With more than 22.2 million past-month users in 2015, marijuana is the most commonly used illicit drug in the United States, according to the National Survey on Drug Use and Health. Regular marijuana use can lead to dependency or a marijuana use disorder. With the increasing legalization of medical and recreational marijuana nationwide, it is important for Americans to understand the side effects and consequences of marijuana use.
Marijuana is derived from the dried flower of the cannabis plant. It is primarily consumed in three forms:
Marijuana users often add the drug to hand-rolled cigarettes called joints or emptied cigars known as blunts. Bongs, or water pipes, are also commonly used to consume marijuana. Several other methods of consuming marijuana are popular because they do not involve smoke inhalation. These include vaporizer devices that deliver THC through an inhalable vapor and edibles such as brownies and candies.
The main active ingredient in marijuana is the chemical delta-9-tetrahydrocannabinol, also known as THC. The THC level in marijuana varies from strain to strain. According to an article published by CNN, the THC levels in marijuana strains grown by one manufacturer in Colorado range from 6 percent in Canna Tsu to 28 percent in Screaming Gorilla.
In 1990, the THC content in marijuana was around 3.7 percent, according to the National Institute on Drug Abuse. In hash oil, a new and popular method of consuming marijuana, the THC content is even higher. The average marijuana extract contains more than 50 percent THC, and some samples even exceed 80 percent. NIDA expressed concerns that the rising THC levels may mean that the consequences associated with marijuana may increase as well.
An increasing number of marijuana users are smoking THC-rich resins that are extracted from the plant, a practice called dabbing.
Marijuana extracts come in three forms:
Compared with traditional cannabis, marijuana extracts contain extremely large amounts of THC, which have sent marijuana users to the emergency room. Preparing the extracts has also proven dangerous because butane is used in the process. Risks usually include fires, explosions and severe burns.
Synthetic marijuana contains mind-altering chemicals that act on the same cell receptors in the brain as THC. The chemicals, sold in products such as K2, Spice and Black Mamba, come in a variety of formulas that are sprayed on plant matter and smoked. Some people purchase synthetic marijuana as a liquid and use it in vaporizers or e-cigarettes.
According to NIDA, these drugs tend to be popular because the chemicals they contain are undetected by standard drug tests. But synthetic marijuana is more powerful than marijuana, and studies have reported that its chemicals bind to brain cell receptors more strongly than regular marijuana and may cause more powerful effects.
Often marketed as safe and legal alternatives to marijuana, synthetic marijuana is dangerous and life threatening. Because the formulas change constantly and consumers can never be sure the chemicals have been tested on humans, side effects are often unpredictable.
Three in 10 marijuana users develop problem use that may lead to dependence or addiction, according to NIDA. In 2015, roughly 4 million Americans had a marijuana use disorder. Only 138,000 sought marijuana addiction treatment on their own. The people most vulnerable to marijuana dependence or addiction were those who started using the drug before the age of 18.
Marijuana dependence occurs when a person experiences withdrawal symptoms upon stopping use of the drug. These withdrawal symptoms may include irritability, mood swings, sleep difficulties, loss of appetite, cravings, restlessness or general discomfort. The symptoms are typically the most prominent one week after quitting the drug and may continue for up to two weeks.
Marijuana dependence can lead to a substance use disorder when people continue to smoke or ingest the drug despite serious consequences. NIDA reports that estimating the number of people addicted to marijuana is challenging because researchers often include people dependent on the drug in their studies. A person can have a marijuana dependency without being addicted.
However, there is a correlation between dependence and addiction. Research has shown that 9 percent of marijuana users develop a dependence on the drug. For those who started using marijuana in their teens, this number rises to 17 percent, highlighting the increased risks associated with marijuana use before adulthood.
Marijuana remains the most used illicit drug among high school seniors. The 2016 Monitoring the Future survey found that 22.5 percent of 12th-graders reported using marijuana in the past month.
The survey also revealed that 68.9 percent of high school seniors did not think that smoking marijuana was harmful, while 68.5 percent expressed their disapproval of regular marijuana smoking.
Adolescents who start smoking marijuana before the age of 18 are four to seven times more likely than adults to develop a marijuana use disorder, according to a study cited by NIDA.
Researchers have identified numerous drawbacks associated with teenage marijuana use. A New Zealand study found that people who smoked marijuana heavily as teens and had an unaddressed marijuana use disorder experienced an average IQ drop of 8 points from age 13 to age 38.
Heavy marijuana use by adolescents may lead to:
“Adolescents who use cannabis regularly and heavily over a period of time show less academic and occupational competence,” Dr. Deborah Hasin, professor of epidemiology at Columbia University, told DrugRehab.com.
Adolescents tend to be the most vulnerable to mental health problems from marijuana use. A 2012 study published in the Proceedings of the National Academy of Sciences found prolonged marijuana use during teenage years had a negative effect on intelligence function. The severity of mental impairment is proportional to a person’s dependence on marijuana, according to the study.
Individuals who started using marijuana before age 18 had greater declines in IQ than those who started when they were adults. Those who never used marijuana did not experience any declines in mental functions. The study also highlighted that those who started using as teens never recovered from marijuana-related mental impairment even after they stopped using the drug.
“There are suggestions that cannabis can have a longer-lasting impact on the health of adolescents, given that their brains are still developing,” said Hasin.
A report by the Office of National Drug Control Policy noted that marijuana has the potential to worsen depression and cause mental illnesses such as schizophrenia and anxiety. The University of Oulu in Finland surveyed more than 6,000 adolescents aged 15 and 16 and found that teenage marijuana users were prone to psychotic symptoms and had a greater likelihood of developing schizophrenia during adulthood.
Studies note that depressed teens are two times as likely to use marijuana and other illicit drugs, and using the drug at least once per month increases suicidal thoughts threefold among all teens. Although the percentage of depressed teenagers equals that of depressed adults, the former group is more likely to use marijuana over other drugs.
The American Congress of Obstetricians and Gynecologists reported that 2 to 5 percent of women use marijuana during their pregnancy. The rate of use tends to differ depending on the group of women — 28 percent of young, urban and socio-economically disadvantaged women report using marijuana.
Marijuana’s active compound, THC, can travel from a mother’s placenta to her baby during pregnancy. Use of the drug during pregnancy may lead to the following complications:
Researchers have said that prenatal exposure to THC may affect the way a baby’s brain develops. The baby may respond differently to visual stimuli, have high-pitched cries and experience trembling.
Prenatal marijuana exposure can result in many negative consequences in later life, according to researchers. Babies exposed to marijuana in the womb were more likely than babies whose mothers did not use marijuana during pregnancy to have impaired memories, difficulty focusing and low problem-solving skills.
Some pregnant women mistakenly believe that vaping or eating marijuana will not harm the baby. But the baby is still exposed to THC by these methods, which may result in complications after birth.
When an individual smokes marijuana, THC and other active chemicals travel through the bloodstream, producing an immediate feeling of relaxation and euphoria. However, the drug may lead to serious short- and long-term side effects.
Smoking marijuana causes THC to rapidly travel from the lungs into the bloodstream. The blood then transports the chemical to the brain and other organs. After eating or drinking marijuana, it typically takes 30 minutes to an hour for the body to absorb the drug.
Some short-term side effects of marijuana include:
THC influences brain cell receptors that usually respond to natural chemicals similar to THC. These chemicals affect normal brain development and function. Marijuana overstimulates these cell receptors, which causes the high that cannabis users feel. Continued use may lead to marijuana dependency.
“Over time, cannabis users begin to crave the drug,” said Hasin. “If they go a day or two without using it, they can become depressed and irritable. They begin to find that using [marijuana] is taking priority over other activities that are important to them.”
The noticeable effects of marijuana typically last from one to three hours; however, THC remains in the system for days or weeks after use. Research supports that marijuana affects the brain over time, according to NIDA.
Some long-term side effects of marijuana include:
Another long-term side effect of marijuana is dependence. One in 10 marijuana users develops a dependence on the drug, according to a 2014 study that reviewed 20 years of research on cannabis use. The researchers reported that one out of six marijuana users started using the drug during their teenage years.
“We are increasingly concerned that regular or daily use of marijuana is robbing many young people of their potential to achieve and excel in school or other aspects of life,” said NIDA director Nora D. Volkow in a Drug Enforcement Administration report. She further explained that THC’s effect on learning and memory lowers a teenager’s IQ and affects other mental functions into adulthood.
THC in marijuana changes the hippocampus, the area of the brain related to learning and memory formation. Several human and animal studies suggest that marijuana exposure during brain development may have long-term or permanent negative effects on the brain.
When people grow older, they lose neurons in the hippocampus, affecting their ability to learn new information. Scientists have found that prolonged exposure to THC may hasten the aging of those neurons in rats, which could explain how the drug impairs memory.
Studies on marijuana’s impact on teenage brains have yielded varying results. Some studies suggest that regular marijuana use changed the connectivity and reduced the volume of key areas of the brain involved in learning, memory and impulse control. Other studies did not find any differences in the structure of the brains of marijuana users compared with the brains of nonusers.
However, the National Institute on Drug Abuse states that it is difficult to obtain conclusive results about the long-term impact of marijuana on the brain because study participants typically use multiple substances of abuse.
Research has revealed a correlation between marijuana use and juvenile crimes. In addition, car accidents caused by drivers under the influence of marijuana have become a serious problem in states that have legalized the drug.
The National Center on Addiction and Substance Abuse reported that youth who were arrested for breaking the law were four times more likely to have used marijuana in the past year than youth who were never arrested. And according to a report by the Office of National Drug Control Policy, drug use among teens increases the likelihood of them engaging in violent and delinquent behavior.
The 2014 DEA report suggests early use of marijuana may predict criminal behavior in later life. It mentioned a proportional relationship between the frequency of teen marijuana use and incidents such as physical attacks, theft and destruction of property.
Because of marijuana’s negative effects on judgment, motor coordination and reaction time, the drug affects a person’s ability to drive. Driving under the influence of marijuana is a public health concern because passengers and other cars on the road are also at risk.
According to NIDA, marijuana is the most common illicit drug involved in road accidents, including deadly ones. Several studies suggest drivers with THC in their bloodstream are two times more likely than sober drivers to cause a fatal accident or be killed.
Police from Washington state — which legalized recreational marijuana use in 2014 — have noticed an increase in the number of marijuana-impaired drivers. In 2012, the Washington state toxicology lab detected THC in about 19 percent of blood samples from DUI cases. In 2015, that number rose to 33 percent.
Some research shows marijuana use may lead to the use of other illicit drugs.
In a study of 300 sets of twins, the Journal of the American Medical Association found that compared with siblings who didn’t use marijuana, those who did were four times more likely to use cocaine and crack cocaine and five times more likely to use hallucinogens.
|Drugs||Likelihood of Use|
|Cocaine or crack||30 times more likely|
|Ecstasy||20 times more likely|
|Prescription pain relievers||15 times more likely|
|Over-the-counter medication||14 times more likely|
Data from the National Epidemiological Study of Alcohol Use and Related Disorders found that adults who used marijuana during the early stages of the survey were more likely than nonusers to develop an alcohol use disorder within three years.
Although numerous state laws have approved medical or recreational marijuana use, the drug is still not legal under U.S. federal law.
Recreational use allows people to consume the drug legally for personal purposes. Marijuana users typically smoke or ingest the drug to achieve a desirable high. People who purchase marijuana in a state where the recreational or medical use is legal cannot take it to a different state where the drug is not legal.
Medical marijuana use involves the use of an unprocessed marijuana plant or its basic extracts for the medical treatment of a disease. However, the Food and Drug Administration has not approved marijuana as a safe and effective treatment for any condition.
In states that have legalized medical marijuana, doctors can prescribe the drug to patients in special cases. In Georgia, doctors can prescribe marijuana only to patients suffering from terminal cancer, Lou Gehrig’s disease, multiple sclerosis, seizure disorders and other debilitating disorders.
Multiple studies have found that adults who seek treatment for marijuana use disorders typically have a history of more than a decade of daily use and more than six serious attempts to quit the drug.
According to a study published in Current Pharmaceutical Design, admissions to treat marijuana addiction significantly increased in the years prior to 2011. The National Survey on Drug Use and Health reported that about 200,000 people 12 or older received treatment for a marijuana use disorder in 2015.
Treatment for marijuana addiction generally includes a combination of behavioral therapy and support group meetings.
Cognitive behavioral therapy is a form of psychotherapy that equips people to identify and correct their problematic behaviors associated with marijuana use. The aim of CBT is to help people enhance self-control, stop their drug use and take into account other underlying issues related to their drug use.
During CBT, clients learn about the underlying cause of their marijuana use and cravings. They are also taught how to understand, recognize and avoid triggers that can lead to relapse. Cognitive behavioral therapy sessions for marijuana use generally span 45 to 60 minutes and take place weekly in a one-on-one or group setting. Clients may have to complete six to 14 sessions depending on the severity of their addiction or marijuana use disorder.
During each session, therapists will analyze a client’s drug use and cravings and develop a series of responses to tricky situations that may trigger a craving. The client will also receive a short training session on how to cope with risky situations through role-playing or other interactive activities.
Motivational enhancement therapy aims to teach individuals in treatment how to change from within. While this approach is not a treatment for addiction, it aims to encourage people to accept change and be more receptive to seeking treatment.
This intervention is ideal for first-time clients and clients who have had little success with previous marijuana treatment plans. The therapy sessions typically last from 45 to 90 minutes, and individuals complete one to four sessions depending on their requirements. The techniques used include setting goals, weighing the pros and cons of drug use, building self-confidence and reflecting on past choices.
Modeled closely after the 12 Steps of Alcoholics Anonymous, Marijuana Anonymous offers a 12-step program to people battling with a dependency on the drug. The group holds in-person meetings around the country as well as online and over the phone. Founded in 1989, the group has expanded to reach thousands of people in 11 countries.
Although there are no medications approved to treat marijuana use disorders, scientists have proposed using sleep aids to tackle the insomnia associated with marijuana withdrawal. Ambien, BuSpar and Neurontin have yielded positive results.