When marijuana becomes a problem

March 16, 2024 Last Updated: March 15, 2024 10:33 PM Special Sections

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Many people believe marijuana isn’t addictive, something medical professionals like Dr. C. Thomas Brophy, the medical director for the Ellen O'Brien Gaiser Center, say is a misconception.

“Addiction has more to do with when something becomes a destructive element in your life,” said Brophy, who is a board certified physician in both emergency medicine and addiction medicine.

While marijuana does not cause a chemical dependency, the substance still can be addictive.

“If something feels good to do it, but it becomes a destructive element in you life, and you know that it’s a destructive element in your life, but you keep returning to it because that feels good,” he said. “Then there’s a good chance, that’s an addiction.”

While addiction and chemical dependency often go hand-in-hand, there are important distinctions, Brophy said.

“The best example I can give you is that somebody who takes an SSRI (selective serotonin reuptake inhibitor),” Brophy said. “That’s medications like Zoloft and Lexapro and Prozac and Paxil … You can very easily and often do become chemically dependent on your SSRI.”

“What that means is that if you’re taking that medication every day and I take it away from you, you’re going to go through some physical changes, some physical withdrawal,” Brophy said.

Addiction happens when destructive behaviors take over one’s life, he said.

Estimates from the U.S. Centers for Disease Control and Prevention say 30% of people who use marijuana have a marijuana use disorder, and there is a 10% chance people who use cannabis will become addicted.

“Marijuana is often one of the first mind-altering substance that people do experience and sort of experiment with in their early teenage years,” Brophy said. “It certainly can be a problem, like all mind-altering substances.”

Effects on the brain

The amount of tetrahydrocannabinol, or THC, the main psychoactive component in marijuana, has changed substantially over the last several decades, according to an August 2023 report from Yale Medical School.

In 1980, THC content found in confiscated marijuana was around 1.5%, according to the report.

“Today many varieties of cannabis flower, plant matter that can be smoked in a joint, are listed at more than 30% THC,” the report stated.

Other cannabis products such as oils and edibles can have as THC levels as high as 90%.

Studies on marijuana have been limited, because the drug is classified as a schedule I substance by the federal government.

Chris Lindsey of Nevada, the director of state advocacy and public policy for the American Trade association for cannabis and hemp said it’s been challenging to study the effects of the drug on developing minds is because of the drug’s legal status.

“It’s just another one of the many reasons we need to federal legalize marijuana,” Lindsey said. “So we can further the research needed on developing brains.”

Brophy said the brain, typically is still developing during adolescence.

“When we say developing, we mean new neurons are developing, there are new parts of the brain growing and developing,” Brophy said.

The brain doesn’t finish maturing until someone is in their mid- to late- 20s.

A 2021 study from Cambridge University found cannabis can use can be harmful to a developing brain.

The report cited a cohort study that showed when adolescents use cannabis regularly there was “a clinically significant eight-point decline” in IQ.

When to get help

Signs of marijuana addiction are similar to other signs of addiction. Once a substance or action takes over one’s life and has a negative impact, it can be classified as an addiction.

“When we’re trying to find out if someone is addicted to something — whether we’re talking about stealing, social media use or we’re talking about marijuana use — I can use different diagnostic criteria to diagnose that person to see if they have an addiction problem,” Brophy said.

General signs of addiction can be a lack of control or inability to stop using a substance, decreased socialization and ignoring risk factors.

“Particularly, when it’s a young person who is self-medicating instead of addressing the mental health issue, it can be very problematic,” Brophy said. “They can check all the boxes: their loved ones will be concerned, it will drain their bank account in a problematic way, they won’t be meeting their responsibilities.”

How to get help

“The important thing about treatment is to make sure everyone can follow a path,” Brophy said. “It’s about having a good plan.”

The National Institutes of Health suggests several forms of therapy to help people who may be addicted to marijuana.

One form of therapy suggested is cognitive behavioral therapy, a form of psychotherapy that teaches people how to identify and correct problematic behaviors.

Another form of therapy may be contingency management, an approach based on frequent monitoring of behavior.

Also available is the motivational enhancement therapy, which does not attempt to treat the person, but rather mobilize his or her own internal resources for change and engagement in treatment.