Myth: Marijuana is an addictive drug.

The Truth: Not everyone has the same definition of addiction.  To some any use of an illicit drug is considered addiction, to others signs of dependency are the determining factor.  Depending on your definition marijuana could fill some of the criteria.

The generally accepted definition emphasizes preoccupation with the substance, compulsive use and frequent relapses.  Those who spend excessive time and money to get a drug may be considered pre-occupied.  As well as groups of friends who talk about nothing but the drug, or blog writers for that matter.  Users who smoke at the same time each day or can’t watch a movie without pot could be considered compulsive users.  What about relapses?  Those who continue use despite repeated attempts to quit are typical of addiction but this is a rare product of marijuana use.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the authoritative tool used by psychiatric professionals to diagnose mental disorders.  The DSM does not use the word addiction because it is too subjective.  It uses the terms dependence and abuse instead.  In the DSM a person is considered dependant if 3 of the 7 criteria are satisfied.  The criteria are

  1. Tolerance
  2. Withdrawal
  3. Use in excess of initial intention
  4. Failed attempts to decrease use
  5. Loss of time related to use
  6. Continued use despite problems
  7. Reduced activities due to use

Tolerance certainly applies to marijuana.  Some effects of pot diminish with continued use; things like dry mouth, munchies, coughing and inebriation are much less pronounced in an experienced user compared to a new user.  Once a tolerance is developed it takes more drug to get high.  The vast majority of marijuana users though will reach an equilibrium where they know the high they want and stop there.  Withdrawal means discomfort associated with absence of the drug.  Some heavy marijuana users report symptoms such as sleep disturbances, anxiety and irritability when they discontinue use abruptly.  These symptoms vary significantly from person to person and many users experience no withdrawal symptoms from marijuana.

The third symptom shows loss of control of the amount consumed.  Binge drinkers and cocaine users frequently display this symptom.  It is uncommon for a marijuana user to buy a big bag and not have any left in the house the next morning.  While some heavy users smoke huge quantities it is their intention to do so and not a loss of control.  For example Bob Marley was quoted in an interview to smoke over a pound of ganja (weed) per week.  That was no accident, he was a Ratafari and ganja  is sacrament in his religion.

The fourth symptom is also not typical of marijuana use.  While many users have a craving for the drug they also have no intention of quitting.  Few people have any trouble at all quitting marijuana use.  Number five, loss of time, is another very subjective symptom.  Marijuana is illegal worldwide and as such it takes time to track down and buy.  In contrast users of caffeine or nicotine can purchase their drug of choice at a variety of stores.  Impairment for the duration of the drug is not considered a loss of time to most users; that is often the goal.

Number six on the list is also subjective but somewhat easier to diagnose.  Any time lost from work as a result of use would qualify as well as unwanted lifestyle changes.  For example someone who previously enjoyed skiing and rock climbing but now spends most of the time laying on the couch  would qualify.  The pop culture image of a marijuana user is the burned-out couch potato but that is not the case in the vast majority of users (see Amotivational Syndrome Myth).  Arrest and or incarceration from a possession charge would not qualify because it is not the result of marijuana use but the result of prohibition.  The final symptom is continued use despite problems related to the drug.  This is another subjective symptom.  Cannabis users could experience confrontations with family members who have a strong opinion about the drug, legal problems, or increased symptoms from a pre-existing disease such as emphysema or asthma.

The criteria for determining drug dependence in the DSM are vague.  Out of the seven symptoms, some don’t apply to marijuana and others are open to interpretation.  Tolerance is the only one that is common in all marijuana users.  The case for marijuana dependence is weak and that is reflected in real-world marijuana use.

Abuse symptoms are even less objective than dependence symptoms.  The DSM requires only one of the four symptoms to diagnose abuse.  These are:

  1. Interference with major obligations
  2. Intoxication in an unsafe setting
  3. Legal problems
  4. Continued use in the face of troubles

Number one can include impairment at work/school or neglect of children due to use of the drug.  Number two often includes driving under the influence but studies show that marijuana users drive slower and are more cautious then non-stoned drivers (Study).  Legal problems have nothing to do with the substance itself and because of its inclusion in the list all use of an illicit drug is considered abuse.  If yogurt was made illegal today your breakfast would be considered abuse.  The final symptom is the same as it is for dependence.

Marijuana definitely fills some of these criteria but the DSM abuse criteria are way to subjective.  Many marijuana users smoke every day and in spite of legal problems, are they abusing it or simply using it?  There are people who do abuse marijuana but they represent roughly 6% of all users.  Marijuana abuse is a phenomenon not a problem.

Scientific studies have been conducted which compare the relative addictive effects of drugs including Heroin, Cannabis, Nicotine, Caffeine and others.  In two prominent studies marijuana was ranked last.  I graphed the data from one study (Hilts, 1994).

In a different study (Franklin, 1990) experts ranked 18 drugs on how easily they hook people.  Marijuana ranked 14th behind all the previously mentioned drugs.  The only ones that ranked lower were MDMA, mushrooms, LSD and mescaline.  This data is echoed in real life as only a small proportion of people who have tried marijuana go on to use it regularly.  Nearly 50% the US and Canada population over the age of 12 has tried pot at least once in their lives while 10% of the US and 14% of Canada’s population use cannabis on at least a monthly basis.

One of the arguments that proponents of this myth use is that large numbers of marijuana users are admitted to treatment every year.  What they don’t tell you is that they are given an ultimatum in court to take treatment or prison time.  The US Department of Health and Human Services admits that 37% of the estimated 288,000 thousand people who entered drug treatment for pot in 2007 had not reported using it in the 30 days previous to their admission.  Not only does this practice create phony statistics (used for anti-drug propaganda) it also allows a completely meaningless industry to thrive.  I’m doing a future post on the corrupt marijuana treatment industry.

Advocates of prohibition will often admit that pot is not addictive but instead they say it is “habit forming”.  What the fuck is that?  Habit forming is a reference to psychological instead of physical addiction.  It is even more vague than the description of addiction.  The habit forming argument is a total cop-out.  Is it that hard to imagine that people can use a drug because they like it and for that reason alone?

So is marijuana addictive?  The data show that it is not but the subjective nature of the word and diagnosis allow some wiggle room.  Millions of people around the world enjoy cannabis in a responsible way with no problems related to addiction.  Marijuana is easier to quit than coffee.  If all use is abuse then we’re all drug abusers.  Maybe our definitions of addiction, dependence and abuse say more about us a a society than about the drugs themselves.