The Dirty Dozen #1: Marijuana Dependence

By Laura Stack

As cartoon character Mr. Mackey once pointed out on South Park, “Drugs are bad, mmkay?” He’s right, despite his later experimentation with “mary-jew-onna.” And made no mistake: marijuana is indeed a drug. Don’t let anyone tell you different. I’ve heard arguments from proponents that you can’t really call herb marijuana a drug, since it’s a natural plant that isn’t processed. Today’s THC products are potent chemicals, with all plant matter removed.

Consider willow bark, the original aspirin; ipecac from ipecacuanha; quinine from the cinchona tree; and digitalis from foxglove—all plant-based drugs that don’t require much processing beyond concentration. Gin, made from citrus peel, juniper, cinnamon, coriander, almonds, and grain alcohol (all plant products) was originally used as a medicine to treat gout and indigestion. And then there’s Aristotle, who was executed with a strong dose of hemlock, an all-natural plant still used to treat breathing problems, anxiety, and mania.

Here’s reality for you: you can use anything intoxicating as a drug, and any of them can kill you, directly or indirectly. That’s what puts the toxic in intoxication.

Even the marijuana and “hemp” advocates who admit marijuana’s true nature have a large litany of claims about how marijuana is still much less damaging than smoking cigarettes or drinking alcohol—both legal intoxicants, despite their known deleterious effects. Really? Do we want to compare marijuana to alcohol, the most addictive and killer substance out there? That’s not a good measure of success. We have a massive amount of data and research to prove the negative effects of booze and tobacco. We are seeing the true horror of frequent marijuana use emerge, and we have the research to prove it.

Nor was old-style “wacky tobacky” nearly as strong as modern marijuana products. These days, herb marijuana can contain as much as 35% THC, and there are claims for even higher-THC strains. That doesn’t even count the legal candy, cookies, oil, shatter, wax, and medical marijuana products that can be as high as 99% THC by weight.

The old arguments about the relative harmlessness of marijuana are dead, run down by today’s truth. When you ingest modern marijuana, you might as well swallow Agent Orange… except pot can hurt you faster.

So, this week, we’re starting a new 12-part article series called “The Dirty Dozen,” outlining twelve of the terrible things marijuana can do to you, mentally and physically.

We’ll start with one of the most insidious: Number One on our list, Marijuana Dependence.

Chewing the CUD

What do more than a third of frequent marijuana users have in common with cows? They both have CUDs. In cows, a cud is a disgusting mass of partially digested food thrown back into the mouth from the stomach for further chewing. While potheads don’t chew a cud, many suffer from a CUD: Cannabis Use Disorder, also called Marijuana Use Disorder (MUD). While these are just acronyms, I suspect it wasn’t just an accident they sound disgusting.

CUD is just one of nine professionally-defined Substance Use Disorders, or SUDs, all sharing the same 11 defining factors:

1. Taking the substance in larger amounts or for longer than you’re meant to.
2. Wanting to cut down or stop using the substance but not managing to.
3. Spending a lot of time getting, using, or recovering from use of the substance.
4. Cravings and urges to use the substance.
5. Not managing to do what you should at work, home, or school because of substance use.
6. Continuing to use, even when it causes problems in relationships.
7. Giving up important social, occupational, or recreational activities because of substance use.
8. Using substances again and again, even when it puts you in danger.
9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
10. Needing more of the substance to get the effect you want (tolerance).
11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.

When someone has a CUD and is addicted to marijuana, stopping is very difficult. Cannabis Withdrawal Syndrome (CWS) includes the following symptoms for several weeks: cravings, anger, aggression, irritability, nervousness, restlessness, anxiety, insomnia, bad dreams, depression, lack of appetite, weight loss, abdominal pain, tremors, excessive sweating, fever, chills, and headaches. When people try to stop using marijuana, they experience these withdrawal symptoms, as with any drug. When they feel horrible, they use again, alleviating their symptoms, further reinforcing their false beliefs that “it’s helping me.”

Sadly, CUD is common. Clinicians divide users into low, moderate, and severe categories, with the last two comprising cannabis dependence and cannabis addiction. The addicted display at least six of the above 11 diagnostic symptoms for SUDs, with the dependent having 4-5. The general consensus is that true addiction afflicts about 9% of users, while 30% count as cannabis dependent—though some recent studies, including a thorough meta-study of 21 prior studies, suggest the percentages of each CUD category are actually higher. This meta-study concluded that nearly half of regular marijuana users have CUD to some degree. Those who start using while adolescents have it worst: among them, cannabis dependence (not addiction) may prove as high as 33%. A young start and long use correlate with higher risks for dependence and CUD—not surprising given other things we know about marijuana use.  

A Sobering Effect

Marijuana users are also more likely to use alcohol and other drugs too, often concurrently. The adventurousness, peer pressure, and/or addictive personalities that led them to try pot in the first place often extends to other things, especially when they perceive marijuana as relatively harmless.  

One result is the monkey on your back called CUD that may afflict users even when they aren’t psychologically or physically addicted to weed. Pot smokers don’t think of themselves as junkies, but it many ways, they are. Cold-turkey rejection can be almost impossible. Add all the physical and mental effects we’ll be discussing in later articles in this series—some of which don’t end even if a user does stop using marijuana, and their deep, dark misery for a stoner can be just as debilitating as that of any drug addiction.