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  • Marijuana Addiction Today

    There’s a fascinating first person account of serious marijuana addiction in Cassie Rodenberg’s Scientific American Blog, The White Noise, posted yesterday (see below for link). As a specialist in addiction, I’ve seen (in psychotherapy and in research) numerous people addicted to marijuana and it’s often quite devastating, despite the neutral or even popular press image.

    In some cases, clients initially insist “It’s not a big deal, I’ve read everything I found about it on the Internet.” They are certainly correct about what’s out there on the web about pot; most information in circulation suggests that the effects of marijuana are minor, unimportant and that marijuana isn’t really addictive. “Pot is relatively benign” — so the myth goes. That’s not what I’ve seen. Marijuana addiction is absolutely pernicious; it’s subtle, deceptive and often hidden, even to the user, while its effects pervade every corner of the user’s life. The state that used to be pinned on pot use, that condition we call “a-motivational syndrome, is very real and very debilitating for many regular users of marijuana. Ambitious people lower or even drop their ambitions. While some pot users may continue to function at their jobs and their personal lives, they do far less than they would if they stopped smoking marijuana. Pot use is a sure way to put yourself in a chemical straightjacket. Furthermore, the pot user finds herself increasingly irritable and depressed if she goes many hours without a hit, and yet often, she remains unaware of the correlation between her irritability and depression, and the use of marijuana.

    People addicted to pot often think they’re not “really addicted” particularly if they don’t smoke pot every day. It’s true, a pot addicts is able to go for a few days between smoking another joint. There are hundreds of metabolites in pot, and some of the more addictive ingredients stay in the system for days. It’s only when their long half life is over that serious symtoms begin to set in. And even they’re subtle, difficult to describe but powerful enough to drive the addict to use again. The first sign is craving.

    While signs of pot withdrawal may begin immediately, within hours, as the user starts craving along with feeling irritable and depressed, she rarely links her mood change to withdrawal from marijuana. Furthermore withdrawal symptoms come on extremely slowly. According to Darryl Inaba, dependency specialist and Doctor of Pharmacy, the most intense pot withdrawal really starts at 4 weeks, post pot use. And it lingers for a long time. Pot withdrawal is not necessarily as clear and obvious compared to withdrawal from alcohol, tranquilizers (particularly benzodiazepenes, i.e., valium type drugs), or opiates. It is not life-threatening. Nevertheless, for many, it’s a devastating experience.

    Withdrawal from marijuana may include physical symptoms, such as nausea and a dislike or disinterest in food. People in withdrawal often report having nightmares, that continue with some regularity for months. The psychological symptoms associated with marijuana withdrawal most prominently is a severe depression and tendency to cry. I have seen both men and women cry, on and off daily, literally for many months after they’ve stopped smoking pot. This depression is defined by the recovering addict experiencing an intense, almost shattering drop in self-confidence and self-esteem. Living under a dark cloud of foreboding, they find themselves ruminating about people they believe they might have harmed during their active addiction. Often, the harms they believe they’ve committed, are entirely imaginary. But they suffer, and most start believing: “this is the way I am, I’ll have to smoke pot or feel like this” instead of realizing that everything they are thinking and feeling is a function of withdrawal from marijuana, and that it will stop at some point. The state of withdrawal does not describe how a person normally thinks and feels without drugs. It’s tempoary. It’s the effect of withdrawal, and time limited.

    In some cases there may be pre-addiction factors that contribute to the post-addiction picture. Not everyone loves pot from that first hit, and in fact many don’t particularly like it. Of those who love marijuana, it’s possible that a sizable percent are genetically prone to mood disorders. While our own research (see at http:/// )demonstrated that there is no “addictive personality,”there is a genetic make up that may at times show itself by way of behavioral and emotional proclivities. Every marijuana addict that I’ve treated has had a family history of unipolar or bipolar mood disorder, and/or addiction (to alcohol or other drugs). My pot addicted clients loved marijuana from that first hit, and preferred it to other “recreational” drugs. Even those who went on to add other drugs to their list of habitually used drugs, for example alcohol, cocaine or heroin (opiates)12 months after withdrawal, they still longed for marijuana, believing that some of their activities they did so much better when under the influence.

    In summary –there are multiple problems with marijuana use, including some I haven’t yet mentioned –for example, hormone production gets disrupted in teenaged boys. It also disrupts the motivation system leading to amotivational syndrome.It becomes all consuming as the addiction process hijacks the brain of the user.

    Despite the disadvantages and real problems associated with regular marijuana use, addiction and withdrawal, there are far fewer people dying from daily pot use than from abuse of alcohol. There are far fewer patients disabled by marijuana than those disabled by valium-like tranquilizers or those addicted to pain medicines. And there are serious medical conditions for which marijuana is an ideal medicine; for example, wasting illnesses (from cancer, or HIV infections etc.). Marijuana has been found to be an effective anti-depressant for some cases of depression. It has been used with some success in isolated cases as an anti-obsessional drug. Using marijuana for a medical reason, as a treatment, is reasonable. Using marijuana as a “recreational drug” slowly ceases to be recreational; it is is isolating, and often disruptive to the life people hope for.

    No one wants to be “an addict,” –addicted to anything. The stigma against drug addicted people in our culture is enormous, heavy and oppressive. The addict always feels a sense of shame and guilt, like a bad person, an outsider. Every addicted patient I’ve seen has wanted to get into recovery. They may not all know it at first, they may not know it consciously, but they want recovery. If they seem to be in “denial” I take that as a sign of feeling hopeless, they believe that they are in this hooked, outsider position for life. Providing a clear picture of what addiction is, the brain mechanisms involved, and how to overcome it using many forms of help; self-helpprograms, psychopharmacological medications, reglious programs if that’s what a patient is into, indivdual and group psychotherapy. People who have become addicted race to recovery, race to the top, when offered some information and given a chance to recover.

    Letter from a Marijuana Addict in Scientific American…,

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