- Is there such a thing as reefer madness? No, at least not compared to heroin and opiates.
You may have made or heard comments about "jonesing for weed," "needing" to smoke or having a "pot habit." The idea that someone has a fever for cannabis that can only be treated with more cannabis implies a "cannabis addiction."
Is that a real thing? Can someone become addicted to cannabis in the same manner as an alcoholic, or a regular user of drugs such as opiates, cocaine or heroin?
Much like a car that's been hotboxed, the answers are hazy. The term "addiction" has a fairly broad definition, and the differences between someone with a consistent daily habit of consuming cannabis versus heroin are vast.
Merry Jane writer Madison Margolin recently posted a piece that breaks down the issue and the categories of addiction, dependence and disorders.
The National Institute of Drug Abuse defines addiction as "...compulsive drug use despite harmful consequences...characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal."
NIDA defines dependence as "...which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal)."
So what's the difference? NIDA continues that "...physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. This distinction can be difficult to discern, particularly with prescribed pain medications, for which the need for increasing dosages can represent tolerance or a worsening underlying problem, as opposed to the beginning of abuse or addiction."
Then there is what the Diagnostic and Statistical Manual of Mental Disorders Vol. 5, defines as a "cannabis use disorder." Margolin writes " ...a person must exhibit two to three of 11 criteria to officially qualify, including symptoms like cravings, developing a tolerance or spending a lot of time getting, using or recovering from a given substance."
What about a medical patient who has a craving for pain relief by using cannabis, who has built up a tolerance from regular use and spends a fair amount of time acquiring and consuming? That checks off three boxes, so...yes? Is reducing or eliminating physical pain truly a "disorder?" Would prescribed opiates be less likely to develop into the same disorder? All signs point to no.
The Denver Post recently published an article stating that cannabis addiction is real and rising, affecting 9 percent of cannabis users and 17 percent of those who start in adolescence. Some blame it on the increased potency of THC in flower and the wider availability of concentrates and extracts. Yet Margolin writes, "Research has found that people who smoke stronger forms of cannabis may tend to smoke less, since they titrate their doses themselves."
The 9 percent addiction rate compares to 15 percent for alcohol and cocaine and 24 percent for heroin. The differences in how the body responds to withdrawal from each of these drugs is stark: irritability, anxiousness and a serious case of "Cranky Pants" are symptoms those quitting cannabis may experience. Heroin users get that, plus sweating, nausea, depression, aches and pains, and best of all, up to a week of severe stomach cramping, vomiting and diarrhea. (You know what might be good for those ailments? Anyone?)
Prohibitionists cite an increase in admissions at rehab centers for cannabis addiction, but fail to mention a major undercutting qualifier. According to a 2015 study by the Department of Health and Human Services, over 50 percent of those in rehab for cannabis had been sent there by the courts and justice system, often facing jail time as an alternative. In 2013, of the 281,991 people in rehab for cannabis, fewer than 20 percent voluntarily sought out treatment.
Anyone who feels cannabis (or any substance) has become detrimental to their well-being should have access to support and services, but perhaps not at the expense of beds in rehab facilities. Those beds are in chronic short supply, and urgently needed by those seeking treatment for heroin and opiates, as a delay in treatment for them can prove fatal.
A cannabis user most likely won't smoke to death waiting for that same bed.