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Legalization of Marijuana Stokes the Flames of Addiction

A marijuana bud rests on wooden circle by a judge's gavel.

A majority of Americans support legalization of marijuana

The climate surrounding cannabis in America is changing. The psychoactive substance, also called marijuana, used to be viewed as one of the greatest scourges of society. Politicians and preachers used colorful acronyms, like “the devil’s lettuce,” to dissuade people from using it. Today, it appears a majority of Americans favor some form of legalizing cannabis. A 2021 Gallup poll found that 68% of Americans supported the legalization of marijuana. That could lead to a drastic increase in addictions.

Many people view marijuana as a “safe drug.” Some even see it as being harmless and therefore ok for daily use. One major issue with increasing the availability of cannabis is the chance of developing a cannabis use disorder, a potentially debilitating condition. Approximately 10% of all cannabis users will develop behaviors consistent with an addiction and most will require treatment to return to normal function.

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Marijuana Actually is Addictive

Although cannabis does not produce life threatening withdrawal symptoms or overdose potential like alcohol and opioids, its effects on a person can be very devastating. To put it bluntly, marijuana is addictive. When someone relies on the effects of cannabis to help them relax or cope with the stresses of everyday life they run a high risk of developing a use disorder. Cannabis is psychoactive, meaning it causes certain neurochemicals to be released, causing those “feel good” sensations found in other substances. That means cannabis can be habit forming. Frequent users can develop a dependency to the drug.

What is Marijuana?

Marijuana is a plant found in mainly warmer climates but can be grown in a variety of regions in the U.S. It contains chemicals called cannabinoids, including delta-9-tetrahydrocannabinol (THC) the psychoactive compound and cannabidiol (CBD). THC causes euphoric responses after binding to the brain’s cannabinoid receptors. It has also been proposed by cannabis advocates that the drug helps with several clinical conditions including pain, anxiety, and nausea among others.

Schedule one drugs (which marijuana currently is) by definition have no medicinal value. Because of this there have not been many well-controlled studies looking into its safety and efficacy. Most early studies looking into the efficacy of cannabis focused on observation, a more scrutinized form of research. The Food and Drug Administration cannot approve marijuana because it is still federally banned, even regardless of state law. Regardless, to date Alabama, Idaho, Nebraska, North Carolina, South Carolina, Tennessee, and Wyoming are the only states that have not legalized medical marijuana. We’ve seen concerning trends regarding adolescent risk taking associated with cannabis in states who have legalized it.

So, why has society’s stance taken such a 180 degree turn? What does it mean for addiction treatment?

A Quick History of Cannabis

Cannabis was originally brought to the US in the late 1800’s by migrant Mexican farmers and began to take root in American culture in the early 1900’s. Initially, the negative connotations surrounding cannabis use was underlaid with racial undertones. By the 1930’s there was a concern over the amount of Mexican immigration to the Southern United States and there was a push for the federal government to act. They began a campaign painting cannabis as the monster under your bed, causing sexual deviance in children and insanity in adults.

In 1937 Congress passed the Marijuana Tax Act requiring every person who sells, deals in, dispenses, or gives away marijuana to register with the Internal Revenue Service and pay a special occupational tax or face a fine and/or imprisonment and it was banned as a schedule one drug by the Controlled Substances Act of 1970.

The medical marijuana movement started in the 1990’s and has ballooned since. While marijuana remains illegal under federal law, more and more states have passed laws allowing marijuana to be “prescribed” by a licensed physician up to a certain amount for predefined physical and mental illnesses. Scientific evidence of its efficacy, however, has been difficult to establish.

The Future of Marijuana Addiction

We in the addiction community need to encourage more research to be done into cannabis’ safety and efficacy. We should study the conditions authorized by medicinal marijuana states’ laws and track the percentage of people who develop negative behaviors using it. Primary care doctors need to screen their patients regularly for possible drug or alcohol use disorders. Then, we need to make sure we have avenues to get folks into treatment and pathways to reshape their behaviors in the long term.

It is becoming more common to see patients who are being admitted into treatment for another substance like medical marijuana among the medications they routinely take. Cannabis, whether we like it or not, is present in our society and it’s not going away. We must continue to mold policies in our field based on the science at hand. I hope to see science guide this issue, not politics or stigma, moving forward as a country. More than anything we must proceed with caution, and view marijuana as the habit-forming, addictive drug that it is.