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

Evidently, “the evidence clearly indicates that long-term marijuana use can lead to addiction. Indeed, approximately 9% of those who experiment with marijuana will become addicted…The number goes up to about 1 in 6 among those who start using marijuana as teenagers and to 25 to 50% among those who smoke marijuana daily.” 

By addiction, they’re talking about the colloquial definition of “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 experience withdrawal symptoms that make it hard to quit. I discuss marijuana addiction in my video Is Marijuana Addictive?.

This withdrawal syndrome, which affects around 50 percent of daily users, typically begins one to two days after stopping and peaks at two to six days. The “craving, sleep problems, nightmares, anger, irritability, dysphoria [unease] and nausea” go away after one or two weeks. 

“Marijuana continues to have the reputation…as being benign, non-habit-forming, and incapable of inducing true addiction. For most users this may be so.” As you can see at 1:20 in my video, 9 percent of users become dependent, making cannabis less addictive than many other drugs, such as alcohol. It has only about half the dependence risk compared with heroin or cocaine and is less than a third as habit-forming as tobacco. But, 9 percent, “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 marijuana.

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

This is not your grandmother’s grass. On the basis of 38,000 samples of marijuana confiscated by the U.S. Drug Enforcement Agency, the potency has tripled in recent years, from 4 percent THC to around 12 percent, as you can see at 2:09 in my video. The THC in marijuana from Denver and California is now approximately 15 percent, and it pushes 20 percent in cannabis from Seattle. In fact, “the THC content of marijuana strains has increased by 15-fold since 1970s.” Today’s pot is like 15 joints all rolled up into one.

Don’t users know this and titrate their dose accordingly, using less of the more potent pot? Yes, but they don’t compensate fully, so they end up getting higher doses, which is perhaps reflected in the increase in emergency room visits for marijuana intoxication in Colorado 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. As you can see at 3:03 in my video, tobacco kills 25 times more people worldwide every year than all illicit drugs combined, and alcohol kills about 10 times more. On its own, “cannabis contributes little to mortality,” so one has to consider the outcomes of substance dependence. Caffeine, for example, can be addictive, too, but if it gets you to drink more green tea, it’s a good thing. The consequences of consuming green tea leaves as opposed to marijuana leaves depends on the health consequences. 

KEY TAKEAWAYS

  • About 9 percent of those who experiment with marijuana become addicted in the colloquial sense, and that number increases to approximately 25 to 50 percent among daily marijuana users.
  • Withdrawal syndrome, which usually begins a day or two after stopping cannabis use and peaks at two to six days, affects about 50 percent of daily users. After one or two weeks, the cravings, sleep issues, anger, irritability, nausea, and other side effects may disappear.
  • Cannabis is less addictive than many other drugs, including alcohol, heroin, cocaine, and tobacco, but approximately one in six who started using marijuana as teens become addicted.
  • The more popular high-potency strains have been associated with a greater severity of cannabis dependence.
  • Potency has tripled in recent years, and the THC content of some strains has increased 15-fold since the 1970s.
  • Parallels have been drawn between the cannabis and tobacco industries intentionally boosting levels of THC and nicotine, respectively, to make them more addictive, but, whereas tobacco kills 25 times the number of people each year than all illicit drugs combined, “cannabis contributes little to mortality.”

Next in my series on cannabis is Does Marijuana Cause Health Problems?.

I’ve produced a whole treasure chest of videos on cannabis available on a DVD—Cannabis: What Does the Science Say.

Other videos on cannabis include:

Speaking of parallels with the tobacco industry, check out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

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