Smoking pot has never been more acceptable than it is today. At the time of this writing, 33 states have passed laws that reduce or remove penalties for buying, possessing, or using marijuana for either medical or recreational purposes. Attitudes towards marijuana use have shifted drastically in the past decade; the most recent Gallup poll indicates that 66% percent of Americans now support the legalization of marijuana, compared to just 44% in 2009. The increased social acceptance of marijuana coupled with new laws sends the message that marijuana is safe… but is this really true?
Certainly, there are plenty of examples which illustrate that legal status and social acceptance do not guarantee safety. For instance, alcohol is legal but it is closely related to injuries, accidents, liver disease and cancer, and it is in the top three causes of preventable death in our nation. Further, while drinking is widely accepted and considered to be “normal” for adults, an estimated 15 million Americans over the age of 18 have a diagnosable alcohol use disorder. Even occasional or “social drinkers” might find that their drinking becomes problematic- they may say or do things they regret or can’t remember, or they might make risky choices like driving home when they’ve had too much to drink.
Smoking weed can be problematic in similar ways, even for occasional users. When people use marijuana, the chemical THC travels through the bloodstream and causes chemical changes in the brain which cause a person to feel intoxicated. In the short term, users can experience impairments in the way they think, perceive situations, and make decisions. Normal tasks can become harder to do, and it might become harder to concentrate and remember things.
Occasional users might actually be more affected by THC than experienced users, with some people experiencing paranoia, hallucinations, and panic attacks. Even for those not as affected, THC can alter thinking and functioning in ways that make routine tasks riskier, increasing the likelihood that they make mistakes, overlook details, or react more slowly than they normally would. These changes might be especially dangerous for those who decide to drive while they are high, with some research estimating that people are twice as likely to get into a car accident when driving under the influence of marijuana.
More regular use also increases the risk of developing long term consequences, including the risk for breathing problems, lung cancer, impaired brain development (for teens and young adults), and mental health symptoms like anxiety, paranoia, or a worsening of existing conditions like depression. Another risk closely linked to more regular use is the risk for developing Cannabis Use Disorder, an addictive disorder where people tend to keep smoking even after it has had negative impacts on their lives.
In fact, whether or not a person has a Cannabis Use Disorder has less to do with how much or how often they smoke and more to do with how smoking impacts them and their lives. When a person’s use becomes problematic, it usually begins impacting their health or mental health, their relationships, their work performance, or some other important aspect of their lives. For example, a person might notice that they feel foggy, more tired, and notice that they have trouble focusing or remembering things. Some might have a significant other or friend who doesn’t like how much they are smoking, and this could have led to disagreements, distance, or more strained interactions. Others might not have experienced any problems because of smoking weed, but they may know that continuing to smoke is a risky choice for them… maybe they get randomly drug tested at work or know they should be more careful because they’ve struggled with addiction in the past. In each of these scenarios, continuing to use would be a strong indicator of problem use.
Many people mistakenly believe that the clearest signs of problem use are physical cravings or withdrawal symptoms, but this is not the case. The reason that cravings or withdrawals are not always a good indicator of problem use is because addiction is not always physical in nature. Some drugs are naturally more physically addictive than others, and marijuana is one with a lower addictive profile which means that some people (even problem users) will not become physically addicted to it.
It is possible for a person to become psychologically addicted, or to experience strong urges or cravings for it and even feel they need the drug in some way. This need might be driven by stress or some other negative emotion they feel unable to tolerate, by situations they feel aren’t as special or fun unless they are high, or by the belief that they function better when high or need weed to feel “normal”. In each of these scenarios, a case for psychological addiction could be made. This case is further strengthened when a person continues smoking even after it has caused problems for them.
When a person first starts experimenting with weed, the question “why not?” usually is driving the decision. At this point, there might really not be any strong justification for why they shouldn’t smoke. But what if this changes over time? What if a person begins noticing they are smoking more than they would like, are relying on it in ways that feel unhealthy, or are thinking about it more and more throughout their day? What if they begin to cross boundaries they have set for themselves- like smoking when they are working from home or hiding it from their significant other? Usually, these are some of the first warning signs that indicate problem use, and also the easiest for people to brush off or ignore. Doing so, however, often gives people the green light to continue using in ways that make it more likely that they experience other, more serious, problems later on.
Responsible use of marijuana, like any other substance, requires self-awareness, honesty, and accountability. People who decide to use marijuana should do so cautiously, setting limits and boundaries for themselves beforehand that will keep them accountable for using responsibly. These limits and boundaries may need to be re-evaluated and changed if their situation changes, like if they take a new job where they are drug-tested or where they have professional licenses that could be revoked for drug use. Sometimes reasons for re-evaluating boundaries and limits might be more personal, like if a person notices one of the warning signs listed above. Usually, the re-evaluation of boundaries should result in ones that restrict or reduce their use, instead of ones which are more permissive. The reason for this is simple- the more permissive boundaries around drug use are, the higher the risk for problem use. In cases where people set boundaries and limits that they find difficult or impossible to follow, it may be important to consider seriously cutting down or stopping their use, at least for a while.
For a variety of reasons (both genetic and environmental), some people are not capable of casual responsible use, and this will become clear over time as they will not be able to set and follow healthy limits around how much or how often they use. Despite its increasing political, legal, and social acceptance, marijuana use has many risks, and users should be cautious, aware, and responsible when making personal decisions about whether or not to use.
By Hailey Shafir, LPCS, LCAS, CCS-I