Disclaimer – as medicine has, within the limits of the human existence, different interpretations and criteria from expert to expert, nowadays the concept of dependence is more discussed than ever as the most recent DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, a psychiatrist’s Holy Bible) stirred things up mixing concepts like dependence, addiction and abuse. Let’s not go into that, but let’s assume the neutral concept of “substance use disorder”.
Addiction – What Is It Really and How Can I Identify It?
For someone to be labelled as a dependent, classically one would have to present both tolerance (the same amount of the substance causes persistently lower effects) and abstinence syndrome. The dependence can be both physical, when the interruption of use manifests itself as physical symptoms of organic dysfunction, and psychical, when it transforms into an intense state of anxiety, desire for the substance (craving) and humor shifts.
In the previous post, we stated that cannabis has the two-edged sword effect, possessing both the relaxation and the euphoria, it is usually positioned in the drugs effect chart somewhere in-between sedatives/depressants (alcohol, benzodiazepines) and hallucinogenic (LSD) drugs.
There is also an abstinence syndrome related to cannabis consumption, and here is where abstinence symptomatology and dependence take place. The dependence associated with marijuana is typically psychical, not so much physical, although there is a clear link (the study was actually published on one of the best medical-science papers, Nature) between cannabis and an appetite-regulating hormone, called leptin.
Can I Treat It? And Should I Treat It? How?
Either way, this addiction has to be diagnosed and treated. On one hand, some drugs as heroin have substitutive treatments which basically replace an opiate (heroin) with another one (methadone, fentanyl), in order to progressively withdraw the first one. Alcohol, responsible for one of the worst withdrawal symptoms, has also some specific pharmacological guidelines, in order to achieve detoxification and dishabituation.
On the other hand, even if cannabis is one of the most consumed psychoactive substances among the population, and even if its consumption leads to altered states and considerable cognitive dysfunctions like loss of memory, attention, coordination and perception, there are really no pharmaceutical drugs that have been shown to be effective on reducing its use. Some can argue that there is already some medication available to treat comorbidities associated with the consumption, but truth be told, the FDA hasn’t approved anything specific until now.
Therefore, marijuana addiction treatment leans toward a psycho-social approach. On a wide range of activities like both group therapy and personal therapy, people are beginning to seek primary care for the abuse or dependence. Through behavioral treatments that go from the classic cognitive behavioral therapy to motivational enhancement and contingency management therapies, some programs have really shown great efficacy indexes to treat this condition, either with inpatients or outpatients. People also tend to search for local support groups and online forums in order to connect with others in the same situation and share their experiences.
Besides that, there are clinics – mainly in the U.S.A. – that admit inpatients and are responsible for the full care of the patient. This means they adjust your diet, control your sleeping cycles, organize activities such as meditation classes and provide the medical care needed for the cause. As in any other psychiatric (or mental) disorder, it is also important for the patient to have his/her medical history investigated by a healthcare professional (most commonly an MD by clinical interview or anamnesis) to find links between this disorder and its triggers, traumas or even other disorders – this is especially important to prevent relapses and avoid further complications.
We would like to finish this post by emphasizing that even if marijuana seems harmless, it is really not. Right now, the tendency is positively shifting towards marijuana legalization (hence Canada), but this is not a synonym of being harmless. In fact, the cornerstone of prevention when talking about drug abuse is to identify the consumer – a friend, your colleague, a neighbor – tackle the problem ASAP and avoid any major, future outbreaks. Please be aware!