Evidence, Causes, Prevalence, and Treatment of Marijuana Addiction

[Redacted]

Author Note

    I was a student at [redacted].
    Correspondence concerning this article should be addressed to [redacted].
    Note: this is the completely unedited copy of a paper I wrote for [redacted].  It is offered as an example of my writing for future university consideration.  Format was slightly altered from APA format.

Abstract

Marijuana is arguably the most controversial illicit substance in United States history.  Indeed, marijuana is currently the most popular illicit drug of abuse in the United States.  This article will present evidence of the addictive properties of marijuana, detail the prevalence of marijuana use, explore the causes of marijuana addiction, and suggest possible treatments for marijuana addiction.  The goal of this article is to provide useful information that will aid in understanding and treating marijuana addiction.  The spirit of this article is to assist the reader in dispelling several myths surrounding marijuana use and addiction.  Finally, the desired outcome of this article is to encourage more research in this field of study.
    Keywords: marijuana, evidence, causes, addiction, prevalence, treatment
    This article will present evidence of the addictive properties of marijuana, explore the causes of marijuana addiction, detail the prevalence of marijuana use, and suggest possible treatments for marijuana addiction.

Evidence of Marijuana Addiction

    Despite public opinion to the contrary, several research studies show that marijuana is addictive.  A study by Goldman et al. (2013) presented evidence that marijuana addicts experience the same cravings and brain patterns as users of other addictive drugs.  Budney, Sargent and Lee (2015) found that, although marijuana's addictive potential is slightly lower, marijuana poses the same addiction risk factors and characteristics as other drugs of abuse.  In addition, Volkow, Baler, Compton and Weiss (2014) found that around 9% of marijuana users become addicted, and that the odds increase dramatically if the individual began using marijuana as a teenager and/or the individual smokes marijuana daily.  The addictive nature of marijuana is easily established.

Prevalence of Marijuana Addiction

    Of all the drugs of abuse, marijuana is the highest in prevalence and persistence.  The Substance Abuse and Mental Health Services Administration (SAMSHA) (2014) reports that 2.4 million people are addicted to marijuana, and that "marijuana was the most commonly used illicit drug in 2013."  Bedi, Cooper, and Haney (2012) reference SAMSHA's 2010 report, pointing out that "the high prevalence of marijuana smoking means that the " number of individuals with problematic use of the drug is greater than that for illegal drugs with higher abuse liability."

Causes of Marijuana Addiction

    Due to the variety of human behavior, experience, and biology, there are many reasons why an individual may develop or relapse back into a substance use disorder (SUD), which will be explored.
    It is important to understand the causes of marijuana addiction so that effective treatment plans may be enacted.  Many reasons people become addicted to substances, include, but are not limited to, expressing forbidden impulses, coping with emotional or physical pain, exploring alternative realities, substituting euphoria for reality, escaping the pain of social status, rebelling, indulging in hedonism, and fitting into a sub-culture (Doweiko, 2014).

Treating Marijuana Addiction

    The majority of treatments for marijuana fall under the category of therapy.  Interventions and 12-step programs like Narcotics Anonymous are currently the leading treatments for addiction.  Research is being done into pharmacological interventions, and some experimental drugs are showing mixed results.  But first, some myths should be dispelled.
    Two myths commonly heard in working with marijuana addicts are the "addictive personality" myth and the "only physical" addiction myth.  Current addictions research, summarized by Owens (2015), refutes both myths.  Owens shows the first myth to be false by pointing out that factors such as "genes, character traits, and early life experiences" combine to make up an individual.  Owens (2015) refutes the second myth by pointing out that behaviors can also be addictive.
    Therapy is still the leading intervention strategy for marijuana addiction.  Doweiko (2014) outlines the Johnson and ARISE models of intervention.  The Johnson model essentially involves educating and coaching those friends and family who will be involved in the intervention and then inviting the addict to the intervention.  The ARISE Model essentially a more sequential, less abrupt intervention style that relies upon progressive detachment steps to try to help the addict (Doweiko, 2014).
    As part of therapy, Doweiko (2014) taught that warning the addict of the dangers of their addiction can aid in recovery.  Many research studies describe the negative effects of marijuana use.  Briefly, the negative effects of marijuana use include, but are not limited to, psychosis, memory problems, a lowered IQ, increased impulsivity, and brain structure abnormalities (Levine, Clemenza, Rynn and Lieberman, 2017; Volkow, Baler, Compton, and Weiss, 2014; Shrivastava et al., 2014).
    In therapy, a major goal is to prevent relapse.  One influence that can cause an addict to relapse is stress.  Two studies (Johnson and Lovinger, 2016; Pizzimenti and Lattal, 2015) found stress can contribute to relapse.  Thus, it is recommended that addictions therapy include teaching coping skills using cognitive behavioral therapy.
    Another risk factor for relapse is a comorbid disorder, such as a co-occurring SUD and post-traumatic stress disorder (PTSD).  Those who suffer from PTSD may have difficulties avoiding relapse in the presence of memories of traumatic events that are triggered by sensory cues or stress (Pizzimenti and Lattal, 2015).  Comorbid PTSD is a vital consideration in selecting what therapies to incorporate.  Pizzimenti and Lattal (2015)'s research that show a possible link between memories, stress, and relapse could potentially also be applied to all marijuana addicts.
    Currently, as stated by Bedi et al. (2012), there are no Food and Drug Administration (FDA)-approved medications for treating marijuana addiction.  Bedi et al. (2012) suggest that a combination of psychotherapy and pharmacotherapy could be used to treat marijuana dependence, and that nabilone could be a part of the pharmacotherapy.
    Of particular interest are the drugs quetiapine and dronabinol.  Cooper et al. (2013) studied both drugs and concluded that quetiapine caused increased relapse (making it unsuitable), but dronabinol users "reported fewer withdrawal symptoms" than placebo.  This research team concluded that more testing is necessary.
    One complicating factor in treating marijuana addicts may be the presence of comorbid PTSD.  Pizzimenti and Lattal (2015) found a 21-43% prevalence of SUDs with individuals diagnosed with PTSD, compared to 8-25% for those without PTSD; and that individuals with PTSD were more likely to relapse.  Pizzimenti and Lattal (2015) called for more research to find drugs that could interrupt forming stressful and/or drug-taking memories, because this might help those with comorbid PTSD and SUDs.
    Another confounding factor in treating marijuana addiction may be the age at which the individual first used marijuana.  Levine et al. (2017) found that those who started using marijuana during adolescence had poorer treatment adherence.
    Another useful healing tool in working with addicts are the 12 step programs.  Consider the finding of Christo and Franey (1995), who studied poly-drug users in London who attended Narcotics Anonymous: after 6 months, 46% of addicts were successfully sober and still attending.  More research needs to be done on the effectiveness of the 12 step programs, but data so far is promising.

Conclusion

    This article has attempted to provide evidence that marijuana use can lead to addiction, outline the prevalence of marijuana addiction, explore the many causes of marijuana addiction, and suggest treatment methods for marijuana addiction.  Hopefully, this information will provide useful in understanding and treating marijuana addiction, dispel several myths surrounding marijuana use and addiction, and encourage more research in this field of study.

References: