The federalist system of government in America has made for some interesting, and highly contentious, rifts between the states and the federal government. One example is the legal issues around marijuana in America. At the federal level, marijuana is an illegal drug, but state to state, marijuana appreciates different statuses. Some states approve it for medicinal use; others agree with the federal government and maintain a strict ban; and a few states even permit marijuana consumption for recreational use. There is no clear nor singular messaging about this drug, which can be confusing to teens, young adults, and even mature adults. But one thing is clear: Despite the many myths around marijuana, it is an addiction-forming drug.
As the National Institute on Drug Abuse notes, of all individuals who use marijuana, it is estimated that 9 percent will become physically dependent on it. It is the number one most commonly abused illicit drug in the US. Research shows that the age at which a person begins to use marijuana has an impact on the person’s likelihood of developing physical dependence. Of those marijuana users who initiated into this drug in their teens, 17 percent will eventually become physically dependent on it. When a person is a chronic user (i.e., uses marijuana daily), the likelihood of becoming physically dependent rises to 25-50 percent.
Since it is established that marijuana is addiction-forming, it becomes clear that there needs to be at least a threefold societal approach to this drug. First, public education and prevention efforts should continue (and according to some, expand) to prevent people from initiating into marijuana use. Second, when someone has started using marijuana but has not yet become addicted, then counseling or other services should be provided to help the person avoid addiction. Third, when someone has become addicted to marijuana, treatment must be made available.
Treatment for Marijuana Abuse
The rehab process necessarily starts with an in-depth intake (i.e., a series of questions that are designed to learn about the client’s health condition and history of drug abuse). When it comes to marijuana, in some cases, individuals are admitted to rehab with this drug as their primary and sole drug of abuse. In other instances, marijuana use is part of polydrug use, and marijuana may or may not be the primary drug of abuse. If during intake, an admissions counselor learns that an individual currently has drugs in their body, then they will be advised to undergo medical detox.
At present, there are no targeted medications available to help individuals recover from a cannabis use disorder (i.e., marijuana addiction). However, individuals who are in withdrawal from marijuana abuse in a medical detox program may be provided with prescription or over-the-counter medications to ease specific withdrawal symptoms.
As the National Institute on Drug Abuse (NIDA) discusses, research is ongoing in this area. FDA-approved medications have, in clinical trials, been used off-label to treat symptoms of marijuana withdrawal. According to the findings of these trials, medications that aid in sleep may be helpful, because sleep problems are closely associated with marijuana withdrawal. In addition, anti-anxiety medications, such as buspirone (BuSpar) and an anti-seizure drug gabapentin (Horizant and Neurontin) have been show to help with sleep troubles and cognitive functioning, such as decision-making abilities. The dietary supplement N-acetylcysteine and chemicals belonging to the FAAH inhibitors class of drugs may reduce the symptoms of withdrawal by stopping the body from breaking down its own naturally occurring cannabinoids. As far as a medication to stop marijuana addiction rather than treat the withdrawal symptoms, research is being conducted on chemicals called allosteric modulators that can be used, potentially, on the site of cannabinoid receptors to stop the rewarding effects of marijuana. Without the rewarding effects, abuse will likely stop.
NIDA further explains that there are numerous treatment services for individuals seeking to recover from marijuana abuse. However, these treatments are not different from the accepted and applied staple of treatments that are used to help individuals recovering from abuse of other drugs. But there may be one difference between people who abuse marijuana and those who focus on other drugs. According to a review of intakes at rehab centers, adults who seek to recover from marijuana abuse have, on average, used this drug for more than a decade and tried to stop doing so more than six times. These individuals, therefore, may need help staying motivated to remain in treatment. It’s feedback like this that helps addiction specialist to treat the broad strokes and nuances of addiction.
Per NIDA, some behavioral therapies have been shown to be effective in the marijuana treatment context in particular. These therapies include Cognitive Behavioral Therapy, Motivational Enhancement Therapy, and Contingency Management. In addition, individuals who are diagnosed with a co-occurring marijuana or other substance use disorder and a mental health disorder are universally advised to seek treatment that can accommodate a dual diagnosis. Studies show that the effective treatment of the mental health disorder, especially those of the more severe and chronic classification (e.g., bipolar disorder) can help to reduce marijuana abuse. Thus, while treatment should be targeted to the marijuana abuse (more specifically, the emotions and psychological processes underlying the abuse), there are also indirect ways of improving marijuana use disorder (again, such as by properly treating any co-occurring mental health disorder).
To review, the process of marijuana abuse recovery begins with detox and then, once detox is complete, the recovering person transitions into primary treatment for the addiction. At that point, therapies, such as the behavioral therapies discussed above, are used. These therapies occur in both one-on-one counseling sessions and in group counseling sessions (these sessions are therapist-led). In addition to counseling, a person who is in recovery for marijuana abuse at a rehab may receive a host of additional recovery services, including but not limited to:
- Group recovery meetings (those that use the 12-Step model, like Marijuana Anonymous)
- Drug education classes
- Family therapy
- Expressive therapy, which can include art and music therapy
- Animal-assisted therapy
- Wellness treatments, such as acupuncture, massage, and chiropractic care
- Yoga training
- Nutritional counseling
- Time away from rehab to engage in a structured, drug-free activity, such as seeing a movie or going to dinner at a restaurant
Unlike group therapy, peer support or 12-Step meetings are member-led as opposed to being guided and moderated by a trained therapist. Group therapy works off the principle of peer support and the simple but healing tendency of people to benefit from the experiences of others. Group recovery meetings are considered to be indispensable to the rehab process for individuals who abuse marijuana or other drugs.
Attending peer support or 12-Step meetings is also critical to the aftercare process. There are countless people who credit ongoing attendance at meetings as instrumental to their ability to maintain abstinence from marijuana and/or other illicit drugs. For this reason, it bears discussing the group Marijuana Anonymous.
About Marijuana Anonymous
It would seem that the most commonly talked about Anonymous groups are Alcoholics Anonymous and Narcotics Anonymous. However, there are a host of other groups, with different drug targets, within the Anonymous fellowship. Marijuana Anonymous is one such group in the Anonymous family. It should be noted, however, that Anonymous meetings are open to anyone who has a desire to stop using drugs. Attendees do not have to be in recovery from the named drug. In other words, a person in recovery from marijuana addiction could attend an Alcoholics Anonymous meeting and feel accepted. But even further, since these mutual aid groups are about the experience of addiction, the particular drug of abuse is not of critical importance. Still, if a person is in recovery from marijuana abuse and lives in commuting distance of a Marijuana Anonymous group, this may be a preferable group to join.
Like all Anonymous meetings, Marijuana Anonymous does not charge its members. These groups do not have any affiliation with other groups, religious organizations, or private or governmental agencies. The group organizes itself it accordance with the 12 Steps of recovery and takes its guidance from the 12 Traditions. The 12 Steps are adapted from the Alcoholics Anonymous model. Each member dedicates to working the 12 Steps, and meetings often revolve around the members’ progress within whatever step or steps they are working. As these steps can be worked over one’s entire lifetime, some individuals attend meetings for months, years, or decades.
While there may be pockets of society that advocate for the legalization of marijuana, it is critical for the public to separate fact from fiction. As this discussion makes clear, marijuana addiction is real but recovery is possible through treatment.
For anyone who is concerned about marijuana use in a teenager, it is helpful to note that research is clear that marijuana can be particularly harmful to the developing brain. This reason alone provides sufficient motivation for a parent, or other concerned person, to intervene early regarding any marijuana abuse that may be occurring in a young person’s life. As youth are among the most vulnerable groups in America, it is necessary that they receive help from adults and society in general. That help can come in the form of treatment for marijuana abuse.
Among adults, even if recovery services have been engaged on more than one occasion, it is essential to keep in mind that the recovery process is not beholden to any set timelines. One recovery attempt may not work, but the next can set the person on the path to lasting abstinence from marijuana or other drugs.