Cannabis Use Disorder 

Understanding Cannabis Use Disorder 

Cannabis use disorder is a medical condition characterized by the problematic and compulsive use of cannabis, leading to significant issues or distress. Individuals affected by cannabis use disorder may find it challenging to control their cannabis use, despite negative consequences affecting their health, relationships, and daily responsibilities.

Cannabis use disorder and related conditions involve issues linked to substances that come from the cannabis plant or related synthetic compounds. Various names are used to refer to cannabis and its products:

• Weed
• Pot
• Herb
• Grass
• Dope
• Skunk
• Kif
• Ganja

Cannabis is the general and scientific term used for all of these mind-altering substances, referring to all substances related to cannabis. Hashish is a commonly used and more concentrated form of cannabis. 

However, cannabis is also used as a prescription drug to treat certain medical conditions, such as nausea and vomiting from chemotherapy, or loss of appetite in people suffering from AIDS. 

Cannabis is most commonly smoked using various methods, including:

• Pipes
• Water pipes (bongs or hookahs)
• Cigarettes (known as joints) 
• Hollowed-out cigars (blunts)

It can also be ingested by mixing it into food. Like similar substances, smoking or vaporizing cannabis leads to quicker and more intense effects. 

Diagnosing Cannabis Use Disorder

People who regularly use cannabis can develop the typical signs of a substance use disorder. Cannabis use disorder is often the only substance use issue someone might suffer from, but it can also develop alongside other substance use disorders involving alcohol, cocaine, or opioids. However, when consumed with multiple substances, the symptoms caused by cannabis may appear less severe or harmful, downplaying its effects.

People who regularly use cannabis may also develop a tolerance to its effects, needing a larger dose of the substance to achieve the same effect. This tolerance usually disappears if cannabis isn’t used for a longer period of time.

People with cannabis use disorder may use it throughout the day for months or even years, spending many hours under its influence. Others may use it less often but still experience repeated problems in areas like family, school, or work, such as frequently missing work or neglecting family responsibilities. Regular cannabis use can impair behavior and thinking, leading to poor performance at work or school and increasing physical risks during activities like driving, playing certain sports, or operating machinery. Additionally, individuals with cannabis use disorder may continue using cannabis despite knowing it causes physical issues, like a chronic cough, or psychological problems, such as excessive drowsiness or worsening of other mental health conditions.

The diagnosis of cannabis use disorder is also affected by whether the substance is used for the treatment of medical conditions. When cannabis is used as prescribed, it’s normal for tolerance and withdrawal symptoms to develop. However, in these cases, such factors do not decide whether the disorder is diagnosed.

Features that Support the Diagnosis of Cannabis Use Disorder 

Regular cannabis users often claim they use it to manage:

• Mood
• Sleep
• Pain
• Psychological issues 

Indeed, people diagnosed with cannabis use disorder often suffer from other mental disorders. However, instead of alleviating the symptoms of other mental conditions, frequent cannabis use often exacerbates them.

Signs of chronic cannabis use include: 

• Red eyes 
• Smell of cannabis on clothing
• Yellow fingertips
• Chronic coughing
• Cravings for specific foods at unusual times of day or night 

Prevalence 

Cannabis is the most commonly used illegal psychoactive substance in the United States. About 3.4% of teens aged 12–17 and 1.5% of adults 18 and older have cannabis use disorder. Cannabis use disorder is more common in males and decreases with age; it is most prevalent in adults aged 18-29 (4.4%). This high prevalence is due to the widespread use of cannabis, not necessarily its addictive potential.

In the United States, the percentage of people affected by cannabis use disorder varies significantly across different racial and ethnic groups. Among 12- to 17-year-olds, Native American and Alaska Native youth have the highest rates (7.1%), followed by Hispanic (4.1%), white (3.4%), African American (2.7%), and Asian American and Pacific Islander (0.9%) teens. For adults, Native Americans and Alaska Natives also have the highest rates (3.4%), compared to African Americans (1.8%), whites (1.4%), Hispanics (1.2%), and Asian and Pacific Islanders (1.2%). Over the past decade, cannabis use disorder has become more common among both adults and teens.

Development of Cannabis Use Disorder

Cannabis use disorder most often begins in adolescence or young adulthood. It typically develops gradually over time, but it can develop faster in teenagers, especially if they suffer from behavioral issues. Most often, people start using cannabis casually but develop a more frequent use of larger amounts. Moreover, cannabis is often considered less harmful than alcohol or tobacco and is sometimes the first substance that teenagers experiment with.

Because the effects of cannabis intoxication are generally less harmful to behavior and thinking than excessive alcohol consumption, it can lead to a more frequent use of cannabis. Because of this, some adolescents quickly develop cannabis use disorder since they consider it less harmful and use it more frequently. 

Progression of Cannabis Use Disorder  

As mentioned, cannabis use disorder often starts in young adulthood. A study from 2015 emphasizes that the average onset for cannabis use disorder is 18.6 years. According to the study, although most individuals recover from cannabis use disorder (81.8%), a great portion of the individuals may relapse within three years (27.7%). However, after 72 months of remission, the likelihood of recurrence drops significantly.

Similarly, another article from 2015 agrees that a majority of the individuals suffering from cannabis use disorder (67% of people) recover within three years. However, the article also states that only 42% of the individuals stop using cannabis entirely. The rest reduce their use but do not completely quit. Recovery is more likely among people with medical issues, those who use cannabis daily, and those who use other drugs.

Risk Factors for Cannabis Use Disorder 

An article from 2021 outlines the risk factors for cannabis use disorder, including: 

• Starting cannabis use at a young age (especially before the age of 16) 
• Use of other substances
• Frequent use of cannabis
• Other mental health issues (anxiety, depression)
• Other substance use disorders 
• Peer influence
• Family dynamics
• Exposure to drug use in the environment

Moreover, a paper published in 2009 emphasizes childhood adversities as one of the most significant risk factors of cannabis use disorder. These include: 

• Aggressive or delinquent behavior
• Poor school performance
• Sexual abuse
• Smoking or alcohol use by the age of 14

Ultimately, most studies highlight that cannabis use disorder is a complex issue, consisting of various potential risk factors. 

Cannabis Use Disorder and Culture 

Cannabis is likely the most widely used illegal substance globally. While the exact rates of cannabis use disorder vary by country, they are probably similar across developed nations. In the United States, cannabis is often one of the first drugs that people experiment with, typically during their teenage years, and this trend is observed across different cultural groups.

However, medical use of cannabis is varying significantly between cultures. Because of this, cultural factors, such as how acceptable and legal cannabis in a certain country is, can influence the diagnosis of cannabis use disorder. Different consequences of cannabis use depending on the culture, such as school suspension, arrest, or job loss, can also influence the diagnosis of cannabis use disorder. 

Cannabis Use Disorder and Gender 

An article published in the American Journal on Addictions discusses gender differences among individuals who sought treatment for cannabis use disorder. According to the article, although men are more likely to use cannabis and be diagnosed with cannabis use disorder, women experience a faster progression and more severe symptoms. Women also experience more severe withdrawal symptoms, including mood swings, headaches, and fevers, and are more likely to suffer from other mental health conditions such as anxiety and panic disorder.

On the other hand, according to an article from 2013, men are more likely to have other substance use disorder and suffer from antisocial personality disorder (a personality disorder characterized by a limited capacity for empathy). However, the article stresses that both genders rarely seek treatment for similar reasons, such as stigma or lack of motivation.

These notable differences may suggest the need for gender-specific treatments, tailored to address the unique challenges each gender is presented with. 

The Impact of Cannabis Use Disorder 

Cannabis use disorder can negatively impact various areas of life, including social interactions, cognitive abilities, and overall health. 

An article from 2019, for example, emphasizes that early cannabis use can lead to changes in brain structure and function, including memory, attention, and decision-making. The article also links long-term cannabis usage to lower academic success, increased risk of mental health conditions, and reduced social functioning. 

Another interesting study from 2018 compares the impact of cannabis use disorder on psychosocial functioning to that of regular cannabis users without cannabis use disorder. Although both groups face psychosocial issues, individuals suffering from cannabis use disorder face more severe problems. They also report lower academic achievement, more strained family relationships, and more involvement with antisocial peers. Because of this, the study suggests that cannabis use disorder amplifies the symptoms present even without the disorder. 

Moreover, there is a significant concern about accidents resulting from engaging in risky activities, such as driving, sports, or work, while under the influence of cannabis. Additionally, similarly to tobacco, cannabis smoke contains high levels of carcinogenic substances, causing respiratory illnesses. Crucially, cannabis use is also linked to the development or worsening of various mental health disorders or may even be a contributing factor of schizophrenia and other psychotic disorders.

Cognitive Behavioral Therapy (CBT) for Cannabis Use Disorder

CBT is often described as one of the most effective treatment methods for cannabis use disorder. A study from the International Review of Psychiatry explains that the skills taught by CBT help reduce psychosocial symptoms of cannabis use disorder by focusing on harmful behaviors related associated to cannabis use. The article also notes that when CBT is combined with other therapies, such as motivational enhancement therapy or contingency management, it shows even more promising results. 

Moreover, a 2016 paper suggests similar benefits of CBT for cannabis use disorder. According to the paper, CBT helps individuals recognize the triggers for their cannabis use, develop coping strategies, and prevent relapse. Techniques involved in the therapy, such as self-monitoring, cognitive restructuring (learning to identify and challenge irrational or harmful thoughts), and role-playing, help change behavior and thoughts associated with cannabis use.  

Finally, a study from 2011 compares CBT to another treatment method, multidimensional family therapy. Although both treatment options proved to reduce cannabis use over time, CBT showed to be less intense and required fewer treatment hours. However, CBT was just as effective as multidimensional family therapy, reducing cannabis use and psychosocial issues. 

CBT thus offers significant benefits in alleviating cannabis use disorder by equipping individuals with coping skills and strategies. This helps them challenge harmful thoughts and reduce cannabis use, reducing the overall severity of cannabis use disorder.

How the Sintelly App can Help

Managing cravings and reducing stress are crucial components of overcoming Cannabis Use Disorder. The Sintelly app offers mindfulness and relaxation exercises that help users stay grounded and manage their urges. These practices, such as guided meditations and deep breathing exercises, can be particularly useful during moments of intense craving, helping users to refocus their minds and reduce their reliance on cannabis as a coping mechanism.

App also provides exercises designed to help users identify and challenge the thought patterns and behaviors that contribute to their cannabis use. For example, a user might work through an exercise that helps them recognize the situations or emotions that trigger their desire to use cannabis, such as stress or boredom. By understanding these triggers, the user can develop healthier coping strategies, like engaging in a physical activity or practicing relaxation techniques instead of turning to cannabis. Personalized feedback from the app after completing exercises also reinforces positive behaviors and encourages continued growth.

The app’s interactive therapy chatbot provides real-time support, offering guidance and encouragement when users need it most. For instance, if a user feels a strong urge to use cannabis, the chatbot can suggest immediate coping strategies, such as engaging in a mindfulness exercise or reviewing personal reasons for wanting to quit. This instant support can make a significant difference in helping users resist the urge to relapse and stay committed to their recovery journey.

Additionally, users can log their mood and activities, and the app generates visual charts that illustrate their journey over time. These insights help users see the impact of their efforts, identify patterns in their behavior, and recognize areas where they may need to focus more attention.

By providing these tools in a convenient, accessible format, the app helps users take control of their recovery, develop healthier habits, and work toward a life free from cannabis dependency.