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The Link Between Marijuana Addiction and Mental Illness in Washington State

Is there a connection between regular marijuana use and mental illness? In Washington State, where recreational use is legal, it is definitely worth finding out.

Legal Marijuana in Washington State – The Positives

On the first day of legal recreational marijuana sales in Washington State, supporters enthusiastically showed up in droves. Lines were several hundred people deep and sales were high.  During the first year alone, $83 million was raised in tax revenue. Proponents of legalization point to the fact that much of this money is used to benefit the public:

  • Academic research about cannabis and its applications
  • Community health care services
  • Drug education for adults and youths
  • Substance abuse prevention and treatment programs

In addition, supporters say that because minor marijuana offenses have dropped 98%. This means that law enforcement resources that were once focused on marijuana can now be more effectively allocated elsewhere.

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Legal Marijuana in Washington State – The Negatives

One immediate impact of marijuana legalization is the huge spike in “green DUIs”—driving while impaired by marijuana. Look at the statistics:

  • In 2015, almost 33% of the more than 7000 impaired driving cases received tested positive for marijuana.
  • That equates to 2310 THC-positive drivers.
  • This is an all-time high in both percentage and total numbers.
  • In 2014, the average blood concentration of drivers who tested positive for THC was 6.7 ng/mL.
  • The Washington State limit for an automatic DUI is 5.0 ng/mL.
  • In 2015, 40% of drivers suspected of being under the influence of marijuana were over the state limit.
  • That equates to 924 automatic marijuana DUIs.

Marijuana and Mental Health

But the one of the biggest—yet least-discussed—negatives to the increase in marijuana use is the impact on the user’s mental and emotional health. Numerous studies have linked cannabis use to several conditions, including:

  • Addictive disorders
  • ADHD
  • Anxiety
  • Bipolar disorder
  • Cognitive difficulties
  • Depression
  • False memories
  • Psychosis
  • Schizophrenia
  • Suicidal ideation

Let’s take a look at each of these in turn.

Marijuana Addiction is Real

Although there may be differences in the physical symptoms of withdrawal, there is no difference in terms of psychological dependence to cannabis or any other drug or behavior.” ~James Langdon, No Need for Weed: Understanding and Breaking Cannabis Dependency King County Public Health estimates that approximately 1 in 10 marijuana users will eventually become dependent on the drug.  While that may sound relatively low, consider the sheer number of pot smokers.  According to CBS News, 12.84% of Washington residents use marijuana. Doing the math, that means over 276,000 users in King County and more than 27,000 potential addicts. Someone with a Cannabis Use Disorder will demonstrate several of the symptoms of marijuana addiction. These include “problematic behavioral or psychological changes.” Another sign of addiction is dependence and withdrawal when use is discontinued. Dr. Wes Boyd, PhD, an Associate Professor at Harvard Medical School, has stated, “Even though the physiological effects of cannabis withdrawal are generally mild, it is not correct to conclude that marijuana is not addictive, because being addicted to something is more than simply being physically dependent on a drug and experiencing physiological effects if the drug is stopped suddenly.”

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Marijuana Use During Recovery from Other Addictions

Anyone smoking marijuana while recovering from another substance such as alcohol, cocaine, or methamphetamine jeopardizes a successful return to sobriety. Pot users are:

  • At quintupled risk of having an Alcohol Use Disorder.
  • 60% more vulnerable to cocaine relapse.
  • More sensitive to methamphetamine’s effects.

Marijuana users also experience disinhibition and clouded judgement. This sets the stage for disastrous poor choices such as drug-seeking or relapse.

Marijuana Worsens ADHD

“I am totally and completely opposed to the use of marijuana by people who have ADHD… People with ADHD are at great risk for developing addiction or dependency on all illicit substances… In my experience, marijuana ranks at or near the top of the list of substances that cause problems for people who have ADHD.” ~ Dr. Edward M. Hallowell, M.D. Many ADHD sufferers use marijuana to self-medicate. They hope that it will calm them down and relieve the anxiety and depression associated with their disorder. Some say that pot makes them feel more “normal”. But here’s the thing–marijuana actually makes ADHD worse. How? Marijuana use negatively affects emotion and cognition in several ways:

  • Decreased learning ability
  • Reduced motivation
  • Increased procrastination
  • Impaired concentration
  • Greater distractibility

Individuals with ADHD who use marijuana tend to engage in inappropriate behavior at work, school, and in social settings. This leads to greater depression and anxiety – the same problematic emotions that caused the self-medication. 

Marijuana and Anxiety

A recent study indicated that long-term marijuana abuse can inhibit users’ ability to respond to dopamine, the neurotransmitter that is responsible for feelings of reward and motivation.  As a result, marijuana users are at increased vulnerability for anxiety disorders. Reciprocally, Dr. Julia Buckner, PhD, headed a separate study determining that Social Anxiety Disorder (SAD) is particularly linked to problematic marijuana use.  The study also suggests that, compared to the general population, people with SAD are seven times more likely to become dependent on marijuana.

Marijuana and Bipolar Disorder

“We wanted to answer two questions: does cannabis use lead to increased occurrence of mania symptoms or manic episodes in individuals with pre-existing bipolar disorder?” “But also, does cannabis use increase the risk of onset of mania symptoms in those without pre-existing bipolar disorder?” ~ Dr. Steve Marwaha, the University of Warwick Per a recent study documented in the Journal of Affective Disorders, available evidence suggests a close relationship between the use of cannabis and the development/worsening of manic symptoms. Among the conclusions:

  • A “significant” link exists between the use of marijuana and mania onset.
  • Pot use precedes, mania symptoms, rather than following them.
  • Among people with bipolar disorder, using marijuana results in worsened manic symptoms

Dr. Marwaha says, “…our review suggests that cannabis use is a major clinical problem occurring early in the evolving course of bipolar disorder.” In 2015, a separate study conducted by Lancaster University researchers, marijuana was tied to both increased depressive and manic symptoms. Strangely, these more-frequent episodes do not occur in the same individuals. The study’s lead author, Dr. Elizabeth Tyler, of Lancaster University’s Spectrum Centre for Mental Health Research, said, “We need to find out whether these relationships play out in the longer term, as this may have an impact on a person’s course of bipolar disorder.”

Marijuana and Cognition

“The younger the individual started using, the more pronounced the changes. Adolescence is when the brain starts maturing and making itself more adult-like, so any exposure to toxic substances can set up the course for how your brain ends up.” ~ Dr. Francesca Filbey, Associate Professor, School of Behavioral and Brain Sciences, the University of Texas at Dallas The Proceedings of the National Academy of Sciences concluded that early onset of heavy marijuana use has a long-term and negative effect on the user’s brain. In fact, it lowers their IQ. In a related manner, CNN reports that individuals who initiate marijuana use by age 14 lose brain volume in the area of the brain associated with decision-making. Study participants were marijuana 14-30 years old, and reported using marijuana an average of three times a day. Most participants had used marijuana for at least 10 years. Regular marijuana users had lowered IQs that were an average of five points lower than non-users. Dr. Filbey concluded, “While our study does not conclusively address whether any or all of the brain changes are a direct consequence of marijuana use, these effects do suggest that these changes are related to age of onset and duration of use.” Dr. Susan Weiss, Associate Director for Scientific Affairs at the National Institute on Drug Abuse, directly condemned the regular use of marijuana when she said, “This is a complex and interesting study that adds to the growing body of evidence that heavy marijuana use, particularly at a young age, is linked to significant adverse brain changes.”

Marijuana, Major Depression, and Suicidal Ideation

“We need to carefully evaluate the relationship between various levels of cannabis use, from casual to heavy and problematic, and serious mental health outcomes, like depression and suicidal thoughts and behaviors.” ~ Dr. Arpana Agrawal, Ph.D., Associate Professor of Psychiatry, Washington University, St. Louis In a study among twins, researchers found that those individuals who used marijuana had a risk of a major depressive disorder and suicidal ideation that was 100 times greater than their identical twin who either had never used the drug or who used it infrequently.

Marijuana and False Memories

“The memory processes that appear to be affected by cannabis are ones that we use every day to solve common problems and to sustain our relationships with friends and family.” ~ Dr. John Csernansky, MD, Professor of Psychiatry and Behavioral Sciences, Northwestern University Long-term use of marijuana results in a lessened ability to distinguish between things that are true and things that are false. Alarmingly, this distortion appears to last long after use is discontinued. Recent research reveals that compared to someone who has never used marijuana, a heavy user will have a hippocampus that is both less active and abnormally-shaped. This is the part of brain responsible for memory retrieval and storage. Even when they had not abstained during the prior month, marijuana users still experienced distorted memories. Of special relevance, the greater the past marijuana use, the lower the activity level within the person’s hippocampus. Study participants reporting marijuana use for an average of 3 years during adolescence scored approximately 18% worse on long-term memory tests than the control group of nonusers. In addition, their hippocampi were found to be abnormally-shaped. Significantly, these issues were discovered via brain scans taken 2 years after the last use of marijuana. Study authors said, “’The present results indicate that long-term heavy cannabis users are at an increased risk of experiencing memory errors even when abstinent and drug-free…This lingering diminished ability to tell true from false may have medical and legal implications.”

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Marijuana and Psychosis

It’s not sensible to wait for absolute proof that cannabis is a component cause of psychosis. There’s already ample evidence to warrant public education around the risks of heavy use of cannabis, particularly the high-potency varieties. For many reasons, we should have public warnings.” ~ Sir Robin Murray, Professor of Psychiatric Research, King’s College Drug experts warn that the risk of marijuana-induced mental illness is so serious enough as to necessitate a worldwide public health advisory. Researchers in Australia, the United States, the UK, and the elsewhere in Europe caution that heavy marijuana use increases the risk of developing psychosis in those people who are already genetically vulnerable. Compared to nonusers:

  • Users of marijuana are 40% more likely to exhibit symptoms of psychosis.
  • Among frequent users, the risk is up to 200% higher
  • This indicates that the risk is dose-dependent.

THC, the active ingredient in marijuana, is specifically associated with psychotic illness.  This is of particular concern because the today’s typical marijuana strain has FAR MORE THC than past strains.

  • 20 years ago, the average marijuana potency was less than 1% THC.
  • By the 1990s, the average THC concentration had quadrupled to around 4%.
  • Now, the average strain has close to 13%.
  • Some bioengineered strains are as high as 37% THC.
  • Popular cannabis concentrates are often more than 99% THC.

Sir Murray opined, “There is no doubt that high-potency cannabis… causes more problems than traditional cannabis, or hash. This is the case for dependence, but especially for psychosis.”

Marijuana and Schizophrenia

“There is growing consensus that cannabis use might increase the risk of developing schizophrenia. Our results support this, but also suggest that those at increased risk of schizophrenia may be more likely to try cannabis in the first place.” ~ Professor Marcu Munafò, School of Experimental Psychology, Bristol University A 2016 study published in Psychological Medicine concluded that individuals who are genetically-predisposed to schizophrenia are more at-risk for marijuana use. But using marijuana also increases the likelihood of schizophrenia. Marijuana-using schizophrenia patients are also more likely to require hospitalization than non-users. Professor Munafò believes that schizophrenics may use marijuana in an attempt to self-medicate, or they may simply “enjoy the psychological effects of cannabis more.”

What Does All of This Mean?

“Adults with serious mental illness (SMI), defined as recurring major depressive, bipolar, and schizophrenia spectrum disorders, have a lifetime prevalence of cannabis use twice as high as that of the general population.” ~ Jordan Skalisky, et al, Washington State University All of these studies from researchers around the world highlight the inescapable fact that marijuana is NOT a harmless recreational intoxicant. On the contrary, it is an addictive gateway drug that is also closely associated with numerous mental disorders. Here’s the bottom line—heavy marijuana use directly correlates with addiction and poor mental health. If pot is negatively impacting your life or the life of you care about, perhaps it is time to seek specialized profession care.