Recognizing Cannabis Use Disorder

Cannabis is legal now in many states, but it still comes with the risk of abuse which can lead to a cannabis use disorder, the clinical definition of cannabis addiction. Generally, this refers to an addiction to marijuana, which is the leaves of the cannabis plant that contain THC, the compound that produces a “high”. Cannabis use disorder can be recognized by many signs, and by criteria specified in the clinical definition.

Note that for clarity in this article, we will use the words cannabis and marijuana interchangeably.

What Is Marijuana?

Marijuana is the dried leaves, flowers, and stems of Cannabis plants that contain THC, the “high” producing compound. It can be consumed by smoking or vaping, or eating what are known as edibles, which are foods like gummies that contain brewed marijuana.

Marijuana is classified as a Schedule 1 drug under the federal Controlled Substances Act in the United States, which means that it has no accepted no medical use and a high potential for misuse. This classification is highly controversial because scientific evidence suggests that it does have legitimate medical uses.

Marijuana’s Effects

When marijuana is smoked or vaped, it produces effects almost immediately, while if it’s taken in edible form, it can take 30 to 60 minutes to have an effect.

Marijuana’s effects include:

• Relaxation
• Euphoria
• Heightened sensory perception
• Laughter
• Hunger (the munchies)
• Anxiety
• Fear or panic
• Paranoia

In high doses, which often occur with edibles, it can also cause hallucinations and delusions.

Illegally purchased marijuana comes with the danger of being laced with other substances, which can lead to accidental overdose on the drug that has been added.

Clinical Definition of Cannabis Use Disorder

The clinical definition specifies 11 criteria that indicate a cannabis use disorder.

1. Using more marijuana than intended or for longer than intended
2. Wanting to reduce or stop marijuana use but not being able to
3. Spending excessive amounts of time using marijuana or recovering from using
4. Feeling cravings for marijuana
5. Failing to live up to responsibilities due to marijuana use
6. Having relationship problems because of marijuana use
7. Giving up activities that you enjoy in order to use marijuana instead
8. Engaging in risky behaviors like driving while under the influence
9. Continuing to use marijuana in spite of negative consequences like health issues
10. Needing more marijuana to get the same effects
11. Having withdrawal symptoms when you are not using marijuana

Having two to three of these symptoms indicates a mild cannabis use disorder, four to five is considered moderate, while six or more is severe.

Signs of Cannabis Use Disorder

If you are trying to determine if someone close to you has a cannabis use disorder, you may or may not know if they meet some of the criteria from the cannabis use disorder definition, but you can look for certain signs and behaviors that indicate marijuana abuse. These include:

• Red eyes, and the frequent use of eye drops
• Snacking frequently outside of mealtimes (the munchies)
• Withdrawal from friends and family
• Declining schoolwork or work performance
• Possessing paraphernalia to smoke marijuana, such as pipes, bongs, or rolling papers
• Complaining of dry mouth frequently
• Smelling of marijuana or of something that might cover the smell, such as cologne
• Their physical space, i.e. their bedroom, smelling of deodorizer to cover the smell of marijuana
• Finding stashes of marijuana in their space
• Stealing, which may be done to finance their marijuana use
• Being secretive
• Getting defensive when confronted about marijuana use

Keep in mind that these signs indicate marijuana abuse, which does not necessarily mean that they have a cannabis use disorder. The criteria from the formal definition are the best indicator, but only a mental health professional can diagnosis a cannabis use disorder.

Treatment for Cannabis Use Disorder

Cannabis use disorder treatment may be inpatient, outpatient, or both, depending on the severity of the disorder.

Inpatient Treatment

Inpatient treatment programs begin with a period of detox, during which you are kept comfortable as you go through withdrawal. Throughout your inpatient stay you’ll participate in intensive therapy, both individually and in groups. Group therapy is crucial to the treatment process, giving you the opportunity to learn, share, and interact with peers.

The type of therapy most commonly used in cannabis use disorder treatment, both individually and in groups, is cognitive behavioral therapy (CBT). In CBT you’ll learn to recognize your irrational thoughts and emotions and to challenge them using more reasonable thinking. You’ll also learn healthy coping skills to face challenges without marijuana.

An example of challenging your thoughts might go like this. You think “I can just smoke marijuana occasionally. I just need a break.” You’ll recognize that this is not a rational thought and consciously change it to “I can’t control my marijuana use and it’s having negative consequences. I need to stop for good. I don’t need it in my life.”

An inpatient program may last anywhere from 30 to 90 days, but 30 days is most common.

Outpatient Treatment

Outpatient treatment programs generally have two levels.

A partial hospitalization program (PHP) allows you to live at home or in a sober living facility while attending treatment for four to six hours per day, five days a week for four to ten weeks. The treatment involves intensive therapy similar to that of inpatient treatment.

A PHP is commonly a transitional treatment after inpatient treatment, although it can be an alternative to inpatient treatment.

The other level is an intensive outpatient program (IOP), which usually involves two to three hours of therapy three days a week. The program may last for eight to twelve weeks. Often, treatment sessions are at times that allow you to still go to work or school.

IOPs can be standalone treatments, or they can be attended after inpatient treatment, a PHP, or both.

Often, people find it helpful to attend addiction support groups after treatment. Recovery is a lifelong process, and support groups give you an opportunity to continue to interact with peers and form mutually supportive relationships.

Comprehensive Treatment

The most effective treatment for cannabis use disorders, particularly if they are severe, is a comprehensive treatment program that involves an inpatient program, a PHP, and an IOP. Research shows that success rates increase the longer people remain in treatment.

In Closing

Only a mental health professional can formally diagnosis a cannabis use disorder, but understanding the definition and knowing the signs can help you to recognize when the disorder may be present. If you or a loved one is struggling with marijuana use, Bridges of Hope is here to help. We will assess you to recommend a treatment plan that’s right for you. We are dedicated to providing comprehensive, compassionate, personalized care. Give us a call today to take the first step.