Recovering and Healing from a Substance Use Disorder, Part I

By Laura Stack

My last article on Cannabis Use Disorder garnered a lot of shares on social media, so I wanted to continue that thread and discuss what experts say about your child recovering and healing from a Cannabis Use Disorder.

Every category of addictive substance has an associated Substance Use Disorder, or SUD. Someone who has developed an SUD has become psychologically and often physically dependent on the substance, if not outright addicted. Make no mistake: if psychiatrists have defined an SUD for a substance, however legal or natural it may be, it’s toxic. As such, it’s like a poison. Toxicity refers to how poisonous or harmful a substance can be. In the context of pharmacology, drug toxicity occurs when a person has accumulated too much of a drug, leading to adverse effects on the body. Sometimes the damage caused by the substance is minimal with short-term use, but it’s always damaging in the long-term. 

This is especially true for young people, since addictive substances affect the brain—and the brains of those under age 21 have not yet finished developing—so there are adverse effects. It’s much easier for someone to develop a SUD if they start using the substance when they’re underage.

Because of the complexity of this topic, we’ll examine it in a two-part blog starting this week and concluding next time.

What Exactly is a SUD?

As defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, published by the American Psychiatric Association (APA), a SUD is a pattern of symptoms arising from the use of a substance the user continues to take, despite experiencing problems as a result. Sometimes the user hates the substance and its effects but can’t function without it. The more they take, the more they need to feel normal.

DSM-5 recognizes NINE SUDs:

  1. Alcohol
  2. Cannabis
  3. Hallucinogens
  4. Inhalants
  5. Opioids
  6. Phencyclidines
  7. Sedatives, hypnotics, and anxiolytics
  8. Stimulants
  9. Tobacco

The publication also provides 11 diagnostic indicators for SUD. If a user presents 2-3 indicators, then they have a mild SUD. Four to five suggests a moderate case, or dependency. Six or more indicates a severe case, which means full-blown addiction.

The specific indicators for Cannabis Use Disorder are:

  1. Using cannabis for a minimum of one year with the presence of at least two of the following symptoms accompanied by serious impairment of functioning and agitation.
  2. Used in larger amounts over a longer time than what was intended.
  3. Repeatedly tried to stop or lessen the amount of cannabis used.
  4. Unusual amount of time is spent trying to get, use and/or recover from cannabis effects.
  5. Having cravings for cannabis, such as thoughts and images, dreams, and perceiving its smell because of an obsession with it.
  6. Keep on using cannabis even in light of the fact that it has negative consequences, such as others warning to leave the relationship or being left by a partner or friends, poor job performance and criminal charges.
  7. Using cannabis is more important than other areas of life—job, school, hygiene and responsibilities to family members and friends.
  8. Using cannabis and taking dangerous risks, such as driving a car.
  9. Using cannabis even though the person is aware of the physical and psychological problems he has because of it (lack of motivation, chronic cough).
  10. Builds a tolerance to cannabis—taking larger amounts to get the psychoactive effect experienced when it was first used.
  11. Cannabis is used to halt the symptoms of withdrawal.

Withdrawal symptoms common to all addictive substances include:

  • Cravings
  • Anger
  • Aggression
  • Irritability
  • Nervousness
  • Restlessness
  • Anxiety
  • Insomnia
  • Bad dreams
  • Depression
  • Lack of appetite
  • Weight loss
  • Abdominal pain
  • Tremors
  • Excessive sweating
  • Fever and chills
  • Headaches

If any of these indicators or withdrawal symptoms sound familiar, you or someone you care about might have a medical Cannabis-Use Disorder.

The Marijuana SUD

I focus on marijuana in my blog and its parent site, Johnny’s Ambassadors, because it destroyed my son’s life and devastated my family. Most people don’t take marijuana and its effects seriously. We recognize that opioids and cocaine, even alcohol and tobacco, are dangerously addictive. But the perception of marijuana as truly harmful is currently at a low point among the American populace, possibly because its effects aren’t as immediately awful as those of some addictions.

The reality isn’t so funny. Modern “top-shelf” herb marijuana is five times more powerful than the smoked weed available 20 years ago—making it one of today’s harder drugs. Processed marijuana products like wax and shatter are much worse: they can contain THC levels as high as 80-90%, or more. So, the perception of marijuana as relatively harmless has become dangerous, and sometimes deadly.

Like other hard drugs, today’s pot can severely damage the brain. Coming back from CUD—Cannabis Use Disorder—can be just as tough as recovering from addiction to a “harder” drug, because today’s marijuana is narcotic strength. Healing the brain and recovering lost function is still a long, hard road. Some of its effects, like the triggering of paranoid schizophrenia, are not reversible; they can only be managed. CUD is nothing to take lightly.

All SUDs do a number on the body and brain. CUD has its physical effects but is especially hard on the brain. The active chemicals in marijuana—collectively called cannabinoids—replace a category of near-identical natural brain chemicals called endocannabinoids. Researchers have discovered that when cannabinoids hook up to endocannabinoid brain-cell receptors, they can cause synapses to misfire. These misfires disrupt your thought processes and goofs up nerve signals controlling sleep, eating, anxiety, memory and learning, reproduction, and metabolism. Hence some of the short-term side effects of marijuana use, including increased appetite, dulling of intellect, and intoxication.

Those who start using marijuana as children or adolescents suffer the worst long-term effects, because cannabinoids also interfere with the transition from child to adult. They do so by hindering brain development and growth—which endocannabinoids also have a hand in—especially in the prefrontal cortex. The prefrontal cortex is one of the last areas of the brain to develop, making it very active during adolescence. Among other things, it governs decision-making and complex behavior.

In addition to CUD, marijuana use can cause or worsen the following mental issues:

Its physical effects include chronic bronchitis symptoms, marijuana toxicity, complications like severe dehydration due to cannabinoid hyperemesis syndrome (CHS), and in very rare cases, sudden death. The jury is still out over whether marijuana can also cause lung cancer, but inhaling smoke of any kind irritates your lungs.

A SUD Is Not a Death Sentence!

As a society in general, we have learned a great deal about how to handle SUDs in the past half-century. If you, a loved one, or a friend suffer from Cannabis Use Disorder or any other SUD, don’t give up. There’s still hope, even if the SUD has progressed to full-blown addiction or has triggered mental illness. While some of the long-term side effects may never recede completely, sufferers can often control them with medication, and the condition can improve with complete sobriety. Brain scan studies have proven that SUD sufferers have a road back to normalcy. They can also address the SUD itself positively and effectively, with therapy, medical treatment, and social recovery methods.

You can overcome an SUD. In Part II, we’ll take a closer look at the recovery methods substance users have used to get a handle on their SUDs, and the scientific proof that the brain can mostly heal itself if given time, rest, and patience.

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