Can cannabis use lead to cannabis use disorder or problematic use? The short answer is yes. But the more complicated answer is that not everyone who consumes cannabis will develop problematic use. While research into cannabis — one of the most commonly used substances in Canada — is constantly evolving, we do know that regular cannabis use can have adverse effects on your health. Important aspects of cannabis use to consider include tolerance, addiction, withdrawal and poisoning, plus where to get help if you need it. Note that this information does not replace professional screening for or treatment of cannabis use disorder.
Cannabis use is a spectrum
People consume cannabis for lots of different reasons and to varying degrees. There is no scientific consensus on the definition of “regular use” (also called chronic, frequent or long-term use), but in general, it refers to weekly or more frequent consumption that occurs regularly for a few months or years, and it increases your risk of adverse health effects. “Heavy use” describes daily (or more frequent) consumption, which can increase your risk of developing cannabis dependence and cannabis use disorder.
Given these generalizations, cannabis use can be considered on a spectrum, ranging from abstinence to cannabis use disorder. While your reasons for consuming cannabis may change, you may move back and forth along the spectrum or never progress to problematic use. It’s important to know that there is risk at every point on the spectrum, but there are always ways to manage and reduce that risk.
Regular cannabis use may lead you to develop a tolerance — you become accustomed to a specific dose and feel you need to consume more to experience the same effects. Reducing your consumption may reduce your tolerance, so it’s best to always start with a low dose and increase it slowly to avoid overconsumption. Or you may choose to stop consuming altogether for a few days or longer, a strategy called a tolerance break, or T-break.
Cannabis use disorder
Medical experts describe addiction specifically as involving the presence of all four Cs:
- craving the substance
- the compulsion to use it
- loss of control of the amount or frequency of use
- use despite the consequences
Cannabis use disorder, is defined in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (commonly called the DSM-5), as “a problematic pattern of cannabis use leading to clinically significant impairment or distress.” In plain terms, that means being unable to stop consuming cannabis, despite severe consequences. For example, you may find yourself needing to consume more to get the same desired effects, needing to use cannabis before doing certain activities, missing work or driving while impaired. You may also notice an impact on your relationships, such as experiencing conflict with family or friends.
1 in 3 people who consume cannabis will develop a problem with their use.
Nine percent of people who consume cannabis will develop problematic use patterns — that number rises to 17% for those who start consuming cannabis as teenagers. (For comparison, the CAMH 2014 Cannabis Policy Framework reported the probability of developing a dependence as about 68% for nicotine, 23% for alcohol and 21% for cocaine.)
Twenty-five percent to 50% of those who consume cannabis daily will develop cannabis use disorder.
Males are more likely to develop cannabis use disorder, but females typically progress more quickly to cannabis use disorder than males.
Will I develop cannabis use disorder?
The possibility that you’ll develop cannabis use disorder depends on many factors, and some people are more prone to addiction than others. The risk factors for cannabis use disorder include:
- Continued frequent and heavy cannabis consumption
- Regular consumption of cannabis before age 16 (or even before age 25, around the time your brain has finished developing)
- Biological factors, such as a family history of substance abuse or mental illness
- Social factors or your immediate environment, including the consumption of cannabis and attitudes toward it among your friends, family and community
While infrequent cannabis consumption can cause short-term effects, like the inability to concentrate and sleeplessness, research shows heavy consumption (consuming daily or almost daily) can cause psychological and/or physical dependence — you may feel anxious when you can’t consume cannabis or develop withdrawal symptoms after stopping.
Symptoms of withdrawal vary among individuals, but they typically include irritability, sweating, nausea, insomnia and body aches. The length and severity of withdrawal will vary too, depending on the dose and how long you’ve been consuming cannabis.
Depending on how you define it, an “overdose” is consumption of a substance that leads to death or the need for resuscitation. Cannabis overdose is more accurately described as poisoning — you’ve consumed more THC than your body can process at one time, producing feelings of severe anxiety and paranoia, and vomiting, and potentially inducing an acute psychotic episode.
You might experience these symptoms until the effects of the cannabis wear off, but there have been no documented cases of death as the result of overconsumption of cannabis. The reason is this: There are no cannabinoid receptors in the part of your brain that regulates vital automatic functions like your heart beating and breathing, so an excess of cannabinoids like THC won’t affect them. In contrast, essential parts of the brain do contain opiate receptors, which is why opioid overdoses can cause death. The same goes for alcohol — it activates neurotransmitters in the brain that inhibit vital functions, potentially with a fatal outcome.
However, cannabis poisoning is serious, especially when it comes to children and pets, because of their small size and weight. Always keep your cannabis safely stored out of reach in a secure child-proof container to prevent unintentional consumption.
Where to get help
If you’re experiencing particularly unpleasant or harmful effects, Health Canada suggests you stop consumption and seek immediate medical attention or call your local poison control centre. The same advice applies to accidental consumption by a child or pet.
When it comes to cannabis use disorder or addiction, there is no universal, one-size-fits-all treatment — options include cognitive behavioural therapy (CBT) and other psychological counselling therapies, medications to treat withdrawal symptoms and using alternative delivery methods. Free, confidential help with addiction, mental health and cannabis consumption is available in Ontario. If you are concerned about your or someone else’s cannabis consumption, Health Canada suggests discussing it with your physician or another trusted healthcare provider, or reaching out to a support group that deals with addiction (this does not replace professional screening for or treatment of cannabis use disorder).
You can also follow the Centre for Addiction and Mental Health Canada’s Lower-Risk Cannabis Use Guidelines.