The Controlled Substances Act (CSA) of 1990 categorizes marijuana as a Schedule I drug. This classification means that the government has adjudged marijuana to have a high potential for abuse while having no officially approved medical utility. THC (delta-9-tetrahydrocannabinol) is the main active chemical in marijuana, and it is responsible for the drug’s psychoactive effects. However, research shows that both THC and cannabinoids have therapeutic value for certain health conditions, such as spasticity symptoms associated with multiple sclerosis. Further, synthetic cannabinoids feature in at least two prescription medications used to ease side effects in chemotherapy patients.
The Politics of Pot
From both a medical and public health standpoint, there is concern that the hot-button nature of marijuana unduly influences research in this area. As discussed in Science Magazine, Dr. Ian Mitchell, a Canadian emergency room physician and prescription-pot advocate, believes that politics drives the public’s opinion about marijuana more than science. In Dr. Mitchell’s opinion, some stakeholders in the marijuana debate have an anti-marijuana agenda while others are decidedly pro-marijuana.
Over 102 million Americans (41 percent of the population) have tried marijuana at least once in their lifetime. Source: Alternet
- Legal for medical purposes
- Legal for recreational use
Is Marijuana Addictive?The short answer is: yes, it can be. Any question as to marijuana’s addictiveness necessarily includes consideration of hallmarks of biological dependence: building a physical tolerance that in turn causes withdrawal symptoms to manifest when the familiar dosage is stopped or significantly reduced. Note that physical dependence is different from addiction. When a person is psychologically addicted to drugs, they manifest unhealthy behaviors, such as becoming remiss in important duties associated with work, family, and/or schools. According to Dr. John Kelly, the lead author of a study published in the Journal of Addiction Medicine (2014), marijuana definitely leads to addiction in certain individuals.
According to Psychiatrist Dr. John Kelly, approximately 8-10 percent of US marijuana users are at risk for addiction. Source: Medical Daily
Dr. Kelly’s study focused on 127 teenagers in the 14-19 age group who were receiving treatment at an outpatient rehab center. In the study, 90 teens advised that marijuana was their primary substance of abuse, and 84 percent of this group were identified as being physically dependent on the drug (various criteria were used to reach this diagnosis). Of the dependent group, 40 percent experienced withdrawal symptoms after ceasing to use marijuana. According to Dr. Kelly, the withdrawal symptoms experienced were akin to those associated with withdrawal from sedative drugs and included cravings for marijuana, anxiety, irritability, and sleep problems. Compared to withdrawal from other drugs, such as opiates, marijuana is considered to have a mild withdrawal profile. However, Dr. Kelly impresses upon the public that marijuana withdrawal is a significant biological event and occurs because there has been damage to the brain and central nervous system.
How Marijuana Works in the BrainThe cannabinoid chemicals found in THC naturally occur in the brain (as part of the endocannabinoid system). The brain houses cannabinoid receptor sites that are designed to activate when cannabinoids attach to them. Once cannabinoids dock at their receptor sites, their main effect is to send out chemical messages that help to slow down communications between cells. When marijuana is consumed, more cannabinoids are released into the brain than would naturally occur.
The brain is a delicate orchestra of chemicals working in concert. When THC is consumed, a disruption to the brain’s balance occurs and can have both short-term and long-term effects. Withdrawal, a short-term effect, occurs because the brain has adapted to the increase in cannabinoids associated with marijuana abuse and then reacts when deprived of the familiar level of cannabinoids. According to the National Institute on Drug Abuse, a long-term effect of marijuana abuse is an impairment in neural connectivity that can causes diminished memory, lowered impulse control, and decreased learning capacity.Sources: Scholastic, NIDA
The Gateway Drug ArgumentAccording to the National Institute on Drug Abuse, early marijuana use may “prime” the young brain for dependence on other drugs later in life. This phenomenon is known as cross-sensitization. The studies that support marijuana and cross-sensitization are animal-based. For example, a study found that rats who received THC had a greater behavioral response later on to THC and other drugs, such as morphine. These results are thought to apply to humans as well. The Institute recognizes that drugs other than marijuana can also cause cross-sensitization. Further, many marijuana users will not progress to taking more potent drugs of abuse, such as heroin. As the Institute notes, social interactions also play a role in predisposing youth to drug use, which in turn may condition their brains to graduate to other drugs of the abuse in the future. One possible explanation is that youth in drug-using environments have easy access to marijuana, nicotine, and alcohol. Since these youths already have a substance use history, they graduate to more aggressive drugs as they age, and these drugs become more readily available. The Institute does not provide any insight into whether the biological or social factors have more weight in the cross-sensitization process.
The Pro-Marijuana OpinionStudies that conclude marijuana is addictive do not necessarily thwart the pro-cannabis position. Perhaps the strongest pro-cannabis argument is that the drug has valuable medicinal properties. If cannabis can gain greater therapeutic legitimacy, it will be more difficult to oppose support for cannabis. Take, for instance, that there is currently a prescription pill abuse epidemic in America. Some opponents of America’s pill culture argue that prescription medications (sedatives, stimulants, and pain relievers) should be removed from the market in order to stop abuse. However, the medical community always prevails in their argument that prescription medications must be used, despite high risks for abuse potential, because they have outstanding therapeutic value. Pro-cannabis arguments range from making the drug legal for recreational use to limiting legalization to use for an approved medical condition. In view of the formidable opposition to marijuana legalization in America, pro-cannabis arguments that are skewed in favor of legalization for medical necessity are more palatable. But does marijuana has a therapeutic effect? If so, for which conditions? As mentioned earlier, marijuana’s Schedule I classification means that doctors and researchers will need a special dispensation to study marijuana benefits, which is difficult to obtain. Therefore, there is a dearth of studies in this area. Of the studies that do exist, THC (whether natural or synthetic) has been shown to be an effective or promising treatment for conditions including relief of nausea associated with cancer and AIDS, seizure reduction in epilepsy, slowing or stopping cancer cell growth, and for relief from the symptoms of Crohn’s disease. If greater therapeutic value is found in medicinal marijuana, pro-cannabis organizations and individuals would have greater leverage in the current debate. Cannabis sympathizers may also seek to directly challenge claims about the addictive potential of marijuana. At present, marijuana is the most used illicit substance in America. Yet, as mentioned earlier, only approximately 9 percent of users will become physically dependent on marijuana. Compare that statistic to the corresponding findings about other drugs: 15 percent of alcohol users will become dependent, 17 percent of cocaine users, and 23 percent of heroin users. Cannabis supporters feel that when looked at with a wide lens, the addiction potential of marijuana does not justify its prohibition at the federal level or in those states which have not passed pro-cannabis legislation. Proponents of marijuana legalization also address the argument that marijuana is a “gateway drug.” A main point they make is that marijuana does not cause further drug abuse. Rather, marijuana use may only be correlated to future abuse of other drugs. In other words, future drug use could occur even if marijuana was not the initial drug of initiation into substance use. Cannabis proponents make the point that a predisposition to drug use (be it biological, social, or a combination of both) could be a greater determinant than a drug user’s attraction to marijuana in specific. In this way, drug use is more about the presence of drug-seeking behavior rather an interest in a particular drug, such as marijuana.
Marijuana Anonymous and TeensMarijuana Anonymous is a fellowship organization based on the 12-step model of recovery, and group meetings are the main resource it provides to members. Life With Hope, the fellowship’s main guide, provides extensive information on how the fellowship works, facts about marijuana addiction, and how to successfully recover. According to MA, there are more teen members today than ever before. The MA official site shares “Teen Stories” that shed light on how easily an addiction can develop, but also how effective rehab treatment can be. One teen writing for the “Teen Stories” page shares that he was 14 years old when he started smoking marijuana and became hooked the first time he got “stoned.” He had started drinking at 13, but after he tried marijuana, it became his drug of choice. He then experience two years of what he calls “hell.” In high school, he joined a “stoner circle,” his grade point average fell to 1.6 overall, and he started to deal marijuana. His parents caught him, but his use continued, in part because he felt in control of marijuana, and that he could stop at any time. He was later caught shoplifting. He fought often with his parents, which had a negative emotional impact on his younger brother. After a big fight with his father, he ran away from home. He was using marijuana daily by this point. When he was found one week later, he had finally had enough, started attending MA group meetings, and began working with a sober sponsor. His life dramatically improved, and he has remained abstinent.
Treatment for Marijuana Abuse
Although the political debate on marijuana continues, one fact that is not debatable is that individuals addicted to marijuana are best advised to seek recovery services. According to the drug use information site The Fix, the typical adult who seeks treatment for marijuana abuse has been a chronic user for more than a decade and has attempted to stop using marijuana more than six times. Unfortunately, marijuana abuse is associated with a high relapse rate. Approximately 50 percent of all marijuana abusers who seek treatment will achieve abstinence in the first two weeks of recovery. However, of this group, 50 percent will resume marijuana abuse within one year.
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 Anderson, L. (June 7, 2015). “Marijuana.” Drugs.Com. Accessed July 16, 2015.  Ibid.  Wade, L. (July 16, 2014). “Q&A: Is Politics Influencing Marijuana Research?” Science Magazine. Accessed July 16, 2015.  Ibid.  “State Medical Marijuana Laws.” (July 14, 2015). National Conference of State Legislatures. Accessed July 16, 2015.  “State Marijuana Laws Map.” (June 19, 2015). Governing The States and Localities. Accessed July 16, 2015.  Ibid.  Dovey, D. (Sept. 4, 2014). “Is Marijuana Addiction Real? Study Finds Habitual Pot Smokers Show Signs Of Dependence And Withdrawal.” Medical Daily. Accessed July 16, 2015.  Ibid.  “Is Marijuana a Gateway Drug?” (June 2015). National Institute on Drug Abuse. Accessed July 16, 2015.  Ibid.  Ibid.  “How Effective Is Medical Marijuana? Here’s A Closer Look At 14 Different Uses.” (April 22, 2105). MSN Health & Fitness. Accessed July 16, 2015.  Ibid.  Arkowitz, H. and Lilienfeld, S. (Mar. 1, 2012). “Experts Tell the Truth about Pot.” Scientific American. Accessed July 16, 2015.  Ibid.  “Marijuana Anonymous FAQ: Frequently Asked Questions.” (n.d.). Marijuana Anonymous. Accessed July 17, 2015.  Ibid.  Ibid.  “Available Treatments for Marijuana Use Disorders.” (June 2015). National Institute on Drug Abuse. Accessed July 17, 2015.  Ibid.  Ibid.  Ibid.  Ibid.  Ibid.
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