Cannabis (also called marijuana) is the third most commonly used psychoactive substance worldwide, after alcohol and tobacco (nicotine). Cannabis can be used by smoking, vaping, dabbing, ingesting (edibles, beverages, and tinctures), and topical cream. Cannabis use disorder develops in approximately 10 percent of regular cannabis users and up to 50 percent of chronic daily users and may be associated with cognitive impairment, poor school or work performance, and psychiatric comorbidity such as mood disorders and psychosis.
Cannabis Use Disorder Symptoms
Symptoms occurring within a 12-month period indicating cannabis use disorder include:
• Continuing to use cannabis despite physical or psychological problems
• Continuing to use cannabis despite social or relationship problems
• Difficulty controlling or cutting down cannabis use
• Problems at work, school, and home as a result of cannabis use
• Spending a lot of time on cannabis use
• Withdrawal when discontinuing cannabis
Cannabis Use Disorder Pathophysiology
Researchers know that prolonged and heavy cannabis use can alter brain circuitry. However, the specific pathophysiological mechanisms are yet unclear. In terms of addiction, tetrahydrocannabinol is the primary molecule responsible for the reinforcing properties of marijuana. Interestingly, despite the striatal dopamine system typically being involved with substances of abuse such as alcohol and opioids, meta-analysis reveals insufficient evidence at this time to support such a conclusion for cannabis. And also that dopamine receptors may not be involved At a symptomatic level, heavy use modifies conscious experience by altering the brain’s network for self-awareness. By reducing anxiety and impairing memory, it also affects motivation and personal experience. At a molecular level, the story is more complex.
Cannabis Use Disorder Diagnosis
Laboratory testing of urine, blood, saliva, or hair can be useful to detect cannabis use, but results should be considered along with a clinical rationale. Assays typically rely on the detection of the most common active metabolite, delta-9-tetrahydrocannabinol acid. It has been studied thoroughly, and this abundant acid metabolite has become an established urinary marker of cannabis consumption in forensic, clinical, and environmental analyses.
Cannabis Use Disorder Treatment
There are a couple of different treatment options for people with cannabis use disorder. Several types of counseling or therapy have been found beneficial for reducing cannabis use and the subsequent problems this drug creates. They are: Cognitive Behavioral Therapy, Motivational Enhancement Therapy, and Contingency Management. At this time, there is no medication approved by the Food and Drug Administration (FDA) to treat cannabis use disorder, though some medicines are currently under investigation.
Read More about Cannabis Use Disorder Pipeline
