Marijuana addiction?

Dear Alice,

For people who are addicted to smoking marijuana, is it a physical or psychological addiction?

— Weed wacker

Dear Weed wacker,

To answer your question, it may help to understand the exact definition of addiction. According to the American Psychological Association Dictionary of Psychology, an addiction is “a state of psychological or physical dependence (or both) on the use of alcohol or other drugs.” When someone is addicted to a substance, they struggle to stop using it even when it begins to have negative impacts on their life. Therefore, someone with marijuana use disorder could struggle with physical dependence, psychological dependence, or both. People with marijuana use disorder don't always smoke the drug; others vape it or mix it into foods or drinks (known as taking edibles). Addiction also manifests itself in the behaviors that affects a person. Someone who is struggling with addiction has difficulty stopping, even when they know the harmful side effects of the addiction. 

Though you may sometimes hear the terms used interchangeably, addiction and dependence don't refer to the same condition. Dependence occurs when the body adapts to the use of a substance and starts to require more of it to produce the desired effects. If you're dependent on a substance and try to reduce or stop using it altogether, you may start to experience withdrawal symptoms such as anxiety, nausea, and fatigue. However, this doesn't mean that they're addicted as they don't necessarily have the behavioral effects that come with addiction. Though you can be dependent on a substance without developing an addiction, dependence is generally an issue for those struggling with addiction. 

When it comes to people who use marijuana, an estimated three out of ten people will develop marijuana use disorder. In fact, in 2019, 4.8 million people in the United States over twelve years old had a marijuana use disorder. Some of the warning signs include:

  • Using marijuana more often than intended;
  • Trying unsuccessfully to reduce or stop marijuana use;
  • Avoiding social activities or responsibilities to use marijuana;
  • Craving marijuana;
  • Using marijuana in high-risk situations, for instance, when driving;
  • Experiencing withdrawal symptoms when not using marijuana.

List adapted from the Centers for Disease Control and Prevention

Even if someone doesn't have marijuana use disorder, their use of the drug could impact the following:

  • Brain health: Marijuana affects how effectively the brain functions and can hinder a person's memory, attention, coordination, reaction time, and ability to make decisions. Some studies have even linked marijuana use to declines in cognitive abilities and IQ.
  • Heart health: Marijuana causes the heart to beat faster, meaning that blood pressure can increase after use. The drug can also lead to increased risk for heart disease and stroke.
  • Lung health: Smoking marijuana in any amount can cause damage to lung tissues. Secondhand smoke may also cause harmful effects.
  • Mental health: Some research studies have linked marijuana use to mental illnesses such as anxiety, depression, and schizophrenia.
  • Driving ability: Marijuana use can cause slow reaction time and poor decision-making skills, making driving a car safely difficult. Though more research is needed, some studies have shown an association between marijuana use and car crashes.

There is also the risk for unintentional poisoning with marijuana. Edibles can often be mistaken as regular food or drinks, especially by children, meaning that they can be ingested in much higher quantities than recommended. 

Not everyone who uses marijuana will develop a dependency or an addiction. In fact, marijuana can even be used medically to help reduce chronic pain and the symptoms of some illnesses. However, if you're concerned about your relationship with marijuana or a loved one’s use of the substance, there are resources available. Behavioral treatments such as the following may be beneficial options:

  • Cognitive-behavioral therapy (CBT): A type of psychotherapy in which someone identifies behaviors that cause problems in their life and uses different strategies to change them.
  • Contingency management: A form of therapy in which a specific behavior is monitored, involving provision (or removal) of rewards when the behavior occurs (or does not occur).
  • Motivational enhancement therapy: An intervention intended to create rapid, internally-motivated change in a person by utilizing their already present resources for change.

List adapted from the National Institute on Drug Abuse.  

For additional support, including local services, you may want to consider reaching out to the Substance Abuse and Mental Health Services Administration (SAMHSA) via its website or its confidential hotline. An honest conversation with a health care provider could also be a good opportunity to discuss how to make your (or your loved one’s) relationship with marijuana a healthier one.

Last updated Oct 21, 2022
Originally published Jan 19, 1995