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Cannabis Use Disorder
WHAT ?
The objective isn ’ t merely substituting one drug , “ cannabis ” for another , but to gateway the patient off dangerous drugs .
by Peter Kershaw , Contributing Writer
Last month ( July 2023 ), The EVOLUTION Magazine featured an article by this author about the use of cannabis in drug treatment programs . The application of cannabis to treat drug addiction is known as “ harm reduction .” The guiding theme of harm reduction is “ progress , not perfection .” The objective isn ’ t merely substituting one drug for another , but to gateway the patient off dangerous drugs ( meth , cocaine , opioids , benzodiazepines , alcohol , etc .) onto a dramatically safer one — cannabis — ultimately resulting in no drug abuse at all .
Many practitioners of harm reduction widely consider cannabis to be an ideal choice . However , in spite of it being dramatically safer , cannabis isn ’ t entirely without risk . Just about anything can be abused ; and when cannabis is abused , adverse consequences can incur . Granted , said consequences pale in comparison to hard drugs , but prudence dictates they still not be ignored .
Cannabis Use Disorder ( CUD ) is a diagnosis given to those who suffer adverse consequences of cannabis dependency . However , where it concerns medical marijuana patients , just because one might become daily dependent on cannabis ( e . g ., chronic pain management , etc .), this in itself doesn ’ t mean they warrant a diagnosis of CUD . This is borne out by the fact that participants in clinical CUD studies have primarily been made up of recreational and not medical cannabis users .
To be diagnosed with CUD , a person must manifest at least two of the 11 symptoms contained in the DSM-5 , 1 and they must occur in the same 12-month period . The number of symptoms determines whether a person is diagnosed with a mild , moderate , or severe cannabis use disorder . The 11 criteria , paraphrased , are as follows : 1 . Loss of control : using more marijuana or using it for a longer period of time than intended 2 . Social impairments : not engaging in important work , social , hobbies , or recreational activities because of marijuana use 3 . Inability to stop : having the desire to quit or to reduce the amount of marijuana used but not being able to do it 4 . Ignoring risks : ongoing use of marijuana despite harms that arise around it 5 . Cravings : Experiencing an urge / need to use marijuana when not using it
6 . Frustration of existing issues : ongoing use even though marijuana use is worsening an existing physical or psychological problem
7 . Troubles in main spheres of life : due to marijuana use , not being able to perform to one ’ s familiar standard at home , work , or school
8 . Tolerance building : over time , needing more marijuana to get the desired , familiar effect .
9 . Disregarding problems caused by use : despite the negative impact that marijuana use is having on relationships , continuing to use the drug
10 . Withdrawal : when not taking the familiar amount of marijuana or when stopping use completely , the emergence of withdrawal symptoms
11 . Disproportionate focus : dedicating too much time and too many resources to marijuana use
A 2016 National Institutes of Health ( NIH ) analysis found that nearly six million American adults , or 2.5 %, experienced CUD in the past year . 2 As such , CUD isn ’ t at all uncommon . Gratefully for most people , the remedy isn ’ t terribly challenging . At worst , it may incur some mild unpleasant symptoms for a few days .
Cannabis Withdrawal Syndrome
Symptoms for heavy cannabis user withdrawal ( approximately six or more one-gram joints / day or equivalent ) may include :
● Insomnia
● Restlessness
● Anxiety
● Irritability
● Night sweats
● Nausea
● Stomach aches
● Intense cannabis cravings
The intensity of these symptoms is nowhere near as unpleasant as withdrawing from alcohol , cigarettes , or other drugs . A 1994 study , “ Relative Addictiveness of Drugs ,” found that cannabis is less addictive and results in less dependence than caffeine . The same study concluded that withdrawing from cannabis incurs fewer unpleasant side effects than withdrawing from caffeine . 3
As with any other drug or medication , it ’ s important to know if one can “ go cold turkey ” or should only taper back . When speaking of addiction , some drugs are dangerous , if not lifethreatening , to quit immediately . Such is the case for opioids and
20 August 2023