Monday, March 31, 2008

Setting the Record Straight on Marijuana and Addiction

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By Paul Armentano

The U.S. government believes that America is going to pot – literally.


Earlier this month, the U.S. National Institute on Drug Abuse announced plans to spend $4 million to establish the nation’s first-ever "Center on Cannabis Addiction," which will be based in La Jolla, Calif. The goal of the center, according to NIDA’s press release, is to "develop novel approaches to the prevention, diagnosis and treatment of marijuana addiction."


Not familiar with the notion of "marijuana addiction"? You’re not alone. In fact, aside from the handful of researchers who have discovered that there are gobs of federal grant money to be had hunting for the government’s latest pot boogeyman, there’s little consensus that such a syndrome is clinically relevant – if it even exists at all.


But don’t try telling that to the mainstream press – which recently published headlines worldwide alleging, "Marijuana withdrawal rivals that of nicotine." The alleged "study" behind the headlines involved all of 12 participants, each of whom were longtime users of pot and tobacco, and assessed the self-reported moods of folks after they were randomly chosen to abstain from both substances. Big surprise: they weren’t happy.


And don’t try telling Big Pharma – which hopes to cash in on the much-hyped "pot and addiction" craze by touting psychoactive prescription drugs like Lithium to help hardcore smokers kick the marijuana habit.


And certainly don’t try telling the drug "treatment" industry, whose spokespeople are quick to warn that marijuana "treatment" admissions have risen dramatically in recent years, but neglect to explain that this increase is due entirely to the advent of drug courts sentencing minor pot offenders to rehab in lieu of jail. According to state and national statistics, up to 70 percent of all individuals in drug treatment for marijuana are placed there by the criminal justice system. Of those in treatment, some 36 percent had not even used marijuana in the 30 days prior to their admission. These are the "addicts"?


Indeed, the concept of pot addiction is big business – even if the evidence in support of the pseudosyndrome is flimsy at best.


And what does the science say? Well, according to the nonpartisan National Academy of Sciences Institute of Medicine – which published a multiyear, million-dollar federal study assessing marijuana and health in 1999 – "millions of Americans have tried marijuana, but most are not regular users [and] few marijuana users become dependent on it." The investigator added, "[A]though [some] marijuana users develop dependence, 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."


Just how less likely? According to the Institute of Medicine’s 267-page report, fewer than 10 percent of those who try cannabis ever meet the clinical criteria for a diagnosis of "drug dependence" (based on DSM-III-R criteria). By contrast, the IOM reported that 32 percent of tobacco users, 23 percent of heroin users, 17 percent of cocaine users and 15 percent of alcohol users meet the criteria for "drug dependence."


In short, it’s the legal drugs that have Americans hooked – not pot.


But what about the claims that ceasing marijuana smoking can trigger withdrawal symptoms similar to those associated with quitting tobacco? Once again, it’s a matter of degree. According to the Institute of Medicine, pot’s withdrawal symptoms, when identified, are "mild and subtle" compared with the profound physical syndromes associated with ceasing chronic alcohol use – which can be fatal – or those abstinence symptoms associated with daily tobacco use, which are typically severe enough to persuade individuals to reinitiate their drug-taking behavior.


The IOM report further explained, "[U]nder normal cannabis use, the long half-life and slow elimination from the body of THC prevent[s] substantial abstinence symptoms" from occurring. As a result, cannabis’ withdrawal symptoms are typically limited to feelings of mild anxiety, irritability, agitation and insomnia.


Most importantly, unlike the withdrawal symptoms associated with the cessation of most other intoxicants, pot’s mild after-effects do not appear to be either severe or long-lasting enough to perpetuate marijuana use in individuals who have decided to quit. This is why most marijuana smokers report voluntarily ceasing their cannabis use by age 30 with little physical or psychological difficulty. By comparison, many cigarette smokers who pick up the habit early in life continue to smoke for the rest of their lives, despite making numerous efforts to quit.


So let’s review.


Marijuana is widely accepted by the National Academy of Sciences, the Canadian Senate Special Committee on Illegal Drugs, the British Advisory Council on the Misuse of Drugs and others to lack the severe physical and psychological dependence liability associated with most other intoxicants, including alcohol and tobacco. Further, pot lacks the profound abstinence symptoms associated with most legal intoxicants, including caffeine.


That’s not to say that some marijuana smokers don’t find quitting difficult. Naturally, a handful of folks do, though this subpopulation is hardly large enough to warrant pot’s legal classification (along with heroin) as an illicit substance with a "high potential for abuse." Nor does this fact justify the continued arrest of more than 800,000 Americans annually for pot violations any more than such concerns would warrant the criminalization of booze or nicotine.


Now if I can only get NIDA to fork me over that $4 million check.

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