The most common definition of addiction is that attempted cessation leads to the discovery that stopping is easier said than done. Further evidence of addiction is that use has caused problems severe enough to impair health, work, and personal relationships. Alcoholism, for example, shortens one's life span by 26 years on average[CDC_2022]. It causes one to miss work or be less productive, and it wreaks havoc with family life[Buddy_2021].
Published addiction rates are surprisingly speculative. They are typically given without reference to a definition of addiction and often equate usage rates with addiction rates. There has been research on how street marijuana affects chemical addictions but relatively little research on how specific cannabis compounds affect addictions.
The following sections cover tobacco, alcohol, opioids, cocaine, and marijuana addictions. The topics discussed include mortality, health effects, risk of addiction, and relationship to marijuana. Regarding mortality, the statistics apply to people living nn the United States.
A final section addresses the impact of variations in the gene for the CB1 cannabinoid receptor that is responsible for the intoxicating effects of THC.
Mortality. Tobacco kills 1300 people a day[t, Mortality].
Health Effects. Smokers are more prone
to develop heart disease, stroke, and lung cancer. They are more
prone to cardiovascular diseases, including strokes, heart
attacks, and narrowing of blood vessels. COPD is more frequent
and more severe in smokers, and the same goes for asthma.
Smoking by either men or women adversely affects conception and
pregnancy and increases congenital disabilities[t, Health].
Risk of Addiction. There is widespread agreement that nicotine is the most addictive of the commonly used psychoactive drugs. The Nicotine addiction rate is around 32% of those who smoke regularly[t, Addict].
Relationship to Marijuana. Cannabis does contribute to the risk of tobacco addiction. Specifically, cannabis use is associated with increased initiation, persistence, and relapse to cigarette smoking[t, Mj1]. Moreover, tobacco addiction is predictive of marijuana addiction[t, Mj2].
Mortality. Alcoholism kills 240 people a
Health Effects. The ill-effects include liver disease, heart disease, hypertension, stroke, and throat cancer[a, Health].
Risk of Addiction. The American Psychiatric Association's DSM-5 uses the term Alcohol Use Disorder (AUD) rather than addiction[a, Addict]. Briefly, AUD is an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences[a, nih-aud]. The rate of AUD is thought to be around 10% for men and 5% for women[a, harv-aud].
Relationship to Marijuana. Alcohol consumption increases the effects of THC by increasing THC levels[a, Mj2]. The terpene β-caryophyllene (BCP) and, even more so, β-caryophyllene oxide (BCPO) may help with alcohol addiction by reducing alcohol consumption[a, BCPO].
Mortality. Overdoses kill 130 people a day[h, Mortality].
Health Effects. Long-term use damages the brain's white matter, causes increasingly severe addiction, and damages veins, nasal passages, or lungs depending on the route of administration. It also brings a continuing risk of overdose and death[h, Vertava_2022].
Risk of Addiction. Most opioids are less addictive than tobacco[t, Addict]. Heroin, for example, has an addiction rate of perhaps 23% of those who use regularly[t, Addict].
Relationship to Marijuana. Legalization of
medical marijuana is associated with a decrease in opioid overdoses[h,
may lessen the intensity of heroin relapse triggers[h, CBD].
Methadone patients who regularly use marijuana tend to
experience less severe heroin withdrawal symptoms during the
initial methadone stabilization phase[h, Mj1]. However,
marijuana use may not aid patients in opioid addiction
Mortality. Cocaine kills upwards of 40 people a day[c, Mortality].
Health Effects. Long-term use damages the
cardiovascular system and creates neurological damage[c, health].
Cocaine, and more especially methamphetamine, damage the mouth, teeth,
and nasal passages[c, teeth].
Risk of Addiction. It has an addiction rate of perhaps 17% of regular users[t, Addict].
Relation to Marijuana. Crack withdrawal symptoms are lessened by street marijuana[c, Mj1]. Jamaican women routinely use marijuana to minimize the undesirable effects of crack pipe smoking, specifically paranoia and weight loss[c, Mj2]. CBD and THC can be helpful in extinguishing drug-motivated learned behavior in rats[c, THC].
This section is about marijuana and marijuana-based products. The information reported here does not apply to synthetic marijuana products or flavored vape products. In some cases, the effects of marijuana may depend on the route of administration. For example, marijuana behaves differently depending on whether it is smoked or eaten.
Mortality. The conclusion of a 1973 animal study was that it is not possible to overdose on marijuana or even on THC[m, Thompson_1973][m, Stoner_2021]. Although there are no known examples of fatal marijuana overdoses, potentially fatal complications to existing conditions can result from marijuana use[m, Patel_2020].
Risk of Addiction. Roughly 10% of regular marijuana users become addicted[m, Addict2][t, Addict]. Furthermore, roughly 30% have withdrawal symptoms when quitting. The total number of marijuana users who abuse marijuana or become dependent on it may also be as high as 30%[m, Addict3]. There is evidence that marijuana addiction is easier to kick than alcohol addiction[m, Addict4]. However, marijuana is somewhat cross-addictive with other psychoactive substances[m, Addict5].
People who begin using marijuana before age 18 are four to seven times more likely to become addicted than people who begin as adults[m, Addict6].
Low, subclinical doses of THC have decreased marijuana craving and withdrawal symptoms[m, Addict7]. A clinical trial indicated that CBD reduces marijuana use[m, Addict8].
Health Effects. Therapeutic doses appear to be safe and well-tolerated in adults, including older adults, whether healthy or frail or suffering from dementia. The following paragraphs discuss the possibility of harm to the brain, effect on the lungs, driving impairment, decrease in crime, and improved longevity.
Brain Development. Repeated high doses of THC may interfere with brain development, with long-term adverse consequences. The research results are not easily explained by other variables such as education, wealth, or use of other drugs[m-bd, Brain1][m-bd, Brain2][m-bd, Brain3]. These results are concerning because functional brain development continues until around age 25, and white matter development continues until middle age[m-bd, Brain4]. However, one study shows that heavy marijuana use after age 18 is not associated with significant cognitive decline[m-bd, Brain5]. The interference with brain development begins in utero[m-bd, Brain6].
In addition to overall brain development, there is the related issue of developing psychiatric problems. For most conditions, marijuana seems to help. The main exception is schizophrenia. See the schizophrenia discussion in Psychiatric Conditions.
Effect on Lungs. Smoked marijuana does irritate the lungs and can cause chronic bronchitis. However, it does not significantly increase the risk of major illnesses such as emphysema or lung cancer[ml, Lung1][ml, Lung2]. The following diagram shows that occasional use of marijuana may actually improve lung function[ml, Lung3].
Impact on Driving. The moderate use of marijuana does not affect crash risk when other variables such as alcohol use are accounted for[md, Risk1][md, Risk2]. This is surprising because marijuana impairs neurocognitive performance[md, Impair1] and impairs driving lateral control[md, Impair2]. Possibly, drivers impaired by marijuana know they are impaired and drive accordingly.
Overall, legalization in Colorado has improved people's driving[md, Benefit1][md, Benefit2]. It appears that when other factors such as the prevalence of drunk driving are factored in, marijuana is actually beneficial.
Impact on Longevity. Very little is known on how usage impacts longevity. It is known that marijuana has some adverse effects, such as increased periodontal disease[mlng, Longevity1] and decreased bone mineral density[mlng, Longevity2]. However, there are also some easily recognized positive indications.
Alcohol sales have dropped 12% In states with medical or recreational marijuana laws[mlng, Longevity3]. Along with the decrease in alcohol sales, traffic fatalities have also declined[mlng, Longevity4].
Marijuana legalization has seen a shift away from the use of
competing prescription drugs, something that is also likely to
affect longevity. The shift is substantial in pain medications
but is also significant for medications used to treat anxiety,
nausea, seizures, and sleep disorders[mlng, Longevity5].
This section is rather technical, but it holds the key to who should and should not use THC. It sheds light on why people's responses to THC vary widely, with a few people having severe reactions.
Some of the genetic variation involves the CNR1 gene that codes for the CB1 cannabinoid receptor. That is the receptor responsible for the intoxicating effects of marijuana. Some involves the FAAH gene responsible for breaking down the endocannabinoid anandamide.
Briefly, locations within a gene with genetic variation are called SNPs (single nucleotide polymorphisms). Most SNPs come in pairs, one SNP from each of one's two parents. Typically, each SNP has a major common variant and a minor less common variant. The minor variant tends to be the more problematic of the two, with two copies more problematic than one. Technically, a SNP variant is an allele, and a pair of alleles is a genotype. SNPs have somewhat random names of the form rsxxxxxxx.
This SNP is on the gene that codes for the CB1 cannabinoid receptor. The minor rs2023239 allele is named C for cytosine. Possession
of the C allele flies in the face of the nearly universal
impression that marijuana has a mellowing effect. In a study
published in 2019, C allele carriers who received THC
experienced more anger and hostility than those who received a
Those with the C allele also experience stronger cravings while using marijuana and have greater withdrawal symptoms in response to abstinence[gi, CNR1-craving].
A study of patients with alcohol dependence linked the minor C allele with greater subjective reward from alcohol as well as greater alcohol consumption[gi, CNR1-alcohol]
This SNP is on the gene that codes for the FAAH enzyme, which breaks down anandamide. The minor rs324420 allele is named A for adenine. It results in less of the FAAH enzyme, causing higher anandamide levels. Anandamide is correlated with happiness[gi, FAAH-Happiness]. Unfortunately, the minor A allele also carries an increased risk for substance use disorder[gi, FAAH-addiction].
The references are rendered according to the Citations Online architecture. Their format is designed exclusively to meet the needs of the web[Williams_2022]. The reference icons are from Freepik - Flaticon[Freepik].
Williams_2022. Adapting Citations and References to the Online Environment. Article. Williams J. pagenotes.com. Updated 2022 February 2.
Freepik. Vector Icons and Stickers. Website. Unattributed. Freepik Company. Undated.
CDC_2022. Excessive Alcohol Use. Article. Unattributed. Centers for Disease Control and Prevention. Updated 2022 April 20.
Buddy_2021. How Alcohol Use Affects Family Members. Article. T Buddy. verywell mind. Updated 2021 September 19.
a, nih-aud. Understanding Alcohol Use Disorder. Exposition. Unattributed. National Institute on Alcohol Abuse and Alcoholism. 2021 April.
a, harv-aud. Alcohol Abuse. Full article. Unattributed. Harvard Health. Published 2014 December 5.
icon icons/tobacco.png. t. Nicotine and Tobacco.
t, Mj1. Is cannabis use associated with increased risk of initiation, persistence, and relapse to cigarette smoking?: Longitudinal data from a representative sample of U.S\. adults. Full text. Andrea H Weinberger, PhD; Jonathan Platt, MPH; et al. Journal of Clinical Psychiatry. Published 2019 January 31.
t, Mortality. Smoking & Tobacco Use | Fast Facts [exposition]. Web page. Office on Smoking and Health. CDC. Updated 2021 June 08.
t, Health. Smoking & Tobacco Use | Health Effects of Smoking [exposition]. Web page. Office on Smoking and Health. CDC. Updated 2020 December 15.
t, Addict. Is Marijuana Addictive [essay]? Web page. Jann Gumbiner, PhD. Psychology Today. Published 2010 December 5.
t, Mj2. Differences in Tobacco Product Use Among Past Month Adult Marijuana Users and Nonusers: Findings From the 2003-2012 National Survey on Drug Use and Health. Abstract. Gillian L Schauer, Carla J Berg, et al. Nicotine & Tobacco Research. Published 2015 May 25.
icon icons/beer.png. a. Alcohol (Ethanol).
a, Health. Alcohol's Effects on the Body [essay]. Web page. Unattributed. National Institute on Alcohol Abuse and Alcoholism. Undated.
a, Mortality. Alcohol Facts and Statistics [exposition]. Web page. Unattributed. National Institute on Alcohol Abuse and Alcoholism. Undated.
a, Addict. DSM-5 Criteria: Alcohol Use Disorder [definition]. Blog. Dr\. Mary Ellen Barnes, Dr\. Ed Wilson. non12step.com. Posted 2013 October 13.
a, BCPO. The sesquiterpene beta-caryophyllene oxide attenuates ethanol drinking and place conditioning in mice. Article. Aboagyewaah Oppong-Damoah, Bruce E Blough, Alexandros Makriyannis, Kevin Sean Murnanea. Heliyon. Published 2019 June.
a, Mj2. Marijuana may boost risky effects of drinking alcohol [research summary]. Article. Unattributed. Science Daily. Published 2021 August 26.
icon icons/heroin.png. h. Heroin and Other Opioids.
h, Mortality. Opioids: Understanding the Epidemic [statistical summary]. Article. Unattributed. Center for Disease Control and Prevention. Updated 2021 March 17.
h, Vertava_2022. Long-Term Effects Of Heroin Use. Web page. Unattributed. Vertava Health. Updated 2022 March 2.
h, CBD. Cannabidiol, a Nonpsychotropic Component of Cannabis, Inhibits Cue-Induced Heroin Seeking and Normalizes Discrete Mesolimbic Neuronal Disturbances [animal study]. Article, reprint. Yanhua Ren, John Whittard, Alejandro Higuera-Matas, et al. Journal of Neuroscience. Published 2009 November 25.
h, Chihuri_2019. State marijuana laws and opioid overdose mortality [meta-analysis]. Full text. Chihuri S,Li G. Injury epidemiology. Online 2019 September 2.
h, Mj1. Impact of cannabis use during stabilization on methadone maintenance treatment [small-scale study]. Article. Jillian L Scavone, Robert C Sterling, et al. The American Journal on Addictions. Published 2013 June 25.
h, Mj2. Marijuana use may not aid patients in opioid addiction treatment [research overview]. Article. Unattributed. Science Daily. Published 2017 December 4.
icon icons/cocaine.png. c. Cocaine, Amphetamines.
c, Mortality. Number of drug poisoning deaths involving cocaine in the U.S\. from 1999 to 2019. Article. John Elflein. Statista. Published 2021 February 9.
c, health. What are the long-term effects of cocaine use? full text. Unattributed. National Institute on Drug Abuse (NIDA). Updated 2021 July 9.
c, teeth. Cocaine Gum Damage, Teeth Grinding, & Other Mouth Problems. Article. Unattributed. ARK Behavioral Health. 2021 April 14.
c, THC. Effect of low doses of delta9-tetrahydrocannabinol and cannabidiol on the extinction of cocaine-induced and amphetamine-induced conditioned place preference learning in rats. Abstract. Linda A Parker, Page Burton, et al. Psychopharmacology. Published 2004 September.
c, Mj1. Therapeutic use of cannabis by crack addicts in Brazil [small-scale study]. Abstract. E Labigalini Jr, L R Rodrigues, D X Da Silveira. Journal of Psychoactive Drugs. Published October-December 1999.
c, Mj2. Crack Heads and Roots Daughters [small-scale study]. Extended abstract. Melanie Dreher. Transnational Institute. Published 2002 January 1.
icon icons/pot.png. m. Marijuana: Addiction.
m, Patel_2020. Marijuana use and acute myocardial infarction: A systematic review of published cases in the literature. Abstract. Patel R S, Kamil S H, Bachu R. Trends in cardiovascular medicine. 2020 July.
m, Thompson_1973. Comparison of acute oral toxicity of cannabinoids in rats, dogs and monkey. Offline. Thompson G R, Rosenkrantz H, Schaeppi U H, Braude M C. Toxicology and applied pharmacology. 1973 July.
m, Stoner_2021. Scientists Tried to Cause a Marijuana Overdose in Monkeys with 9,000mg of THC, They All Lived But Were 'Very Stoned'. Article. Undercover Stoner. Cannabi.net. Undated.
m, Addict2. Medicine or menace\? Psychologists' research can inform the growing debate over legalizing marijuana. Article. Christopher Munsey. American Psychological Association. Published 2010 June.
m, Addict3. Prevalence of Marijuana Use Disorders in the United States Between 2001–2002 and 2012–2013 [large-scale study]. Abstract. Deborah S Hasin, PhD, Tulshi D Saha, PhD et al. JAMA Psychiatry. Published 2015 December.
m, Addict4. Is recovery from cannabis use problems different from alcohol and other drugs\? Results from a national probability-based sample of the United States adult population. Article. John F Kelly, M Claire Greene, Brandon G Bergman. The International journal on drug policy. Published 2018 March.
m, Addict5. Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence From a US National Longitudinal Study. Abstract. Carlos Blanco, Deborah S Hasin, et al. JAMA Psychiatry. Published 2016 April.
m, Addict6. Likelihood of developing an alcohol and cannabis use disorder during youth: Association with recent use and age (Discussion) [metaanalysis]. Article section. Ken C Winters, Chih-Yuan S Lee, et al. Drug and alcohol dependence. Published 2008 January 1.
m, Addict7. Marijuana withdrawal in humans: effects of oral THC or divalproex [small-scale study]. Abstract. Margaret Haney, Carl L Hart. Neuropsychopharmacology. Published 2004 January.
m, Addict8. Cannabidiol for the treatment of cannabis use disorder: Phase IIa double-blind placebo-controlled randomised adaptive Bayesian dose-finding trial. Article. Tom P Freeman, Chandni Hindocha, et al. Lancet Psychiatry. 2020 July 28.
icon icons/brain.png. m-bd. Marijuana: Brain Development.
m-bd, Brain1. Dare to delay\? The impacts of adolescent alcohol and marijuana use onset on cognition, brain structure, and function [literature review]. Full text. Krista M Lisdahl, Erika R Gilbart, et al. Frontiers in Psychiatry. Published 2013 July 1.
m-bd, Brain2. Long-Term Effects of Cannabis on Brain Structure [small-scale study]. Article. Giovanni Battistella, Eleonora Fornari, et al. Neuropsychopharmacology. Published 2014 April 16.
m-bd, Brain3. The Influence of Marijuana Use on Neurocognitive Functioning in Adolescents [literature review]. Article. Alecia D Schweinsburg, Sandra A Brown, Susan F Tapert. Current drug abuse reviews. Published 2008 January.
m-bd, Brain4. At What Age Is The Brain Fully Developed [exposition]? Article. Unattributed. Mental Health Daily. Published 2015 February 18.
m-bd, Brain5. Persistent cannabis users show neuropsychological decline from childhood to midlife [large-scale study]. Article. Madeline H Meier, Avshalom Caspi, et al. Proceedings of the National Academy of Sciences U.S.A. Published 2012 October 2.
m-bd, Brain6. Long-term effects of maternal cannabis vapor exposure on emotional reactivity, social behavior, and behavioral flexibility in offspring [animal study]. Abstract. Halle V Weimar, Hayden R Wright, Collin R Warrick, et al. Neuropharmacology. Published 2020 August 26.
icon icons/pot-head.png. ml. Marijuana: Effect on Lungs.
ml, Lung3. Association Between Marijuana Exposure and Pulmonary Function Over 20 Years [Figure 2]. Article. Mark J Pletcher, MD, MPH; Eric Vittinghoff, PhD; et al. JAMA Network. 201Published 2 January 11.
ml, Lung2. Effects of cannabis on lung function: a population-based cohort study [large-scale study]. Article. R J Hancox, R Poulton, et al. The European Respiratory Journal. Published 2009 August 13.
icon icons/driving.png. md. Marijuana: Impact on Driving.
md, Risk1. Drug and Alcohol Crash Risk: A Case-Control Study [large-scale study]. PDF file. J H Lacey, T Kelley-Baker, et al. National Highway Traffic Safety Administration. 2016 Published December.
md, Risk2. Drugs and Alcohol: Their Relative Crash Risk [large-scale study]. PDF file. Eduardo Romano, PhD; Pedro Torres-Saavedra, PhD. komornlaw.com. Undated.
md, Impair1. Dose-related neurocognitive effects of marijuana use [small-sacale study]. Extended abstract. K I Bolla, K Brown, et al. Neurology. Published 2002 November 12.
md, Impair2. Cannabis Effects on Driving Lateral Control With and Without Alcohol [small-scale study]. Article. Rebecca L Hartman, Timothy L Brown, et al. Drug and alcohol dependency. Published 2015 June 23.
md, Benefit1. Colorado Division of Criminal Justice Publishes Report on Impacts of Marijuana Legalization in Colorado [report overview]. Article. Unattributed. Colorado Department of Public Safety. Published 2018 October 26.
md, Benefit2. Impacts of Marijuana Legalization in Colorado [technical report]. PDF file. Jack K Reed (Statistical Analyst), et al. Colorado Division of Criminal Justice. Published October 2018.
icon icons/time.png. mlng. Mariuana: Impact on Longevity.
mlng, Longevity1. Associations between Cannabis Use and Physical Health Problems in Early Midlife: A Longitudinal Comparison of Persistent Cannabis versus Tobacco Users large-scale study]. Article. Madeline H Meier, PhD; Avshalom Caspi, PhD; et al. JAMA Psychiatry. Published 2016 July 1.
mlng, Longevity2. Heavy cannabis use is associated with low bone mineral density and an increased risk of fractures [clinical study]. Abstract. Antonia Sophocleous, PhD; Roy Robertson, MD; et al. American Journal of Medicine. Published 2017 February.
mlng, Longevity3. Marijuana and Alcohol Evidence Using Border Analysis and Retail Sales Data [working paper]. Abstract, PDF file. Michele Baggio, Alberto Chong, Sungoh Kwon. Social Science Research Network. Posted 2017 November 2.
mlng, Longevity4. Medical Marijuana Laws, Traffic Fatalities, and Alcohol Consumption [literature review]. PDF file. D Mark Anderson, Daniel I Rees. IZA. Published 2011 November.
mlng, Longevity5. Medical Marijuana Laws Reduce Prescription Medication Use In Medicare Part D (Exhibit 3) [statistical analysis]. Article. Ashley C Bradford, W David Bradford. Health Affairs. Published 2016 July.
icon icons/dna.png. gi. Marijuana: Genetic Influence.
gi, CNR1-anger. CNR1 and FAAH Variation and Affective States Induced by Marijuana Smoking [small-scale study]. Article. Rohan H C Palmer, John E McGeary, et al. The American journal of drug and alcohol abuse. Published 2019 June 11.
gi, CNR1-alcohol. The Incentive Salience of Alcohol: Translating the Effects of Genetic Variant in CNR1 [multidimensional study]. Article. Kent E Hutchison, PhD; Heather Haughey, PhD; et al. Archives of general psychiatry. Published 2008 July.
gi, FAAH-Happiness. A Genetic Component to National Differences in Happiness [statistical analysis]. Abstract. Michael Minkov, Michael Harris Bond. Journal of Happiness Studies. Published 2016 January 12.
gi, FAAH-addiction. Genetic variation in FAAH is associated with cannabis use disorders in a young adult sample of Mexican Americans small-scale study]. Article. Whitney E Melroy-Greif, Kirk C Wilhelmsen, Cindy L Ehlers. Drug and alcohol dependence. Published 2016 June 25.