Can You Become Addicted to Medical Cannabis?
Learn about the potential for addiction with medical cannabis and how to recognize signs of dependence.
Short answer
Marijuana use is considered addictive when it meets the DSM-5 criteria for cannabis use disorder. The threshold is at least 2 of 11 listed problems within a 12-month period. The list covers craving, failed attempts to cut down, use that damages work or school, and withdrawal. A person can use marijuana and meet none of these.
Can You Become Addicted to Medical Cannabis?
The American Psychiatric Association publishes the DSM-5. The 2013 edition dropped the terms "abuse" and "dependence" and grouped the symptoms under "cannabis use disorder."
when is marijuana use considered addictive
The 11 criteria
- Using more, or for longer, than intended.
- Wanting to cut down or stop, or trying and failing.
- Spending a lot of time getting, using, or recovering from use.
- Craving.
- Use that causes failure to meet duties at work, school, or home.
- Continued use despite social or relationship problems caused by use.
- Giving up or reducing hobbies, work, or social activities.
- Use in situations where it puts the person at risk of injury.
- Continued use despite physical or mental problems caused or worsened by use.
- Tolerance: needing more to get the same effect, or getting less effect from the same amount.
- Withdrawal: symptoms when stopping, or using to relieve or avoid those symptoms.
Severity levels
Count the criteria met in 12 months.
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- Mild: 2 or 3.
- Moderate: 4 or 5.
- Severe: 6 or more.
Clinicians often use "addiction" for the severe category. The DSM-5 does not use the word.
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How many people meet criteria
The CDC estimates about 3 in 10 people who use marijuana have marijuana use disorder. NIDA puts the figure at 9% of adults who use, 17% of people who start in their teens, and 25% to 50% of daily users.
Risk factors
- Starting before age 18. NIDA reports that group is 4 to 7 times more likely to develop a use disorder than people who start as adults.
- Daily or near-daily use.
- Family history of substance use problems.
- Depression, anxiety, or other mental health conditions.
- Products with high THC content. Some studies tie higher THC concentration to higher risk of cannabis use disorder.
Withdrawal and tolerance
The DSM-5 recognized cannabis withdrawal as a syndrome in 2013. Symptoms start 24 to 72 hours after the last use. They peak around days 2 to 6 and fade within about 2 weeks. Symptoms include irritability, anger, insomnia, appetite loss, restlessness, depressed mood, headache, chills, sweating, and stomach pain.
Tolerance and withdrawal are two of the 11 criteria. One criterion alone does not meet the threshold.
What is not part of the diagnosis
The DSM-5 removed the "legal problems" criterion that the DSM-IV included. An arrest for possession is not part of the current diagnosis. Use alone is not a diagnosis either. About 7 in 10 people who use marijuana do not develop a use disorder.
Treatment
No drug has FDA approval to treat cannabis use disorder. Behavioral therapy is the standard: cognitive behavioral therapy, motivational enhancement therapy, and contingency management, in which rewards follow negative drug tests. The SAMHSA National Helpline is 1-800-662-4357, free and open 24 hours.