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MARIJUANA
Overview

Information about marijuana, identifying signs of addiction, and recovery.

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Understanding marijuana as a Drug

Marijuana, or cannabis, is a psychoactive drug from the Cannabis plant, primarily known for its active component, delta-9-tetrahydrocannabinol (THC). Its effects vary based on strain, potency, consumption method, and individual physiology but commonly include altered perception, impaired memory, coordination issues, and potential for addiction. Despite trends toward legalization, marijuana is still a controlled substance in many countries due to its risks. If you or someone you know is struggling with marijuana use, seek professional help and support.1

Understanding Marijuana

The use of marijuana dates back thousands of years, with evidence of its cultivation and use found in ancient civilizations across Asia, Africa, and the Middle East. The earliest known written record of marijuana use comes from ancient China, where it was used for medicinal purposes and as a source of fiber for clothing and paper. Marijuana was also used in ancient India for religious and medicinal purposes, and it played a role in the development of Ayurvedic medicine. In the Middle East and North Africa, marijuana was used for its psychoactive effects and was associated with Sufi mysticism and other spiritual practices. Marijuana was introduced to the Western world in the 19th century, where it was initially used for medicinal purposes and as a recreational drug among artists and intellectuals. In the early 20th century, marijuana became increasingly criminalized in the United States and other countries, primarily due to concerns about its psychoactive effects and associations with marginalized communities. Despite this prohibition, marijuana use continued to grow throughout the 20th century, and in recent years, there has been a growing movement toward legalization and decriminalization.2

Identifying Marijuana

Identifying marijuana can be relatively straightforward when it is in its most common form of dried flower buds. Marijuana buds are typically green to brown in color, with a distinctive skunky, herbal aroma. They may also have visible trichomes, which are small, crystal-like structures that contain high concentrations of THC and other cannabinoids.

Other identifying characteristics of marijuana include:

  1. Leaf structure: Marijuana leaves have a distinctive serrated edge and a fan-like shape, with five to seven leaflets per leaf.
  2. Seeds and stems: Marijuana buds may contain small, round seeds and thin, woody stems, although high-quality marijuana is often seedless and stemless.
  3. Packaging: In jurisdictions where marijuana is legal, it may be packaged in distinctive containers with labeling indicating the strain, potency, and other product information.

However, identifying marijuana in other forms, such as edibles or concentrates, can be more challenging. In these cases, laboratory testing may be necessary to confirm the presence and potency of THC and other cannabinoids. It is important to note that the appearance and aroma of marijuana can vary widely depending on the strain and growing conditions, and that synthetic cannabinoids or other substances may be used to mimic the effects of marijuana.3

Facts About Marijuana

Medical marijuana refers to the use of cannabis or its derivatives to treat various medical conditions, such as chronic pain, multiple sclerosis, epilepsy, and chemotherapy-induced nausea. The therapeutic effects of marijuana are attributed to its active compounds, particularly THC and cannabidiol (CBD), which interact with the body’s endocannabinoid system. Many countries and U.S. states have legalized marijuana for medical use, although the specific conditions and regulations vary by jurisdiction. The use of medical marijuana remains controversial, with ongoing debates about its efficacy, safety, and potential for abuse. However, a growing body of research supports the potential therapeutic benefits of marijuana for certain conditions, and many patients report significant improvement in their symptoms and quality of life with medical marijuana use.
The legalization of marijuana for recreational use has been a topic of growing interest and debate in recent years. As of 2021, several countries, including Canada and Uruguay, and many U.S. states have legalized marijuana for adult recreational use. Proponents of legalization argue that it can reduce the harms associated with marijuana prohibition, such as racial disparities in arrests and incarceration, and generate tax revenue for public services. Opponents, on the other hand, raise concerns about the potential negative impacts of legalization on public health, safety, and youth drug use. The effects of recreational marijuana legalization are still being studied, but early evidence suggests that it may lead to increases in adult marijuana use and some health risks, such as cannabis use disorder and impaired driving. However, legalization has also been associated with reductions in arrests and some measures of racial disparities in the criminal justice system.
The effects of marijuana on cognitive function have been a topic of extensive research and debate. While the acute effects of marijuana can include impairments in attention, memory, and decision-making, the long-term impacts of marijuana use on cognitive function are less clear. Some studies have found associations between heavy or long-term marijuana use and deficits in memory, attention, and executive function, particularly when use begins in adolescence. However, other studies have found no significant long-term cognitive impairments in adult marijuana users, and the extent and permanence of any cognitive effects may depend on factors such as age of onset, frequency and duration of use, and genetic vulnerability. More research is needed to fully understand the complex relationship between marijuana use and cognitive function, and to develop evidence-based guidelines for safe and responsible use .

The relationship between marijuana use and mental health is complex and multifaceted. While some individuals report using marijuana to alleviate symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD), heavy or long-term marijuana use has also been associated with an increased risk of developing or exacerbating certain mental health conditions. For example, research has found associations between heavy marijuana use and an increased risk of psychosis, particularly in individuals with a genetic vulnerability or family history of the disorder. Marijuana use has also been linked to an increased risk of depression and anxiety, although the direction of causality is not always clear. It is important to note that the effects of marijuana on mental health can vary widely depending on individual factors, such as genetics, personal history, and frequency and duration of use. More research is needed to fully understand the potential risks and benefits of marijuana use for mental health, and to develop targeted interventions and guidelines for individuals with co-occurring substance use and mental health disorders.

Marijuana use during pregnancy has been a topic of growing concern, as the prevalence of use among pregnant women has increased in recent years. THC and other cannabinoids can cross the placenta and enter the fetal bloodstream, potentially affecting fetal development and birth outcomes. Some studies have found associations between maternal marijuana use and an increased risk of low birth weight, preterm birth, and neonatal abstinence syndrome. However, the evidence is mixed, and the effects of marijuana use on pregnancy outcomes may be confounded by other factors, such as tobacco or alcohol use, socioeconomic status, and access to prenatal care. Medical organizations, such as the American College of Obstetricians and Gynecologists, recommend that pregnant women discontinue marijuana use and that healthcare providers screen for and counsel against marijuana use during pregnancy. More research is needed to fully understand the potential risks of marijuana use during pregnancy and to develop evidence-based guidelines for prevention and treatment.
Marijuana use can impair cognitive and motor functions that are essential for safe driving, such as attention, reaction time, and coordination. Research has shown that acute marijuana intoxication can double the risk of involvement in a motor vehicle crash, and that the risk may be even higher when marijuana is combined with alcohol or other substances. However, the relationship between marijuana use and driving risk is complex, and may depend on factors such as the dose, potency, and route of administration of marijuana, as well as individual tolerance and driving experience. The increasing legalization of marijuana has led to concerns about the potential impact on traffic safety and the need for evidence-based policies and interventions to prevent impaired driving. Some strategies that have been proposed or implemented include per se laws that set legal limits for THC concentration in blood or saliva, roadside drug testing, and public education campaigns about the risks of driving under the influence of marijuana. More research is needed to evaluate the effectiveness of these strategies and to develop evidence-based guidelines for safe and responsible marijuana use in the context of driving.

Recovering From Marijuana Addiction

Although often perceived as safe and non-addictive, long-term or heavy marijuana use can lead to cannabis use disorder, characterized by problematic use causing significant impairment or distress. Overcoming marijuana addiction is challenging but possible with support and treatment. The first step is recognizing the problem and seeking help from a healthcare provider, mental health professional, or addiction specialist who can assess the severity and recommend treatment.

Treatment typically involves behavioral therapies like cognitive-behavioral therapy (CBT), motivational enhancement therapy (MET), and contingency management (CM) to identify and change thoughts, feelings, and behaviors contributing to use, develop coping skills, and build motivation for change. Support groups like Marijuana Anonymous or SMART Recovery provide community and accountability. Pharmacological interventions may manage withdrawal or co-occurring mental health conditions, but no FDA-approved medications specifically treat marijuana addiction.

Overcoming addiction may involve lifestyle changes, avoiding triggers, developing new interests, and building a strong support network. Recovery is gradual and non-linear, with setbacks and relapses common. However, long-term recovery is achievable with persistence, self-compassion, and commitment to change.

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The Stages of Marijuana Addiction

The stages of marijuana addiction typically begin with experimentation or recreational use, which may be influenced by social, environmental, or personal factors. As use becomes more frequent, tolerance can develop, requiring higher doses or more potent forms of marijuana to achieve the desired effects. This can lead to problematic use, where marijuana becomes a priority over other responsibilities and relationships, and use continues despite negative consequences. Dependence may develop, characterized by withdrawal symptoms such as irritability, sleep disturbances, and decreased appetite when use is reduced or stopped. Addiction, the most severe stage, is marked by compulsive use, loss of control, and significant impairment in daily functioning. It’s important to note that not everyone who uses marijuana will progress through these stages or develop an addiction. However, certain factors can increase the risk, including early age of initiation, genetic predisposition, and co-occurring mental health disorders. Marijuana addiction can have wide-ranging impacts on physical health, mental well-being, and overall quality of life, underscoring the importance of prevention, early intervention, and comprehensive treatment approaches.4

FAQs About Marijuana

Is marijuana addictive?

Yes, marijuana can be addictive, particularly with heavy or long-term use. Research suggests that about 9% of people who use marijuana will develop an addiction, and the risk may be higher for those who start using in adolescence or who have a personal or family history of substance abuse or mental health disorders. Signs of marijuana addiction may include tolerance, withdrawal, craving, and continued use despite negative consequences.

What are the health risks of marijuana use?

The health risks of marijuana use can include:

  • Respiratory problems, such as chronic bronchitis or lung infections
  • Cardiovascular risks, such as increased heart rate and blood pressure
  • Mental health problems, such as anxiety, depression, or psychosis
  • Cognitive impairments, such as problems with memory, attention, and decision-making
  • Increased risk of accidents or injuries due to impairment
  • Potential for addiction or dependence with heavy or long-term use

Is marijuana safe during pregnancy?

No, marijuana use during pregnancy is not considered safe. THC and other cannabinoids can cross the placenta and enter the fetal bloodstream, potentially affecting fetal development and birth outcomes.

Studies have found associations between maternal marijuana use and an increased risk of:

  • Low birth weight: Marijuana use during pregnancy has been linked to a higher likelihood of low birth weight, which can increase the risk of infant mortality and developmental problems.
  • Preterm birth: Some studies suggest that marijuana use during pregnancy may increase the risk of preterm birth, which can lead to various short-term and long-term health complications for the baby.
  • Neonatal abstinence syndrome (NAS): Infants exposed to marijuana in utero may experience symptoms of withdrawal, such as irritability, tremors, and difficulty feeding, a condition known as neonatal abstinence syndrome.
  • Neurodevelopmental problems: Exposure to marijuana during fetal development may affect brain development and lead to long-term cognitive, behavioral, and attention issues in children.

However, it is important to note that the evidence on the effects of marijuana use during pregnancy is mixed, and more research is needed to fully understand the potential risks. Some studies have found no significant associations between marijuana use and adverse pregnancy outcomes, while others have reported increased risks. The conflicting findings may be due to differences in study design, marijuana use patterns, and confounding factors such as concurrent use of tobacco, alcohol, or other substances.

CLINICALLY REVIEWED

Dr Yar Khan, MD

Faz Yar Khan, MD FACP

Medical Director

Dr. Faz Yar Kahn, our Medical Director, is an American Board of Internal Medicine-certified physician. He graduated from the Medical University of the Americas and completed his residency at Mercy Hospital in Chicago. With expertise in primary care, hospitalist medicine, critical care, and addiction medicine, along with ACLS certification, Dr. Kahn leads our team in providing exceptional substance abuse treatment.

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