How to know if your cannabis use is problematic?

Everyone who uses cannabis does so in different ways for different reasons, which can make it hard to spot the signs

by Ruby Deevoy

All good cannabis advocates know that to deny potential for abuse is futile, and unhelpful. Cannabis misuse does exist. But how does one establish when cannabis use becomes a problem?

It’s not necessarily down to how strong cannabis is, or how much is used. 

It would be easy to think that using large amounts of high THC cannabis should be where the line is drawn between cannabis being a help or hindrance, but there’s no real sense in this. 

While some people only feel the need to use a very small amount of cannabis to experience therapeutic benefit (have a watch of this fantastic overview of cannabis and pain management, by Dr Mark Ware, for more on that!), others need what might be considered by the next person to be a lot. 

Perhaps the person using cannabis has severe Ehlers Danlos Syndrome (in some cases, this can be an ‘invisible illness’ to an onlooker), with a complex set of symptoms including crippling joint pain, inflammation and nausea. In this case, they might feel the benefit of high doses of cannabis – often without even feeling stoned, which is also often the case for people who potentially have an endocannabinoid deficiency. 

However, someone else using the same amount of cannabis might find they are completely unable to function. It happens. 

An ‘appropriate’ dose of cannabis can be very different from one person to the next, so although chronic use of high THC cannabis can be problematic, that’s not the case for everyone.

How is cannabis impacting your life?

Did you know that alcoholism isn’t determined by how much you drink, but by how drinking affects your life? The same goes for cannabis. Is the amount you’re taking benefitting you and others around you? Or is it detrimental? 

Millions of people use cannabis without any problems, even ‘recreationally’. Just like you can enjoy a few glasses of wine with friends from time to time without being an alcoholic. And of course, cannabis is a vital medicine for millions as well. Not to mention the fact that cannabis can also be very helpful in treating addiction to other, more harmful drugs.

Dr Ben Sessa, (MBBS BSc MRCPsych) performed a short survey in 2020 in which 56.4% of participants reported that they used less of other substances which are known to be more harmful as a result. These substances included heroin (51.3%), tobacco (82.1%) and alcohol (over 50%).

But the soothing effects of cannabis, that can help alleviate pain and depression, can be very easy to sink into and want more of – particularly if you’re feeling very low, or lonely and lacking in support. When you use a lot of weed, it can almost feel as though your problems don’t matter anymore, or you’re so removed from them that you can pretend they don’t exist.

This holds some benefit of course: many people have anecdotes about a time where perhaps they felt suicidal, and getting super stoned was the only thing that helped them slip out of that mindset. But, using cannabis in this way on a regular basis can exacerbate and cause issues, and is likely to even prevent you from getting to the root of the problem, dampening symptoms rather than taking action to make meaningful change. 

Dr Simon Erridge, Head of Research and Access at Sapphire Medical Clinics says “Problematic cannabis use is defined as ‘persistent use despite negative effects on the social functioning and physical or mental health of the user or the health of other individuals’. Cannabis addiction can manifest as both psychological or physiological dependency.”

Dr Erridge explains that the core signs and symptoms of cannabis misuse are therefore framed in three broad categories:

  • Impaired control of cannabis use, whereby an individual consumes cannabis in larger amounts than intended, there is an unfulfilled desire to cut down on cannabis use, or having strong cravings to consume cannabis. 
  • Increasing priority of cannabis consumption over other activities such that it results in social and physical risk. This involves giving up on or failing to fulfil important activities or obligations, or placing oneself in harmful situations to consume cannabis. 
  • Physiological dependence which is displayed by a marked tolerance to the effects of cannabis and/or the presence of withdrawal symptoms following cessation or reduction in cannabis use.

If cannabis is helping you, that’s wonderful. But it’s important to be honest with yourself. If you’ve reached a point where using cannabis prevents you from spending time with family and friends, prioritising self-care and care for others, or ushers you into isolation, debt or danger, it’s time to seek support. Just as you would if anything else was leading you to feel or behave this way.

Maybe cannabis isn’t right for you

Cannabis is ideal for some people, and not right for others.

In some cases, cannabis might start out being incredibly useful but then you might reach the end of the road in terms of what it can offer you. This is an amazing plant, with many uses, but it’s not a panacea. In some situations, it can provide a much needed bandage, to help you cope with life and protect wounds, but it might not be what you need to heal and progress. 

It’s really only you who can decide if it’s time to take a break from cannabis, or say goodbye completely. Others might tell you they think you have a problem, but it’s you and you alone who can make the call. So, be honest with yourself.

If you’re a cannabis patient, but you think you’re at risk of abusing cannabis, check in with yourself on a regular basis, and know there’s no shame in admitting you have a problem. It’s actually a very strong thing to be able to do.

What should I do if I have a cannabis addiction? 

Like many medications, there is potential for addiction and abuse with cannabis – but it’s worth bearing in mind that addiction is a mental health issue in and of itself, and is caused not by the act of taking drugs but by a combination of biological, psychological and social factors.

So, what can you do if you think cannabis has become a problem for you?

“No pharmacological therapies have been approved for the treatment of cannabis use disorder, including cannabis dependence. The majority of treatment options therefore revolve around psychological approaches.” Says Dr Erridge

“Those with the most evidence of effectiveness include cognitive behavioural therapy and motivational enhancement therapy. In addition, many people may gain benefit from measures to manage specific symptoms, such as avoiding caffeine to reduce restlessness or exercising to help with irritability.”

Can CBD help with cannabis misuse?

There are a number of studies showing promise for CBD as a treatment for addiction, including cannabis misuse, tobacco addiction and alcohol dependency, but we’re still waiting on randomised controlled trials looking specifically at CBD for cannabis misuse for a definitive answer.

However, one study published in the 2019 American Journal of Psychiatry observed positive effects of treating long-term heroin users with CBD, who experienced significantly less cravings and anxiety induced by the drug cues as a result of taking a regular dose. Similar findings were noted when a group of researchers peer reviewed 26 studies spanning 44 years exploring the effect CBD had on animals who had been administered ethanol via a ‘self serve’ push lever.

The results showed reduced alcohol consumption in the animal subjects regularly treated with CBD. And One randomised controlled trial, published in the Addictive Behaviours, revealed that those given a CBD inhaler to use every time they felt the need to smoke reduced their number of cigarettes by 40%.

This suggests that in general, CBD has potential for helping with addictive behaviours and there’s really no reason to think it wouldn’t be the same for cannabis misuse.

Everything has the potential for addiction, depending on the predisposition of the individual. Obviously some drugs are riskier than others, because of the effect they have on your body, but it’s very important to understand that cannabis can be (and is) used benignly, most of the time. 

However, addiction is addiction, and if it’s cannabis that presents a problem for you then it should be treated as seriously as any other addiction, to help you get well. 

Ruby Deevoy is a U.K. cannabis journalist with years of experience covering CBD and cannabis in mainstream publications such as The Independent, The Mirror, The National, Elle, Red, Top Sante and Natural Health magazine. She’s also the U.K’s only CBD columnist, writing monthly for Top Sante magazine, cannabis agony aunt for Leafie, writes the Indybest CBD product lists, is founder of The CBD Consultancy and is the primary press member for The Cannabis Industry Council. Tweets @RDeevoy.

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