Can Your Medical Marijuana Actually Lead To A Cannabis Addiction?

Did you know that marijuana is, according to the 2017 National Survey on Drug Use and Health (NSUDH) the most used illicit drug in the US — all despite a ban at the federal level? 

Defining medical marijuana

Medical marijuana is weed used as a treatment for diseases or to alleviate symptoms. Many states in the US have now legalized medical marijuana. Health experts use it as a pain management strategy and to tackle the side effects that come from some medical treatments. Medical marijuana is also approved as a treatment for certain conditions. 

What forms of medically prescribed marijuana are available?

Different medications derived from elements found in marijuana (cannabinoids) are now being prescribed in the US:

• Dronabinol. This is a synthetic THC drug that comes in two forms — the pills  are called Marinol and the oral solution is available under the name Syndros. ​
• Marinol. This medication is a dronabinol oil suspension available in gelatin shell capsules. Approved by the FDA in 1985, medical professionals can prescribe it to treat nausea and vomiting that result from chemotherapy. In 1992, it began to be used for appetite stimulation to tackle weight loss related to AIDS. At first, it was listed among Schedule II drugs but in 1999 was made a Schedule III drug. 
• Syndros. This dronabinol drug comes in a liquid oral formula and is also designed to treat nausea and vomiting arising from chemotherapy, as well as AIDS-related weight loss. After gaining approval from the FDA in 2016, the DEA classified it among schedule II drugs in 2017. 
• Nabilone. This synthetic cannabinoid has a molecular structure similar to THC. It is only available in pill form, under the brand name Cesamet. Cesamet was approved by the FDA in 1985 and is used to treat nausea and vomiting related to chemotherapy. It still remains on the list of Schedule II drugs. 
• Cannabidiol. Also known as CBD, this compound is sourced from cannabis plants and is not psychoactive like THC. The FDA has approved it as Epidiolex. It comes in a liquid oral formula and is used to treat Lennox-Gastaut syndrome as well as Dravet syndrome. It is listed as a Schedule V drug. Epidiolex began to be prescribed in 2018. ​Cannabidiol also has other nonprescription uses as individuals believe that it has a wide range of medicinal benefits (claims that are unverified by the FDA). CBD is legal in many states but the nature of its legality varies. 

Is marijuana addictive?

While it is easy for millions of marijuana users to use or drop it without any difficulties, this is by no means true for everyone. Some users stand the risk of becoming addicted to marijuana. Recent data from the National Institute on Drug Abuse (NIDA) suggests that of all marijuana users, a massive 30 percent may develop mild to severe marijuana use disorder. They further add that using marijuana under the age of 18 can increase the risk of addiction by as much as seven times. 

In its fifth (and current) edition, the Diagnostic and Statistical Manual of Mental Disorders highlights cannabis use disorder as a medical issue that can be diagnosed. It states that using cannabis regularly could cause the symptoms and behavioral issues usually seen in other substance use disorder cases. 

Marijuana contains delta-9-tetrahydrocannabinol, a psychoactive substance popularly called THC. On ingesting marijuana, THC gets to the lungs and makes its way into the bloodstream. From there, it is transported to the brain. This process may require up to 30 minutes or more to produce a high. 

As marijuana reaches the brain, it triggers certain receptors and can lead to symptoms like memory and movement impairment, an inability to process thoughts with ease, mood changes, and more. 

Drugs infiltrate the brain and override its natural processes. Depending on its type, a drug can enhance or suppress a function above or under its optimum level. This may cause the brain to protect itself by building a resistance to the drug's effects. So, in the case of marijuana, for a user to get a similar feeling of highness, they would have to progressively ingest larger doses. As time passes, users would begin to explore higher doses of marijuana in the form of concentrates known as dabs or in the form of edibles. The continuous use of marijuana after tolerance sets in may result in dependence and addiction. 

What happens during the dependence and withdrawal phases?

Marijuana dependence may occur after tolerance sets in. The regular use of the drug causes the brain of the user to adapt to having THC. So, when the drug is absent or its effects wear off (if the user stops smoking, for instance), they begin to experience negative reactions known as withdrawal. 

Withdrawal is characterized by a spike in heart rate, being irritable, insomnia, restlessness, cravings, as well as, bad moods, loss of appetite, and more.  Marijuana users who experience use disorders usually have a high dependence on the drug. Their body becomes reliant on marijuana and needs it badly to carry out normal functions. While tolerance or dependence does not necessarily mean that a user will suffer addiction to marijuana, they show that problematic use has set in. 

When does marijuana addiction set in?

The use of marijuana can result in addiction when it interacts with the reward centers in the brain. 

When marijuana is ingested, THC causes the release of dopamine. This brain chemical is responsible for producing the feel-good sensation that we refer to as a high. Then again, it causes the reward pathways in the brain to take note of the experience and continue to repeat it. 

This means that THC activates chemical processes that make the user love marijuana and start to want more. When the body develops a physical dependence on marijuana and starts to crave the drug, addiction sets in. 

Compulsive use even in the face of adverse effects is a huge signal of marijuana addiction. The user becomes unable to control how they ingest marijuana even if it causes issues in their personal lives and relationships, at their place of work or school, and even with the law.

But can medically prescribed marijuana cause addiction?

How safe is medically prescribed marijuana? Sufficient data is needed to reach strong conclusions, and medical marijuana has not been around long enough to say. But typically speaking, using medical marijuana does not lead to serious adverse effects. Users of medical cannabis may experience:

• Dizziness
• Psychoactive effects
• Enhanced appetite
• Feelings of tiredness
• Impaired memory in the short term
• Psychosis or paranoia when ingested in high doses
• Impaired movement

Withdrawal is barely ever an issue when cannabinoids are administered under control. Advocates for medical marijuana speak about its safety but more research will be needed to determine how safe it is to use medical cannabis in the long term.

Did you know? Prescription drug addiction vs medical marijuana

The Centers for Disease Control and Prevention reported that in 2014, the number of deaths from drug overdoses in the US reached a new high. Most deaths occurred due to increased prescription use, which seems to be a growing epidemic. Among the misused prescription drugs, CNS depressants, stimulants, and opioids have the highest rates of abuse. Hydrocodone and OxyContin, two opioids, have resulted in more deaths from drug overdose than other prescription substances. 

In almost two decades, prescription painkillers have led to an increase in deaths arising from an overdose. And the CDC reports that since 1999, prescription opioid use has increased almost four times. Even if pain reports between 1999 to 2014 were stable, more Americans died from prescription opioids. 

A lot of people are checking into treatment centers all over the US to seek help. So, it is clear that even if these prescription drugs are administered for good reasons, their addictive potential is extremely high. With these facts in mind, it would only be rational to ask why there is not yet a strong movement to see that these highly addictive prescriptions are banned, even though people are worried about medical marijuana.