of Drug Abuse estimates that about 9 percent of heavy users develop symptoms of physical dependence.
Marijuana is a widely abused the drug. As mentioned above, the age group most significantly affected by cannabis abuse are individuals between the ages of 18 and 26; however, individuals over all ages abuse marijuana.
Risk factors for developing a cannabis use disorder include:
Those attempting to recover from a substance use disorder of any type will benefit from the assistance of a professional treatment program. These programs address the substance use disorder from a number of different perspectives and help clients to learn structured approaches to relapse prevention.
While marijuana abuse or a cannabis use disorder is not associated with the potential to develop significant physical dependence and potentially dangerous physical withdrawal symptoms, many individuals will experience some level of withdrawal symptoms, and about 10 percent will experience fairly significant withdrawal symptoms. Most of the symptoms are emotional and psychological, but some minor physical symptoms may also occur.
A formal medically assisted detox program may be useful for individuals who have long histories of chronic marijuana usage. While some type of residential or inpatient treatment program is not necessary for most individuals, it might be advisable under certain conditions.
Individuals looking to recover from a cannabis use disorder should consider the following:
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