The increasing availability and evolving potency of cannabis products have brought renewed focus to the potential for cannabis use disorder (CUD). Understanding the risks associated with dependency, particularly with high-tetrahydrocannabinol (THC) concentrations, is crucial for both patients and clinicians.
Prevalence and Mechanisms of Cannabis Use Disorder
There has been a persistent misunderstanding regarding the addictiveness of cannabis. However, according to the Centers for Disease Control and Prevention (CDC), an estimated 30% of individuals who use cannabis may develop a dependency. Cannabis use disorder (CUD), as defined by the DSM-5 and the CDC, involves continued usage for 12 months or more despite experiencing negative physical, social, or psychological effects, spending significant time using or thinking about using, and repeated unsuccessful attempts to quit.
THC, the primary psychoactive component in cannabis, stimulates the brain’s reward system by prompting the release of dopamine. This mechanism contributes to the associated ‘high’. For individuals with heavy usage, withdrawal can lead to a sharp decrease in dopamine release, which may encourage continued use. Research indicates that the risk of developing CUD is higher for those who begin using before the age of 25, individuals with heavy usage patterns, and those with pre-existing mental health conditions or genetic predispositions to addiction.
The Impact of Evolving Cannabis Potency
Modern cannabis products often contain significantly higher THC concentrations compared to those available decades ago. Dr. Deepak D’Souza, a professor of psychiatry at Yale School of Medicine and director of the Yale Center for the Science of Cannabis and Cannabinoids, notes that typical THC content half a century ago was around 4%. Today, street cannabis can contain closer to 20% THC, with concentrates available at dispensaries reaching up to 95% THC.
This increase in potency appears to be associated with a higher incidence of cannabis use disorder. Dr. D’Souza highlights that newer studies suggest approximately one in three users might develop CUD, a notable increase from earlier estimates of one in ten. He adds that clear changes in the brain have been observed in heavy cannabis users, reflecting the consequences of prolonged exposure to high levels of THC.
Recognising Withdrawal and Associated Risks
For frequent users, discontinuing cannabis can lead to cannabis withdrawal syndrome (CWS), now included in the DSM-5. Symptoms may include:
- Inability to sleep
- Night sweats
- Loss of appetite
- Irritability
- Feelings of emptiness or emotional flatness
These physical symptoms often ease within a few days, but emotional and psychological effects can persist for weeks or months. Beyond dependency, high-THC consumption is increasingly associated with other health concerns. These include a growing link to psychosis, particularly in younger users, and cannabinoid hyperemesis syndrome (CHS), a rare but debilitating condition characterised by severe vomiting and abdominal pain. Frequent use may also have deleterious effects on memory and executive function.
Navigating Misconceptions and Seeking Support
Dr. Jonathan Caulkins, a drug policy researcher at Carnegie Mellon University, points to a “persistent misunderstanding” that cannabis is not addictive, partly because many individuals use it without developing CUD. However, his research indicates that a significant portion of current frequent users self-report that cannabis interferes with their lives in consequential ways.
Regarding mental health, a comprehensive review co-authored by Dr. Jack Wilson from the University of Sydney’s Matilda Centre for Research in Mental Health and Substance Use found no evidence that medical cannabis is effective in treating anxiety, depression, or PTSD—conditions for which it is sometimes prescribed. While Dr. D’Souza acknowledges that the immediate effects of cannabis may offer some short-term psychological relief, he cautions that this does not address underlying conditions, likening it to using Valium for every form of distress.
For individuals struggling with cannabis use disorder, addressing the root causes of usage and seeking professional guidance are important steps.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Hemp Gazette does not provide medical recommendations, diagnoses, or treatment plans. Always consult a qualified healthcare practitioner before making any decisions regarding your health or any medical condition. Statements concerning the therapeutic uses of hemp, cannabis, or cannabinoid-derived products have not been evaluated by Australia’s Therapeutic Goods Administration (TGA). Medicinal cannabis products in Australia are accessed via prescription pathways under TGA regulation.
