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Running Head : Cannabis Use Disorder

Cannabis Use Disorder

Tom Goode

Lake Shore High School

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Cannabis Use Disorder

Cannabis Use Disorder affects roughly 30% of people who partake in consumption of

Marijuana. According to a survey published in October 2015 by the National Institute on Alcohol

Abuse and Alcoholism, over 30 million Americans admitted to smoking marijuana in the past

year. This means approximately 9 million Americans are affected by Cannabis Use Disorder

(almost 3% of the entire population of the US).

But what is Cannabis Use Disorder? For an individual to be diagnosed with CUD, they

must have at least 2 of the following 11 features occur within a 12 month period: The individual

consumes larger quantities of marijuana than anticipated/consumes it over a longer period of

time than anticipated. The individual wants to consume less/manage their marijuana

consumption, but are fruitless in their attempts. The individual spends large amounts of time to

attain/consume marijuana, and to be high. The individual yearns for cannabis constantly. The

individuals continuous marijuana use results in collapse of their daily duties at

home/work/school. The individual maintains their marijuana consumption in spite of

social/interpersonal issues resulting from the immediate effects of cannabis. The individual no

longer participates as much/completely in activities they use to in order to consume more

marijuana. The individual places themselves in dangerous scenarios to smoke cannabis. The

individual sustains their marijuana consumption even though they are aware of a

physical/psychological ailment that was most likely caused by their marijuana use. The

individual builds a tolerance to marijuana, which can be described one of two ways ; the need to

consume larger amounts of marijuana in order to get as high as they want, or they no longer get

as high from the same amounts of marijuana that they smoked in the past. And last but not least,

if the individual goes through marijuana withdrawal, which can be evident in 2 ways ; the

individual suffers the symptoms of withdrawal from marijuana, or they smoke marijuana to
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Cannabis Use Disorder

relieve themselves of the symptoms of withdrawal. On the subject of withdrawal, the symptoms

are quite common generally speaking, and they are also not as harmful or as long lasting as other

drugs. Symptoms of marijuana withdrawal are as follows: The individual is easily angered and in

a state of irritability, the individual is nervous/anxious, the individual may have going to sleep

and staying asleep, the individuals appetite may dwindle and possibly lose weight, the

individual may seem like they have a rain cloud over their head. There are also physical

symptoms, but the amount the individual has may differ: Abdominal pain, shakiness/tremors,

sweating, fever, chills, or headache. (DSM 5, 2016)

With recent politics adversely affecting the number of people smoking cannabis, the

number of people with Cannabis Use Disorder would indubitably grow as well. As of November

2016, 7 states in the U.S. have cannabis legalized for medical/recreational use, and 21 states have

medical cannabis legalized. Since the number of people with Cannabis Use Disorder is estimated

to skyrocket, we must learn as much about the disorder as much as possible. To learn as much as

possible, we must be able to distinguish said disorder from others, or the differential diagnosis.

One of the disorders is Brief Psychotic Disorder. Brief Psychotic Disorder is

characterized by its sudden onset of psychotic episodes, and short duration (usually less than a

month). Some similar features comparing BPD to CUD, are individuals with BPD are

emotionally volatile, which could be confused with individuals who are in a state of extreme

irritability and or depressed while affected with Cannabis Use Disorder (Memon, 2015). Another

disorder similar to Cannabis Use Disorder is Hallucinogen Use. Hallucinogen Use is described

as: the use of hallucinogenic drugs. Depending on the hallucinogen consumed, the immediate

effects of the drug could certainly seem similar to the immediate effects of cannabis. For

instance, users of the drug Magic Mushrooms report having a sense of intense euphoria, an
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altered state of time, and uncommon thinking processes. Cannabis users, depending on the strain

of cannabis, also commonly report a sense of euphoria, have short term memory loss and other

time disfigurements, and also have a general change in thought processes (Parish, 2015).

Another disorder similar diagnosed differentially from Cannabis Use Disorder, is the

classic delirium. Delirium is quite analogous to Cannabis Use Disorder, as most trademark

symptoms of delirium are also very similar to the immediate effects of cannabis use. The

symptoms include, but are not limited to; Disorientation, difficulty concentrating/short attention

span, decrease in motor skills, and a cloudy perception of the immediate vicinity. Under

certain circumstances, it would be very possible for cannabis consumption to cause cases of

delirium (Alagiakrishnan, 2015). Moving on to another disorder equally as analogous to

Cannabis Use Disorder: Asthma. Asthma is a condition in which an individual has episodes of

airway impediments that cause difficulty breathing, volatile reactivity in bronchi, and

inflammation in the airways (Kelly, 2015). Smoking and inhaling anything, not just cannabis,

could easily cause difficulty breathing, and result in coughing which could also trigger

inflammation. Interestingly enough, cannabis inhalation itself is not particularly dangerous to

people with asthma if consumed through vaporization or inhalers, but through the use of rolling

papers or cigarillos, could easily trigger asthma attacks. More on the matter, cannabis was

frequently prescribed to individuals who had asthma, as marijuana has anti-inflammatory

properties. To explain further, certain cannabinoid receptors on nerve cells in the airways play a

role in the contraction of airway muscles when the CB1 receptors are activated. Yet another

disorder, atrial tachycardia, which is a disorder that causes the individuals heart to beat over 100

times per minute (Budzikowski, 2015). In a cannabis user, this rapid heartbeat could be easily

attributed to many things, such as; nervousness/anxiety that many people have reported, rapid
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heartbeat is common while the individual is experiencing euphoria, and also tachycardia is a

usual symptom of cannabis use. Last but not least, the disorder Primary Hypersomnia.

Hypersomnia is characterized by the individual being excessively sleepy/tired regardless of

adequate sleep, plus one of the following 3 symptoms: The individual recurringly falls asleep on

the same day, the individual sleeps for 9 or more hours and is not recuperative, or the individual

cannot fully awaken after being suddenly awoken. Cannabis users commonly report a sleepy

feeling after consuming marijuana, most likely due to the main chemical in cannabis, THC.

Consummation of THC gives the user a very relaxed and mellow feeling, so it is easy for a user

to fall into some strange sleep habits. Hypersomniacs sleep schedule also has adverse effects on

their social and occupational lives, because they sleep through activities. Missing social

activities, missing work, and missing other interpersonal activities are commonplace in people

with Cannabis Use Disorder, so the two disorders can easily be attributed to each other.

Although Cannabis Use Disorder can adversely affect an individuals life, it is quite

simple to treat. Withdrawal symptoms usually only last a week, so all that is needed is a strong

will and a desire to quit. There are currently no medications to treat Cannabis Use Disorder,

mainly because the drug is not addictive in the physical sense, and it is not that serious of a

disorder. Cannabis can be described as mentally addictive however, meaning that an individual

does not need to smoke cannabis, but they have become accustomed to it, or they do not want to

stop smoking cannabis because they believe it is benefiting them. There are several accounts of

people who consumed cannabis on a regular basis, and then stopped due to whatever reason, and

they never experienced any withdrawal symptoms. However, with that being said, if an

individual were to consume much larger amounts of cannabis on a regular basis, the effects may

differ. Anhedonia may be present, but only in very severe cases, such as if the individual
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consumed not only cannabis, but more potent forms of cannabis, such as hash-oil, or marijuana

wax, which can have more than 80-99.7% THC, opposed to 10-28% in cannabis plants. Not only

does wax have a much higher amount of THC, but the byproducts it is produced with, butane, is

highly toxic in large amounts, and can cause serious side effects.

Some studies claim that individuals, who are already at risk of developing schizophrenia,

whether they have a family history of the disorder, or by some other means, are potentially

increasing their possibility of developing it by consuming cannabis (Whiteman, 2013). The way

this happens is a part of the brain called the thalamus slowly deteriorates while using cannabis on

a regular basis. This deterioration of the thalamus is also present in schizophrenics. Assuming

that it is steady influx of THC causing the deterioration, then individuals who smoke cannabis

wax, which is up to 5 times more potent in THC content than most strains of cannabis, the risks

are multiplied exponentially. Coincidentally, people who have already developed schizophrenia

are at a higher risk of smoking marijuana, and in larger quantities (Evins, 2014). This is

presumed through the individuals genetics, which also plays a vital role in deciding whether or

not an individual will develop schizophrenia, whether and individual will enjoy smoking

cannabis, and according to recent studies, the link between most schizophrenics enjoy smoking

marijuana. The possible cause is that, in the brains of schizophrenics, the release of dopamine

when smoking cannabis is amplified. This amplification puts the individual at increased risk of

psychotic episodes, and makes their disorder overall more complicated to care for.
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Genen, L., MD. (2016, October 5). Cannabis-Related Disorders Clinical Presentation.

Retrieved November 14, 2016, from

http://emedicine.medscape.com/article/286661-clinical

NIDA (2016). Marijuana. Retrieved November 14, 2016, from

https://www.drugabuse.gov/publications/marijuana

Brief Psychotic Disorder. (2015, November 17). Retrieved November 14, 2016, from

http://emedicine.medscape.com/article/294416-overview

Cannabis-Related Disorders Differential Diagnoses. (2015, November 5). Retrieved

November 14, 2016, from http://emedicine.medscape.com/article/286661-

differential

H. (2014). Marijuana and Asthma: Benefits vs Risks. Retrieved November 14, 2016,

from http://www.truthonpot.com/2013/05/11/medical-marijuana-and-asthma-

benefits-vs-risks/

Hallucinogen Use. (n.d.). Retrieved November 14, 2016, from

http://emedicine.medscape.com/article/293752-overview

Delirium. (n.d.). Retrieved November 14, 2016, from

http://emedicine.medscape.com/article/288890-overview

Atrial Tachycardia. (n.d.). Retrieved November 14, 2016, from

http://emedicine.medscape.com/article/151456-overview

The link between weed and schizophrenia is way more complicated than we

thought. (2014, June 24). Retrieved November 15, 2016, from

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http://www.theverge.com/2014/6/24/5836762/the-link-between-weed-and-

schizophrenia-is-way-more-complicated-than

Delta-9-Tetrahydrocannabinol-Induced Dopamine Release as a Function of Psychosis

Risk: 18F-Fallypride Positron Emission Tomography Study. (2013, July 25). Retrieved

November 15, 2016, from http://journals.plos.org/plosone/article?

id=10.1371/journal.pone.0070378