Marijuana, also known as “cannabis,” “weed,” “pot,” and “reefer,” is the most commonly abused illegal drug in the United States and the most commonly abused drug overall behind alcohol and tobacco.
Marijuana contains compounds called cannabinoids, chemicals that bind to cannabinoid receptors in the brain. Some of these cannabinoids, such as THC, are psychoactive, meaning they produce a psychological effect or “high.” Other cannabinoids such as CBD do not produce the “high” associated with THC.
According to a 2015 survey by the Substance Abuse Center for Behavioral Health Statistics and Quality, more than 11 million adults between the ages of 18 and 25 used marijuana in the past year. The 2018 Monitoring The Future survey by the National Institute on Drug Abuse reported that nearly 1 in 16 high school seniors reported daily use of marijuana.
As of 2019, 11 states, including California, have legalized marijuana for recreational use. In these states it is legal to purchase, possess and grow.
Despite individual states de-criminalizing marijuana, possession is not completely risk free. Marijuana is still considered an illegal substance under federal law, in the same category as heroin and LSD.
It is important to note that although many states are legalizing marijuana, this does not make the drug any less dangerous.
There are several different ways marijuana can be used.
Smoking – Users will often grind the plant material where it can be hand-rolled into a joint or smoked in a pipe or bong. Since smoking involves lighting the plant material on fire (combustion), users who choose to smoke marijuana also inhale carbon monoxide, a dangerous compound that causes dizziness and headaches.
Vaping – A growing number of people who use marijuana choose to vaporize Vaporization involves heating the marijuana to a temperature hot enough to release the psychoactive compounds without igniting the plant material and generating carbon monoxide. While this is often perceived to be healthier than smoking, a 2018 study found that vaporizing marijuana produced higher THC levels in the body compared to smoking.
Edibles – A less common way of taking marijuana is by eating food infused with THC. Since THC is fat-soluble, it is dissolved in butter, then used to prepare edibles such as brownies or cookies. Since edibles must first pass through the digestive tract before reaching the bloodstream, more time is required to take effect, however the effects last longer than smoking or vaping.
A particularly dangerous way of taking marijuana is called “dabbing.” The marijuana plant produces a waxy, oily, honey-like resin commonly referred to as “hash.” Hash contains a significantly higher concentration of THC than the plant material, making it much more potent.
The production of hash also requires the use of butane, a flammable compound found in lighter fluid. Several people have been admitted to the emergency room for burns acquired while making hash.
When smoked, marijuana is quickly absorbed from the lungs and into the bloodstream, where the user feels the effects almost instantly. Some of the effects include:
Altered senses – Colors may appear more vibrant or colorful and music may sound different.
Euphoria – Users may feel a sense of warmth, relaxation and happiness.
Paranoia – Many users have a negative reaction, feeling incredibly paranoid and anxious
Increased appetite – Most users report an increase in appetite, commonly known as the “munchies.”
Impaired memory – Users often have a difficult time remember things while under the influence of marijuana.
Cognitive impairment – It is often difficult to think clearly while under the influence of marijuana, making it harder to perform essential job or academic duties.
Skunk-smelling odor – The marijuana plant has an incredibly strong and pungent odor resembling a skunk. Marijuana users will often either have this odor on their person if they have used it recently or their room/car may smell.
Failing drug tests – Most employers will screen a potential candidate for THC, which can be detected up to a month after use in a typical urine screen. Since most job candidates are aware they will be screened, failure of a pre-employment drug screen often indicates that the user has difficulty stopping.
Poor performance at work or school – Marijuana makes users feel mentally sluggish and can impact the ability to concentrate on a task. Poor performance at work such as frequently forgetting obligations, not completing tasks and arriving late may indicate abuse.
Marijuana’s effects can be addicting, leading to a substance use disorder. In the context of marijuana abuse it is known as “marijuana use disorder.
”While marijuana is not often perceived as an addictive drug, research has shown that 9-30% of users may be dependent on marijuana and meet the criteria for marijuana use disorder.Early use has been associated with marijuana use disorder.
Those who begin using before the age 18 have been shown to be 4-7 times more likely to develop a marijuana use disorder.
Treatment of marijuana addiction focuses primarily on behavioral modification therapies. Addiction treatment may occur in a treatment center or in an outpatient setting where the user regularly schedules appointments.
Some of the following strategies are often employed in treating marijuana addiction.
Cognitive Behavioral Therapy (CBT) – This type of therapy focuses on helping the user identify and correct problematic behaviors associated with their marijuana use. Development of coping strategies is also a central theme of this therapy. For example, if a user identifies a pattern of using marijuana to cope with stress, a plan will be developed to deal with stress in a healthy way without the use of marijuana.
Contingency Management – This type of therapy focuses on providing rewards for meeting pre-defined therapy goals. For example, to reinforce abstinence a user may be awarded prizes for providing negative-drug screens.
There are no FDA-approved medications for treating marijuana addiction, however medications may be used to combat symptoms of marijuana withdrawal, which may help prevent relapse. Since insomnia is often a common symptom of marijuana withdrawal, sleep medications such as Ambien may be used short term.