How Addictive Is Marijuana?
General Reference (not clearly pro or con)
National Institute on Drug Abuse (NIDA) stated the following in its Feb. 2018 article, “Is Marijuana Addictive?,” available at drugabuse.gov:
“Marijuana use disorders are often associated with dependence—in which a person feels withdrawal symptoms when not taking the drug…
Marijuana use disorder becomes addiction when the person cannot stop using the drug even though it interferes with many aspects of his or her life. Estimates of the number of people addicted to marijuana are controversial, in part because epidemiological studies of substance use often use dependence as a proxy for addiction even though it is possible to be dependent without being addicted. Those studies suggest that 9 percent of people who use marijuana will become dependent on it, rising to about 17 percent in those who start using in their teens.”Feb. 2018 - National Institute on Drug Abuse (NIDA)
Timothy Fong, MD, Clinical Professor of Psychiatry at the Semel Institute for Neuroscience and Human Behavior at the University of California at Los Angeles, stated the following in a Feb. 13, 2018 interview with Randy Robinson for an article titled “Marijuana under the Microscope: A Conversation with UCLA’s Cannabis Research Initiative,” available at merryjane.com :
“The science is crystal clear here. We have a large database across the world that shows when you start smoking cannabis there’s roughly a 9 percent chance you’ll get addicted to it. When you drink alcohol, or start smoking cigarettes, or start using cocaine, that chance gets a little higher. But 9 percent is not zero…
The neurobiological data shows it affects the same exact brain regions as a lot of other addictive substances. But there are also the human stories. It’s the people who come into our offices, emergency rooms, and hospitals, and it’s very clear: they have the same condition of addiction as someone has with alcohol or cocaine…
When we look at national surveys, we estimate that maybe 6 to 8 percent of the entire country may have a harmful or addictive relationship with cannabis. That may seem like a low number — and it’s lower than tobacco or alcohol — but it’s certainly a lot higher than cocaine, opiates, or heroin, and I think that’s the real shocking part.”Feb. 13, 2018 - Timothy Fong, MD
J. Wesley Boyd, Assistant Clinical Professor of Psychiatry at Harvard Medical School, stated the following in his Jan. 14, 2015 article titled “Will Legal Marijuana Lead to More Addicts? Probably Not,” available at theconversation.com:
“Because the symptoms of marijuana withdrawal are somewhat mild compared to other drugs, people often believe that marijuana is not addictive. After all, those who quit generally experience fairly subtle physiological signs of withdrawal – a mildly elevated pulse, irritability and cravings…
Just because the signs of cannabis withdrawal are comparatively mild, though, doesn’t mean it isn’t addictive. Being addicted to something is more than simply being physically dependent on a drug and experiencing physiological effects if it’s suddenly stopped. ‘Addiction’ refers to behaviors that are compulsive and partially out of control or worse…
The best estimates are that 9% of marijuana users are dependent. That is less than the number of users of tobacco (32%) or alcohol (approximately 10-15%) who become dependent on those substances.”Jan. 14, 2015 - J. Wesley Boyd, MD, PhD
Norman S. Miller, MD, JD, CEO of Health Advocates PLLC and Clinical Professor of Psychiatry, et al., stated the following in the Jan. 16, 2017 article titled “Marijuana Addictive Disorders: DSM-5 Substance-Related Disorders,” published in the Journal of Addiction Research & Therapy:
“[M]arijuana is highly addicting, harmful and dangerous as other drugs of addiction… Addiction potential and potency of marijuana determine probability and strength of addiction to marijuana…
The same mesolimbic system that underlies addictive use to alcohol and other drugs is a common pathway for addictive use of marijuana. Dopamine and endogenous cannabinoid system function in the reward system to promote the preoccupation, compulsion, or relapse to the use of marijuana…
The higher potency preparations for ‘medical marijuana’ increase the addiction potential… The rise in marijuana use and addiction has been dramatic particularly over the last 10-20 years.”Jan. 16, 2017 - Norman S. Miller, MD, JD
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association in 2013, defined “Cannabis Abuse Disorder,” found in the diagnostic category “Addictive Disorders,” as follows:
“A problematic pattern of cannabis use leading to clinically significant impairment or distress as manifested by at least two of the following occurring in a 12 month period:
2013 - Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
- Cannabis is often taken in larger amounts over a longer period than was intended.
- There is a persistent desire or insignificant effort to cut down or control cannabis use.
- A great deal of time is spent in activities necessary to obtain cannabis, use cannabis or recover from its effects.
- Craving or a strong desire or urge to use cannabis.
- Recurrent cannabis use resulting in failure to fulfill major role obligations at work, school or home.
- Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.
- Important social, occupational or recreational activities are given up or reduced because of cannabis use.
- Recurrent cannabis use in situations which is physically hazardous.
- Cannabis use is continued despite knowledge of having persistent or recurrent physical or psychological problems that are unlikely to have been caused or exacerbated by cannabis.
- Tolerance, as defined by either:
1) A need for markedly increased amounts of cannabis to achieve intoxication and desired effect, or
2) A markedly diminished effect with continued use of the same amount of cannabis.
- Withdrawal, as manifested by either:
1) The characteristic withdrawal symptoms for cannabis, or
2) A closer related substance is taken to relieve or avoid withdrawal symptoms.”
Alan J. Budney, PhD, Professor of Psychiatry and Researcher at the University of Arkansas Center for Addiction Research, stated in his Oct. 2001 article “Marijuana Abstinence Effects in Marijuana Smokers Maintained in Their Home Environment,” published in the Archives of General Psychiatry:
“This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant.
These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal…
Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other.”Oct. 2001 - Alan J. Budney, PhD
Jack E. Henningfield, PhD, Associate Professor of Behavioral Biology at Johns Hopkins University School of Medicine, and Neal L. Benowitz, MD, Chief of the Division of Clinical Pharmacology and Experimental Therapeutics at the University of California at San Francisco, in an Aug. 2, 1994 New York Times article titled “Is Nicotine Addictive? It Depends on Whose Criteria You Use,” and Daniel M. Perrine, Phd, Associate Professor of Chemistry at Loyola College in Maryland, in his 1996 book The Chemistry of Mind-Altering Drugs: History, Pharmacology, and Cultural Context, ranked the addictiveness of six drugs, with 1 being the most addictive, as shown in the chart below:
Jack E. Henningfield, PhD Neal L. Benowitz, MD Daniel M. Perrine, PhD 1. Heroin Heroin Nicotine 2. Alcohol Cocaine Alcohol 3. Cocaine Alcohol Heroin 4. Nicotine Nicotine Cocaine (Nasal) 5. Marijuana / Caffeine Caffeine Caffeine 6. — Marijuana Marijuana
To read more about the addictiveness ratings, please visit our Addictiveness of Marijuana page.Aug. 2, 1994 and 1996 - Daniel M. Perrine, PhD Jack E. Henningfield, PhD Neal L. Benowitz, MD
The Institute of Medicine published in its Mar. 1999 report titled “Marijuana and Medicine: Assessing the Science Base”:
“In summary, although few marijuana users develop dependence, some do. But they appear to be less likely to do so than users of other drugs (including alcohol and nicotine), and marijuana dependence appears to be less severe than dependence on other drugs…
Adolescents, especially troubled ones, and people with psychiatric disorders (including substance abuse) appear to be more likely than the general population to become dependent on marijuana…
Some controlled substances that are approved medications produce dependence after long-term use; this, however, is a normal part of patient management and does not generally present undue risk to the patient.”Mar. 1999 - "Marijuana and Medicine: Assessing the Science Base" Institute of Medicine
Colin Blakemore, PhD, Chair of the Department of Physiology at Oxford University, and Leslie Iversen, PhD, Professor of Pharmacology at Oxford University, wrote in their editorial “Cannabis, Why It Is Safe,” published in The Times [United Kingdom] on Aug. 6, 2001:
“For some users, perhaps as many as 10 per cent, cannabis leads to psychological dependence, but there is scant evidence that it carries a risk of true addiction. Unlike cigarette smokers, most users do not take the drug on a daily basis, and usually abandon it in their twenties or thirties.
Unlike for nicotine, alcohol and hard drugs, there is no clearly defined withdrawal syndrome, the hallmark of true addiction, when use is stopped.”Aug. 6, 2001 - Leslie Iversen, PhD Colin Blakemore, PhD, ScD
The Merck Manual of Diagnosis and Therapy stated in Section 15, “Psychiatric Disorders,” Chapter 195, “Drug Use and Dependence” and published on its website (accessed Nov. 20, 2002):
“Any drug that causes euphoria and diminishes anxiety can cause dependence, and cannabis is no exception. However, heavy use and complaints of inability to stop are unusual.
Cannabis can be used episodically without evidence of social or psychological dysfunction.
The term dependence probably is misapplied to many users. No withdrawal syndrome occurs when the drug is discontinued, but some heavy users report disrupted sleep and nervousness when they stop.”Nov. 20, 2002 - Merck Manual of Diagnosis and Therapy
John Cloud, Staff Writer for Time magazine, stated in his Nov. 4, 2002 article “Is Pot Good For You?”:
“Those who believe you can’t become physically or psychologically dependent on marijuana are wrong. At least three recent studies have demonstrated that heavy pot smokers who quit can experience such withdrawal symptoms as anxiety, difficulty sleeping and stomach pain.
On the other hand, the risk of becoming dependent on marijuana is comparatively low. Just 9% of those who have used the drug develop dependence. By comparison, 15% of drinkers become dependent on alcohol, 23% of heroin users get hooked, and a third of tobacco smokers become slaves to cigarettes.”Nov. 4, 2002 - John Cloud