Between the narrative that nothing natural could ever do us any real harm, and scaremongering ideas that – even if it doesn’t act as a gateway to the use of stronger substances – smoking cannabis will turn you into a lazy, paranoid and ultimately useless member of society, the space for nuanced interpretations is sadly lacking.
There’s little middleground when it comes to discussing the effects of smoking cannabis. This is likely why, anecdotally speaking, those who believe the latter will steer clear of cannabis their whole lives, whilst those inclined to believe the former embrace cannabis as a lifestyle choice.
Although compared with other drugs, such as opiates and nicotine, cannabis has much less potential for addiction, it still has some potential – and dependence on cannabis is more common than you might think, particularly amongst young people.
The Facts
Studies carried out by drug welfare companies NeuroSight and Drugs and Me looked at drug use trends in UK university students in 2020. Of 1,200 participants, the vast majority of those aged 18-23 at the time (86 percent) said they used cannabis. Of this cohort, 29 percent said they used it everyday or almost everyday, 25 percent multiple times a week and 9 percent at least once a week.
Separately, of the massive 81 percent of students who had tried any illicit drug in 2020, one third reported feeling dependent on a drug, a further 9 percent said they were addicted, and more than one in 10 said they’d experienced withdrawal symptoms resulting from illicit drug use.
While these findings aren’t specific to cannabis, official government figures show that 89 percent of all young people aged 12-17 in treatment for a drug both before and during the pandemic said they had a problem with cannabis. For those over 18, this figure drops to 21 percent.
There are likely multiple reasons for this: A 2016 study by Chandni Hindocha found that people who mix cannabis with tobacco are more likely to become dependent on cannabis, something that is uniquely common among cannabis users in Europe.
Another reason, according to Ivan Ezquerra Romano, the co-founder and director of Drugs and Me, is that we don’t have any “cultural practices” around cannabis use. “Cultural practices, such as drinking wine after dinner are usually learned from parents and grandparents, etc.,” he says.
“Usually, when you do anything from those practices, you have the automatic social and cultural punishments that go along with them [such as being hungover] that help you adjust your behaviour.”
The problem with cannabis use, then, is that we don’t have these cultural practices that we can follow, or examples of what constitutes healthy vs unhealthy cannabis use, which leads to people using cannabis in a consistently unhealthy way – with little information on how to use it in a healthier manner.
Another important reason for the prevalence of cannabis dependence is that it operates in an illegal, and therefore unregulated market.
“When you buy alcohol at the shop or at a bar, you’re able to see how many units of alcohol are in each drink, so you know how much you’re getting,” explains Ezquerra Romano.
“With cannabis, you have no idea what you’re getting; not just the strain, but also the composition of the plant and, when you grind it, you have no idea how much you’re actually using. When you can’t truly calculate your dose, you are more likely to develop dependence because you can’t know how much is too much.”
The Experiences
Bella*, 28, from Birmingham, whose name has been changed to protect her anonymity, smoked cannabis for the first time when she was 13-years-old. But it wasn’t until a few years later that she started smoking regularly.
“It never really entered my mind as a risk or anything, because it was always one of those drugs that was sold as non-addictive, and not really that problematic,” Bella tells Volteface.
She’s not alone: according to NeuroSight’s survey, 50 percent of students who smoked cannabis believed that it was harmless – and that number remains stubbornly high at 39 percent, even among those who don’t smoke cannabis.
Hannah began smoking cannabis on a daily basis in her final year of university, because she found it helped with managing her chronic pain condition and undiagnosed C-PTSD. “It was the most effective pain relief I’ve ever had,” she says.
“But it also helped me mentally in that managing chronic pain is also a psychological battle; you’re constantly trying to compartmentalise it or mitigate it or sleep through it, and I’m an incredibly hyperactive person, so smoking cannabis slowed me down and helped me function in a way that I’d never been able to function before.”
Rafael*, 19, from New York, has also experienced the mental health benefits of smoking cannabis. He smoked for the first time at 15, slowly, it became a monthly and then weekly thing and, by the time he was 17, he was smoking cannabis every day. “The feeling was something I grew to love, and I started to use cannabis daily to cope with anxiety and relax,” he says.
But it wasn’t long before he started to notice the negative impacts. By the time the pandemic hit, Rafael says he was “smoking like crazy” and was “high all day every day for two years.” In this time he says, he has had trouble with his appetite, a lack of energy from morning to night, no motivation to do anything and, importantly, he noticed that his social skills dropped off.
Despite multiple attempts to quit, Rafael has only managed to go three consecutive days without smoking. “When I’ve tried to stop, I’ve experienced withdrawals, which include extreme cravings [for cannabis], increased sweating, especially when sleeping, paranoia and depression. I’ve got to the point where I’ve been fed up with this habit for months or even years, but I can’t seem to kick it.”
Although Bella says she doesn’t notice many negative side effects from smoking cannabis regularly, she does experience withdrawal symptoms when trying to quit. “I have always been able to stop smoking for around three to seven days, sometimes longer, without any issues, but when I stop for longer than that, I get horrific nightmares, it’s one of the reasons I smoke a lot.”
Bella is currently trying to cut down before travelling to Asia, where she expects sourcing weed to be much more difficult. “I took a break while on holiday recently and, at first, I was fine, but after a few days I got what felt like flu-like side effects,” she says. “I literally got shivers from withdrawal, which was a big wake up call of how addictive this drug actually is.”
The Signs and Symptoms
Both Bella and Rafael, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which serves as the principal authority for psychiatric diagnoses in the USA, show symptoms of Cannabis Use Disorder (CUD).
The DSM-5 defines CUD as: “A problematic pattern of cannabis use leading to clinically significant impairment or distress, as manifested by at least two of 11 symptoms, occurring within a 12-month period.”
One major factor of CUD is withdrawal. Withdrawal symptoms can include irritability, anger, or aggression; nervousness or anxiety; sleep difficulty (e.g., insomnia, disturbing dreams); decreased appetite or weight loss; restlessness; depressed mood; at least one of the following physical symptoms causing significant discomfort: abdominal pain, shakiness/tremors, sweating, fever, chills, or headache.
Withdrawal symptoms begin to show within a week of quitting, especially after prolonged and heavy use, and should not be able to be explained by another mental disorder, including intoxication or withdrawal from another substance.
However, noticing the signs and symptoms of cannabis dependence isn’t always easy.
As Arda Özçubukçu, the co-founder and director of NeuroSight explains: “Looking out for withdrawal symptoms is helpful, but you might not notice them if you use cannabis every day. So ask yourself if you need cannabis to feel in a certain way or to be able to do something.
Whether you consume cannabis to wind down after a long day of lectures, to be able to sleep or hang out with friends, if you “need” it and crave it when you don’t have it, then it is a sign. If you end up finding yourself spending more and more time getting high at the expense of other activities you used to enjoy or find rewarding, that’s also a red flag.”
Using Cannabis Without Becoming Dependent
Despite the negative side effects of Cannabis Use Disorder, it isn’t a given that everyone who uses cannabis will become dependent. Although it may be difficult for someone who has already developed a dependency to get their usage under control, for those who haven’t there are steps they can take to avoid falling into the trap of dependency.
Don’t go to sleep high
“When you go to bed high, the architecture of your sleep changes,” explains Ezquerra Romano. “There are multiple phases of our sleep and when you go into that high, those phases change, and you can’t rest as well as usual.”
Because the endocannabinoid system in our brains helps to regulate sleep and maintain our sleep-wake cycles, using cannabis has a big impact on our sleep. “When you consistently go to bed while high, your body adapts,” Ezquerra Romano continues. “So when you try to sleep without consuming cannabis, it’s as though something is missing, so you’ll find it much harder to fall to sleep.”
Learn how to dose
Although, as we mentioned earlier, it can be near impossible to truly calculate your dose due to cannabis being unregulated in countries and states where it is illegal, there are ways around this.
“If you are consistent in your sourcing of cannabis, including who you buy it from and what strain the offer, you can use a scale – or even a visual reference – of how much you are taking each time, and try not to use more than that.”
Özçubukçu seconds this. She says: “Keeping an eye on tolerance is key. If you find yourself consuming more cannabis to feel the same, then it’s time to have a break.”
Don’t mix cannabis with tobacco
Again, it is proven that mixing cannabis with tobacco increases the likelihood of dependency. So, Ezquerra Romano says, ingesting cannabis without tobacco may help to avoid becoming dependent, especially if done in accordance with the previous tips.
A Case for Legalisation
Clearly, where cannabis isn’t legal, there is a lack of support for people dealing with signs of CUD, and young people are slipping through the net.
“There aren’t any pharmaceutical drugs, like there are for opioids and alcohol, to help people come off cannabis,” says Ezquerra Romano. A recent study by Drugs and Me found that psychoactive drug use research is asymmetric. This means that there is a bias in the literature when it comes to studying drugs, and that bias leans towards legal substances, namely alcohol and benzodiazepines.
“The War on Drugs has hindered research into psychoactive substances,” he continues. “The laws are on the manufacturing, distribution and sale of drugs, but they shouldn’t be affecting research – and the fact is, they have.”
Without as much research on cannabis, there is less scope for developing treatments that could help people not only treat their dependency, but to understand the signs to begin with.
“A legal framework would allow research to be conducted,” Ezquerra Romano tells Volteface. “That means that, ultimately, there will be treatments and initiatives and apps and wherever you want to help people to quit smoking cannabis. What we need is research, and that would be easier to deploy in a legal market.”
As Rafael says: “Weed addiction is an issue because it’s not viewed as an issue, people don’t take it seriously. A true understanding of weed is what’s needed to curb addiction. The way it’s portrayed makes it seem cool and rebellious but it sucks teenagers and others into a cycle. It should be viewed more seriously.