Is Medical Marijuana Addictive?

As more and more states legalize marijuana for medicinal use to qualified patients, one of the questions asked “Is medical marijuana addictive?” With opiate medications being highly addictive if abused with significant risks of overdose and withdrawal, it is important to either confirm marijuana having addictive qualities or to refute the notion. The answer is that medical marijuana may have a psychological dependence but it does not produce a physiologic dependence so therefore not a true addiction.

Studies of marijuana users overall show that a large majority do not become long term users. In the 1990’s, studies showed that although 31% of Americans 12 years and older had tried marijuana at some point, only 0.8 percent of Americans smoked marijuana on a daily or near daily basis.

It is not unheard of for heavy chronic marijuana users to enroll in a drug treatment program for marijuana dependence. There is a significant difference, however, between a dependence on marijuana and a true addiction. Are there any symptoms of withdrawal when a heavy or frequent user stops smoking? The answer is – possibly. Some individuals report nervousness and some sleep disturbance – about 15% of the time. But you do not see the sweating, hallucinations, nausea, vomiting, etc that is commonly seen from narcotic withdrawal.

In animal studies looking at high dose marijuana administration, no matter how much of the drug is given, animals do not self administer the drug after cessation. Narcotics are a different story.

In 1991, a congressional report from the US Dept of Health and Human Services stated: “Given the large population of marijuana users and the infrequent reports of medical problems from stopping use, tolerance and dependence are not major issues at present.”

The main point here is that marijuana may cause psychological dependence, but not physical and physiologic dependence. Narcotics cause both and even if a patient is able to overcome the psychological attachment to the drug, the simple fact that the side effects are harsh may prevent going “cold turkey” or being able to stop at all.

Thankfully marijuana does not act in that fashion. Even after long term heavy use, there is minimal if any physiologic reaction upon cessation. Marijuana acts on the brain in a different pathway than opiate medications. This may allow medicinal marijuana being utilized to effectively decrease the amount of opiates patients need for pain control, and in some cases entirely replace them.

Also, medical marijuana has a psychoactive effect of decreasing anxiety and improving mood. This is different than opiates, where patients may see a decrease in pain but also may see a depressive effect. This helps explain why so many chronic pain patients need to take anti-depressant medication along with the narcotics.