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Marijuana: addiction, symptoms and treatment
Last reviewed: 07.07.2025
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Marijuana is the most commonly used illegal substance. With prolonged use of marijuana, psychological dependence can develop, physical dependence is very slight.
Like any substance that produces euphoria and reduces anxiety, marijuana can be addictive. However, heavy use and inability to stop are not commonly reported. Marijuana is typically used episodically, without causing social or psychological dysfunction. When stopping use, a mild withdrawal syndrome similar to that of benzodiazepines may occur, but some long-term users report sleep disturbances and nervousness when stopping use.
In the United States, marijuana is typically smoked as cigarettes made from the tops of the dried plant's flowers and leaves, or as hashish, the pressed resin of the plant. Dronabinol, a synthetic form of -9-tetrahydrocannabinol (the main active ingredient in marijuana), is used to treat nausea and vomiting associated with cancer chemotherapy and to increase appetite in AIDS patients. This form is not sold on the street.
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Symptoms of Marijuana Addiction
Smoking marijuana produces a state of consciousness in which thoughts are scattered, unpredictable, and free-flowing. The perception of time, color, and space may be altered. A general feeling of well-being and relaxation (drug intoxication) is created. These effects persist for 2-3 hours after inhalation. There is no convincing evidence of prolonged or residual effects. Tachycardia, conjunctival injection, and dry mouth are common. Many of the psychological effects are probably related to the environment in which the drug is taken. Panic reactions and paranoia occur, especially in inexperienced users, but such reactions become unusual when the cultural environment has become quite familiar with the substance. Communication and motor skills are reduced, depth perception and tracking are impaired, and the sense of time is altered - all of which are dangerous in certain situations (e.g., driving, operating complex equipment). Appetite is often increased. Marijuana use can exacerbate and even trigger psychotic symptoms in patients with schizophrenia, even if the patients are being treated with antipsychotics.
Critics of marijuana point to extensive scientific evidence of adverse effects, but most claims of significant biological damage are unsubstantiated. The evidence is mixed even among relatively large users and in areas of intensive study such as immunological and reproductive function. However, heavy marijuana smokers develop bronchopulmonary symptoms (episodes of acute bronchitis, wheezing, cough, sputum production) and impaired pulmonary function. These disorders involve changes in the large airways, the clinical significance of which has not been proven. Even daily marijuana smokers do not develop obstructive pulmonary disease. There are no reports of lung cancer in people who smoke marijuana exclusively, possibly because less smoke is inhaled than with tobacco and the smoke contains fewer carcinogens. However, precancerous changes in bronchial tissue are occasionally detected in biopsies, so cancer may be present. Several controlled studies have found cognitive decline in small groups of long-term, heavy marijuana users; This data requires confirmation.
The effects of prenatal marijuana use on neonates are unclear. Decreases in fetal birth weight have been reported, but when all factors (eg, maternal alcohol and tobacco use) are taken into account, the effect on fetal birth weight is diminished. n-9-Tetrahydrocannabinol is excreted in human milk. Although harm to breastfed infants has not been proven, nursing mothers, as well as pregnant women, should avoid marijuana use.
Because cannabinoid metabolites are persistent, urine tests after each use remain positive for days or weeks after use has stopped. Tests that detect inactive metabolites detect only use, not dysfunction; a user may not be experiencing the effects of the drug at the time their urine is tested. The test can detect extremely small amounts and is therefore of little value in determining patterns of use.