Marijuana Problems

Differences between Diagnoses

Model poses as a marijuana smoker
Marijuana users are often confused about whether they have a problem with the drug. BraunS / Getty Images

Marijuana Problems - The Diagnoses

Marijuana problems can happen during or after one of the first times you use the drug, or they can build up over time. There are several medical diagnoses that have been given for problems related to using marijuana, leading to confusion among both marijuana users and professionals. Clarification on these disorders is provided below.

Before 2013, people with problems related to marijuana use could receive a diagnos of  either Cannabis Abuse or Cannabis Dependence.

In 2013, the diagnostic criteria changed, and a new disorder, Cannabis Use Disorder, appeared in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), almost entirely replacing cannabis abuse and cannabis dependence.

Marijuana use, marijuana abuse and marijuana addiction appear to overlap perhaps more than use, abuse and addiction in any other drug, not least because of the drug's current status in the minds of users as a relatively harmless drug. Because these beliefs are very pervasive among the marijuana-using population, it is rare for a user to admit to any problems or to move beyond the pre-contemplation stage of change. If negative effects are experienced, the user will typically blame it on a "bad" batch of marijuana, arguing that it was probably cut with a harmful substance, rather than an effect of the drug itself, or a problem with their own patterns of use.

Yet there are major differences between recreational and medical marijuana use, abuse and addiction.

The Differences

The differences depend on several factors, including how much and how frequently marijuana is used, the context in which it is used, how necessary it is in the mind of the user to have access to the drug, the extent to which their life revolves its use, and the way that the drug effects their mental and physical health and results in other problems for them.

Yet marijuana users themselves are unlikely to recognize this. It is not unusual for smokers who use the drug daily and who require marijuana to get through the day to identify as recreational smokers who could quit at any time. So, if you really want to know whether you have a marijuana problem, be honest about the impact the drug is having on your life.

Marijuana Use

Marijuana use involves use of the substance in a non-problematic way, without any negative consequences for the user or for other people. The term "marijuana use" can be applied to recreational or medical use.

Characteristics of recreational marijuana use

Medical marijuana use

Marijuana Abuse

Cannabis abuse was a recognized substance-use disorder, before 2013. It was common for marijuana users to meet the criteria for this disorder, although most would think of their abuse as simply marijuana use, because they do not perceive marijuana as addictive or harmful. People who met the criteria for marijuana abuse often go for long periods without using the drug, and their use may not seem to be compulsive.

However, the defining characteristic of marijuana abuse was harmful, non-compulsive use.

Now that the diagnosis of cannabis abuse has been replaced with cannabis use disorder, and combined with the previous criteria for cannabis dependence, people who would have met criteria for cannabis abuse may not receive a diagnosis -- two symptoms are required for a diagnosis of cannabis use disorder, whereas only one was required for cannabis abuse -- or receive a diagnosis of cannabis use disorder.

Characteristics of marijuana abuse

Marijuana Addiction

Marijuana addiction is also a recognized substance-use disorder, although addiction is no longer separated from other problems related to marijuana use. Cannabis dependence, the diagnosis given before 2013, has been entirely replaced by Cannabis Use Disorder. People addicted to marijuana will often use it daily. People addicted to marijuana will rarely admit to being addicted and will often be quite defensive of their use or need for the drug. For example, while denying that they are addicted, an addict may claim that they "need" marijuana to cope with anxiety and help them relax, even though anxiety is a common effect of marijuana.

Characteristics of marijuana addiction

If you recognize your own drug-using patterns as problematic use or addiction, or if your marijuana use is negatively affecting the way you think, feel or live your life, get help through your doctor or local drug treatment center.

Sources

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, DSM 5, Fifth Edition, American Psychiatric Association. 2013.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, DSM-IV-TR, Fourth Edition, Text Revision, American Psychiatric Association. 2000.

Fiestas, F., Radovanovic, M., Martins, S., Medina-Mora, M., Posada-Villa, J. and Anthony, J. “Cross-national differences in clinically significant cannabis problems: epidemiologic evidence from 'cannabis-only' smokers in the United States, Mexico, and Colombia.” BMC Public Health 10:152. 2010.

Dragt, S., Nieman, D., Becker, H., et al. Age of onset of cannabis use is associated with age of onset of high-risk symptoms for psychosis. Can J Psychiatry 55:65–171. 2010.

Beck, K., Caldeira, K., Vincent, K. et al. The social context of cannabis use: Relationship to cannabis use disorders and depressive symptoms among college students. Addictive Behaviors 34:764–768. 2009.

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