Marijuana: Addictive or Medicine?

Marijuana: Addictive or Medicine?

By Darisse Smith

For some suffering from chronic pain, marijuana is miracle medicine. For others, marijuana is a dangerous, addictive drug. Looking through the lens of chronic pain, is marijuana miraculous, harmful or something in between?

Let’s take a look how marijuana works on one’s system. The human body has its own endocannabinoid system, a series of receptors and binding sites that work against and with each other to reduce or increase different symptoms in the body such as pain, appetite and anxiety. The cannabis plant contains similar phytocannabinoids that act in a similar way, the most known being THC and CBD. One area of the brain that lacks cannabinoid receptors is the medulla, where breathing and respiratory processes are regulated. Since there are no cannabinoid receptors in this part of the brain, one cannot overdose on marijuana (though higher doses can create some odd and for some, uncomfortable side effects).

Anecdotal evidence and some scientific research demonstrate that marijuana can be effective for many different illnesses and symptoms. Marijuana can be effective for acute, chronic and neuropathic pain, anxiety, loss of appetite, different mental disorders and epilepsy, among others. The therapeutic benefits of marijuana are difficult to study since the FDA does not recognize marijuana as a medicinal plant, making scientific study difficult, limited and underfunded. There are a few scientific studies, though, such as one from the University of Michigan that recently conducted research into marijuana and its usefulness as medicine. The Michigan study demonstrated that among the pain patients tested who were on an opioid regimen, using marijuana led to increased quality of life and mobility, less side effects and even caused a reduction in opioid medication in some cases. Another study performed by Dr. Mark Ware at McGill University in Canada, marijuana provides reasonable pain relief without major side effects.

On the other side of the argument, there are those who view marijuana not as medicine but as a harmful, addictive and illegal drug. Opponents of marijuana use argue that the body’s endocannabinoid system, instead of being enhanced by marijuana is overwhelmed by the phytocannabinoids, causing impairment, paranoia, slow reaction time, euphoria and an increase in appetite.  When one smokes marijuana, heart rate and blood pressure increase, and in young people, THC can impact development of the brain. Whether or not marijuana is addictive is up for debate, though many anti-drug websites equate addiction purely to physical tolerance. According to the National Institute on Drug Abuse, marijuana can create a physical tolerance leading to withdrawal symptoms such as restlessness and irritability in heavy users. “Of course, tolerance doesn’t mean addiction.  A good definition found for describing addiction as it relates to marijuana is by Dr. Roger Roffman, professor of social work at the University of Washington: “Addiction results from a combination of biological and psychological factors that contribute to conditioned behavioral patterns that are very difficult to stop or resist.”  According to a 2014 study conducted by the National Institute on Drug Abuse (NIDA), 4.176 million people used marijuana and of that number, 138,000 voluntarily sought treatment for marijuana use.

When one suffers from debilitating pain, finding pain relief which allows an acceptable quality of life is a life-long struggle. With opioids being under attack these days due to the prescription drug epidemic, marijuana can be a reasonable alternative for many. Others who may struggle with previous addiction will have to decide what therapy works best for them without serious risk of further addiction and negative consequences. This is my current struggle-do I use marijuana to treat my various ailments or, with my history of opioid addiction, do I keep looking? I’ll let you know what I decide.

Capt. Darisse Smith

Darisse Smith is a contributor to the National Pain Report. An Army veteran who has suffered from chronic pain for over a decade.

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Authored by: Darisse Smith

There are 16 comments for this article
  1. John Antonellis at 8:31 pm

    I’m a 3 1/2 year pancreatic cancer survivor, my treatment consistented of Whipple surgery, chemo and radiation. Aside from the temporary side effects of chemo and radiation the surgeries side effects continues, occasional vomiting for no reason, stomach spasms/cramps daily and the need to take enzymes with my meals. Just about 2 yrs prior to my diagnosis I fractured several veterbra in my cervical spine area and dislocated a shoulder mountain biking. This was on top of other orthopedic issue’s from a very active life style all of which have left me in a constant state of discomfort. Registered in NJ’s program I use medicinal marijuana to manage a number of these issues without the side effects of many of the alternative prescriptions recommended. In addition to personal experience in managing pain, as a volunteer I provided transportation for veterans to their VA appointments. Many of the veterans I’ve met were dealing with issues that could be helped with medicinal marijuana as part of their treatment protocol. Reducing the need for addictive opioid medications. Managing pain or for that matter certain other health issues may not be about complete elimination of the symptom but reducing/managing so one can be safe, functional and productive without potentially serious side effects.

  2. Catherine Rusk at 3:38 pm

    Marijuana is an awesome for chronic pain, anxiety, etc. I can’t possibly get “high”. It helps the pain and anxiety for me. I guess there are people who just use it to get high but with my physical issues I don’t and don’t want to. My dr. Has told me that I have to wait 18. Months for the dispenseries to get up and running. I wait..I take opiates. Right now that is my only option except for when I can afford it Kratom. I can’t hardly ever afford any.
    I’m anxious waiting for these herbs to be more available. Please help us chronic pain patients be able to get the herbals.
    Ty, Catherine

  3. TOPDOG1 at 9:01 am

    ..Because of the misuse and abuse of responsibility and credibility as well as incompetence. The enforcement power of the D.E.A. should be removed and placed back into the hands of the state. A semi-secret elite police force within what is already a police state is way over the top. America does not need this throwback to the cold war era. These Federal offices have become a renegade haven of Authoritarian despots and tyrants commandeering and miss-directing hundreds of millions even billions into their drug war against citizens and likewise funding state police regimes both within the U.S. and worldwide.It is these federal agency’s that have created the drug problem solely to commandeer funding and as their power base. Over sixty percent of F.D.A. employees go to work for the pharmaceutical industry. These renegade authoritarians as well as the F.B.I. need to be controlled or removed.

  4. Chuck at 8:17 pm

    Thank you Darrius for your voluntary service to our country. I hope you find the answer. SSG CW

  5. Catherine Rusk at 9:09 pm

    Marijuana and Kratom are having the same problems.
    Marijuana is a schedule 1 and the DEA wants to make KRATOM a schedule 1.
    Marijuana all over again!! This has to stop. They both have medicinal properties. The DEA has no idea what they are talking about.

  6. dockut at 11:28 pm

    Addiction is doing something repeatedly that you know hurts you.

    Sadness lets us know when we’ve lost something important to us. When that loss is self-worth and hope the sadness can become so sever that it seeks relief at all costs. When that relief is found by changing the chemistry of the brain it is the disease of addiction. When you realize that you were created on purpose for a purpose, you gain back that Spirit of worth and hope you lost. From there you have the foundation to understand and treat the disease addiction.

    So the problem we all miss is acknowledging that it does not proceed from the substance but instead from an underlying biopsychosocialspiritual etiology. Addiction is initially the driving symptom until the substance effects change in the patients physiology which leads to pathology, thus disease. Physical Dependence and Tolerance are parts of the same natural process of adaption which leads to withdrawal symptoms. This in itself is another adaption of the body to find balance. Substance Use Disorder includes both addictive behavior and physical adaption.

    Marijuana (MMJ) may be an expression of an underlying biopsychosocialspiritual problem that leads one to not care if they hurt themselves and have no hope. But since MMJ really won’t do any harm comparable to all other substances then calling it an addictive substance is certainly questionable. Granted is a patient consumes MMJ 24/7 they may be living a life of stoned stupid and apathetic. In that this can be harmful, especially if associated with depression, then I am willing to accept this as an addiction. But it is not because of the substances in MMJ but instead in the patients’ lack of a spiritual sense of self-worth and hope.

    MMJ certainly isn’t a SUD because that requires, not only qualifying as an addiction, but also as having a physiological change that can lead to physical dependence, tolerance, and withdrawal. I do not contest the concept that there is a physiological change of adaption to MMJ but because its half life is so very long, a month or so, that withdrawal symptoms are essentially never seen or experienced. If you say that “restlessness and irritability” are the signs of MMJ withdrawal I would respond with; Ok, so? My dog is like that when she has to have a bowel movement. Really now, get real, most substances withdrawals are far worse than this, even death. In addition, I would suggest that the symptoms of restlessness and irritability may be more related to the patients deeper issues of lack of self worth and hope that drive their addictive behavior in the first place.

    So, in summary, MMJ does not cause any real semblance of withdrawal and it really cannot be call a SUD or Addiction. The problem lies, as with all addictive behavior, to an underlying sense of worthlessness and no-hope.

    Thus, if you want to help those with Addictions aim first at the underlying problems that drive the behavior, not the substance abused.

    As far as MMJ for pain we need to understand that the THC is not helpful as it is the only CBD that is hypnotic (gets you high). It is the MMJ’s other CBD’s that help with muscle and emotional relaxation, anxiolysis, and pain relief. This is why we need to only recommend low THC and high CBD MMJ. Other choices like hybrids and sativa’s reverse that relationship and can be associated with paranoia and increased anxiety.

    At this time in our history I would not recommend oral consumption of MMJ as there is no way to control the dose or length of action. Until the Feds get their heads out of their political rectums the best approach as a pain management tool is to only use medical grade high CBD/low THC Indica in a few small and short puffs until a slight high is noticed. This is best done at night prior to going to bed. The THC in the smoke causing a slight high can be used as an indicator of reaching adequate other CBD levels. When tired go to sleep. If the THC is still keeping you high then have a glass of milk. preferably warmed. which will help bind up the THC. The CBD’s you inhaled will stay in your system for a month or so. If you follow this, over the ensuing days, with capsules of CBD’s, one cap three times a day. Your CBD levels will stay therapeutic for 3 to 5 days. When you notice you aren’t getting the sustained effect of the MMJ and CBD Caps its time to take a few more puffs at night to bump up your CBD levels. This is a treatment developed and told to me by my patients who have managed to substantially lower or even cease their narcotic use.

    On another note: MMJ is not the cure all for pain management, it is simply another tool Pain and Addiction Medicine specialists may use to help the patient function to their best ability while lowering the attendant risks of morbidity and mortality from narcotics. When you break your leg don’t ask for MMJ, instead ask for morphine 🙂

    Bottom line is that all addicts need to work through their biopsychosocialspiritual issues. When they do, their addiction will lose its flavor, its reward. If there is physical pathology then it is best to treat that while addressing their underlying causes of their behavior.

    Pain and Addiction is a string that pulls both ways while both being symptoms of an underlying problem.

  7. Teresa haney at 9:54 pm

    Marijuana helps me tremendously. I don’t have the side effects of lethargy or increased appetite. They finally legalized it in Ohio for medical use. Unfortunately it will be at least 2 years before its available. I’m so tired of needless suffering. I wish people who don’t have chronic pain would butt out. I’m not a mean person I wouldn’t wish my pain on anyone. But I just wish they could just leave us alone so we can relieve this misery. If they felt arachnoiditis for one hour laws would change rapidly. Marijuana would be available instantly.

  8. Jon at 3:50 pm

    I suffer from both PTSD and chronic pain. I’ve tried the pharmaceutical approach through the VA, which gave me 7 prescriptions and a bad case of the zombies. Using marijuana let’s me narrow it down to one prescription. I’m a much happier guy now, and my family is happier with me.

  9. Freedom Fighter at 3:17 pm

    The medical definition of the word “addictive” refers to drugs that present definite physical withdrawals symptoms. Examples of Drugs of this type are pharmaceuticals such as Vicodin, OxyContin or alcohol which can be fatal during the physical withdrawal process. Cannabis dependence can be formed but there is never an addiction. There are never withdrawal symptoms from discontinuing cannabis let alone fatal withdrawal symptoms like those produced by pharmaceutical drugs and alcohol.

  10. BL at 12:28 pm

    Marijuana can be abused and addicting like any other drug.

  11. JoDawn at 11:41 am

    Thank you for such a thoughtful and informative article! You reinforced some things I’ve learned and answered questions about others.
    I’m not so much baffled by the US Gov not legalizing MMJ as I am frustrated by it.
    Before I educated myself, I was firmly against any type of legalization. Now I’ve done a complete 180 degrees. This is not the drug I was taught about in High School!
    In everything I’ve read, this IS a medication. Any medication can be misused, but it can also bring a great deal of good to many people desperate for relief and begging for their “old life” back.
    I think the government should give it, and us, a chance!

  12. TOPDOG at 11:18 am

    Marijuana is seen as a dangerous and addictive drug almost exclusively by those who have never used it. or by law enforcement who use any excuse or lie to wage a drug war on the citizens..

  13. Dan at 10:59 am

    Marijuana did nothing for my pain or myself other than empty my pockets. Not the answer

  14. BRIAN HILTON at 10:10 am

    Anything can be abused to one’s own decline and death. Ultimately it’s up to the individual how it will play out. Regardless whether the government outlaws it or not. marijuana can be medicine

  15. Mark Ibsen MD at 8:54 am

    80% of my pain patients got off opiates entirely using Cannabis.
    In EVERY state where Mmj is now legal, prescription drug OD went down 25%.
    In my state of Montana, that is 75%
    Prescription drug use and costs also dropped significantly in those states

  16. Tamara Johnson-Scott at 5:10 am

    THAN YOU! THANK YOU! THANK YOU!!!!!!😊😊😊
    I’ve been SCREAMING this to ALL my doctors (except for my GI doc that prescribed it) just how EFFECTIVE and FASTER ACTING than all the NARCOTICS COMBINED!! NO ONE, NOT ONE LISTENED they just kept prescribing the NARCOTICS! Made me so bad I almost DIED, I lost 82lbs in 4 mos. when FINALLY they shipped me to IU MEDICAL in INDIANAPOLIS where my GI DOCTOR diagnosed SPHINCTER OF ODDI DYSFUNCTION and told me MAJORITY of his SOD and PANCREATIC patients smoked MARIJUANA for relief and found it WORKS BETTER than ANY NARCOTICS! Then he prescribed liquid MARINOL and put in a JG Peg to feed and inject meds. FINALLY after 6yrs I’m pretty much BACK to my “OLD NORMAL SELF”!!!!😊😉😍😍😍
    I NEVER tried it when I was younger so I can’t say for sure how a “HIGH” feels BUT I CAN SAY that IF feeling “NORMAL” is a “HIGH” then EVERYONE OVER the age of 22 EVERYWHERE NEEDS A PRESCRIPTION!!! Can you IMAGINE how much NICER this world would be?!?!😉