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What is Cannabis Use Disorder?

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“Its first effect is sudden, violent, uncontrollable laughter; then come dangerous hallucinations… followed by emotional disturbances, the total inability to direct thoughts, the loss of all power to resist physical emotions… leading finally to acts of shocking violence… ending often in incurable insanity.”

America has changed a lot since those introductory words from Reefer Madness greeted the theater audiences in 1940. In the past several years, marijuana has enjoyed rapid increased societal and legal acceptance. As of 2017, eight states have legalized marijuana for recreational use and 29 allowing medicinal use. Just over one in five (21%) Americans lives in a state where marijuana is legal. Marijuana is going mainstream.

People now frequently view marijuana as separate from other ‘harder’ drugs and alcohol. It is true that physical effects, withdrawal syndrome, and average dependence severity from marijuana use are less significant compared to other drugs of abuse. Decreasing numbers of people, especially adolescents, perceive significant risks to be associated with regular marijuana use.

Still dangerous

But increased societal acceptance of marijuana doesn’t change the fact that, for some, quitting marijuana is just as difficult as quitting other ‘hard’ drugs. The percentage of those who benefit from treatment and the reasons for wanting to quit are similar across marijuana and other drugs. The reality is that marijuana affects different people different ways; some stop with ease while others suffer a much mightier compulsion.

So what does heavy marijuana use really look like? The most well known picture of someone who is ‘high’ is giddiness, anxiety, and bad short term memory coupled with bloodshot eyes and hunger. High doses can cause panic attacks, paranoia, and even hallucinations. The negative effects of THC (delta-9-tetrahydrocannabinol, the main psychoactive compound in marijuana) on memory, attention, and learning are measurable for several days after single use. This means getting high daily or even every other day doesn’t give the brain time to recover. THC also decreases dopamine concentration in circuits controlling motivation. In the long term, it can cause “amotivational syndrome”, where patients suffer reduced drive and impaired concentration.

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References
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