Over the course of our careers as social service professionals, we collect memories that stick with us for life. I’d like to share one of those memories with you:
In my group therapy sessions, I occasionally show a film to stimulate reflection and discussion. One morning, I played a documentary about a young man’s struggle to stop smoking marijuana. My intention was to have a discussion about how addiction is a thinking problem versus a substance problem. The film caused so much outrage that we were unable to finish watching. Although the young man’s functioning was clearly interrupted by his substance use – and he was distraught by his inability to stop – the group struggled to summon compassion for his plight.
I am no stranger to contention in the therapeutic process, but what bothered me is that one of my group members looked like he wanted to melt into the floor. It was clear he could relate to the film… but his experience was viciously invalidated by his peers. By the end of the session, some group members were willing to look at the film from a different perspective, but the damage had already been done.
This snapshot is a microcosm of our society. Marijuana lives on two extreme poles. There is no middle ground. Marijuana is cast as either devil’s lettuce or heaven’s herb. Neither camp is particularly helpful in the process of integrating marijuana into society in a balanced way. One camp perpetuates the demonization and marginalization of drug users, and the other camp perpetuates the myth that marijuana use is completely safe.
Yes, Marijuana is a Drug
Although most of our client population presents with opioid, alcohol, or amphetamine use disorders, we do have clients who quietly struggle with marijuana. Strangely, one of the chief lamentations we hear from clients across the board is, “I can’t believe I can never smoke weed again”. If it’s hard to imagine life without marijuana, why did my group react the way they did to the marijuana documentary? The answer is complex.
Part of the equation is what we describe as “street thinking” or, sometimes, “criminal thinking,” depending on an individual’s using environment. With its long association with the hippie generation, marijuana is not a “tough guy” drug. When some help seekers come to treatment after years of doing so-called “hard” drugs, marijuana use is perceived as a joke.
The other side of the coin is that, not unlike alcohol, society doesn’t view marijuana as a “real” drug – especially younger generations. A lack of “severe” withdrawal symptoms equates to “non-addictive” in the mind of the masses. Some would even argue that marijuana has no physical withdrawal symptoms whatsoever. However, that perception is inaccurate.
The following information is excerpted from the seventh edition of the book Drugs in Perspective by Richard Fields:
“In the 1960s, the THC content of marijuana was 1 to 2 percent in potency…[The] increase in the potency of marijuana means we are looking at a new drug with new problems” (111).
“Strong psychological dependence does develop in many regular users of marijuana, as evidenced by a need for cannabis use every day to perform certain tasks, to relax and unwind, or to sleep. The individual’s life begins to revolve around the use of marijuana as a primary activity” (111).
“Withdrawal symptoms after steady use may include irritability, decreased appetite, restlessness, sleep disturbances, sweating, nausea, or diarrhea. Hangovers are not uncommon…[and may present as] light-headedness characterized by the inability to gather thoughts…Researchers have well established the fact that chronic marijuana use can cause physical dependence by identifying full blown withdrawal symptoms in the newborn babies of marijuana dependent mothers” (111).
“Cannabis intoxication and chronic marijuana use impair short-term memory, alter the user’s sense of time and space, and impair overall coordination and motor functioning. The ability to track other vehicles is also impaired and is a major problem in driving a car…A study of airplane pilots reported that, after smoking marijuana, performance was impaired up to 2 to 3 days later” (112-113).
According to Fields, marijuana meets the criteria for addiction. All the markers of a substance use disorder are present: tolerance (drug seeking behaviors marked by a need for more and more of a certain substance), withdrawal symptoms, and psychological and physical dependence.
Fields released the seventh edition of his book in 2009, not long before I was sitting in a classroom pursuing my own counseling degree. He has since released newer editions. However, it’s safe to say that marijuana has become more dangerous even as we have learned how to further benefit from the cannabis plant. The most imminent danger is an increase in potency. Some marijuana users are now extracting pure THC from cannabis in the form of butane hash oil. (Yes, butane.) This process is known as dabbing. THC – or tetrahydrocannabinol – is the psychoactive compound in marijuana that makes it addictive.
Just because marijuana is a plant doesn’t mean it can’t be dangerous. To be fair, alcohol is from a plant, and it kills 2.8 million people globally each year. In order to be balanced about marijuana, we need to acknowledge that benefits and risks exist. But this isn’t the point we want to leave you with.
Drug Addiction is Not About the Drug
These are the most important words I will ever write in my quest to illuminate addiction: Addiction is not a substance use problem. Addiction is a thinking problem. Substances are the maladaptive solution to the thinking problem. If addiction were a substance problem, you could remove the substance from the picture and the addiction would be resolved. However, when you remove the substance from the picture, you’re left with a brain in need of cognitive rewiring.
A brain becomes wired toward substance use for varied reasons. The human brain changes in relation to the environment. Some people may develop a predisposition due to the way trauma changes the brain. Others may be predisposed due to developmental factors. Still others may experience changes in the brain due to the substance itself. More often than not, all these factors convene at once. Whatever the case, the wiring involved in substance use disorder is treatable but not reversible. That’s one of the reasons we define recovery as “the daily repetition of intentional action”. Rewiring the brain requires repetition.
Help-seekers are typically dismayed to discover that putting down a substance is not enough. This disillusionment is the product of a society that continues to perpetuate the myth that addiction is about drugs. The substances are only a symptom of the true cause.
Autumn Khavari is the Process Recovery Center’s in-house writer. She received an education in Substance Use Counseling from Beal College in Bangor, Maine.
Fields, R. (2010). Drugs in perspective: causes, assessment, family, prevention, intervention, and treatment (7th ed.). Boston: McGraw-Hill.