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Chapter 28 - Cannabis and Addiction

from Part VIII - Special Topics

Published online by Cambridge University Press:  12 May 2023

By
H. Valerie Curran ,
Will Lawn  and
Tom P. Freeman
Edited by
Deepak Cyril D'Souza ,
David Castle  and
Sir Robin Murray
Deepak Cyril D'Souza
Affiliation:
Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine
David Castle
Affiliation:
University of Tasmania, Australia
Sir Robin Murray
Affiliation:
Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
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Summary

Although the majority of people who use cannabis do not become addicted, globally there are more people in treatment for cannabis addiction than for any other drug. And as the THC concentration in cannabis has increased, more adolescents are seeking help for cannabis addiction. This chapter addresses the following questions to provide an overview of cannabis addiction. What is the neurobiology that underlies cannabis addiction? What factors make some individuals more vulnerable than others to developing cannabis addiction? Why do only a minority of people who are addicted seek treatment? How effective are currently available pharmacological and psychological treatments? Would delivering therapy remotely increase treatment uptake by reducing stigma? Increasingly across the globe cannabis is available for medicinal use so how can we minimize these patients’ risk of addiction? How can drug policy be used to promote harm reduction by providing a safer, regulated market and lower potency cannabis products?

Keywords

vulnerabilitycannabinoidsTHC potencyaddiction treatmentsdrug policy
Type
Chapter
Information
Marijuana and Madness , pp. 299 - 309
Publisher: Cambridge University Press
Print publication year: 2023

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References

Albrecht, D. S., Skosnik, P. D., Vollmer, J. M., et al. (2013). Striatal D2/D3 receptor availability is inversely correlated with cannabis consumption in chronic marijuana users. Drug Alcohol Depend, 128, 52–57.Google Scholar
Allsop, D. J., Copeland, J., Lintzeris, N., et al. (2014). Nabiximols as an agonist replacement therapy during cannabis withdrawal: A randomized clinical trial. JAMA Psychiatry, 71, 281–291.Google Scholar
American Psychiatric Association. (2013). DSM-5 diagnostic classification. In Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.Google Scholar
Anthony, J. C., Warner, L. A., and Kessler, R. C. (1994). Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the National Comorbidity Survey. Exp Clin Psychopharmacol, 2, 244–268.CrossRefGoogle Scholar
Arterberry, B. J., Padovano, H. T., Foster, K. T., et al. (2019). Higher average potency across the United States is associated with progression to first cannabis use disorder symptom. Drug Alcohol Depend, 195, 186–192.CrossRefGoogle ScholarPubMed
Bahji, A., Meyyappan, A. C., Hawken, E. R., et al. (2021). Pharmacotherapies for cannabis use disorder: A systematic review and network meta-analysis. Int J Drug Policy, 97, 103295.Google Scholar
Blakemore, S. J., and Choudhury, S. (2006). Development of the adolescent brain: Implications for executive function and social cognition. J Child Psychol Psychiatry, 47, 296–312.Google Scholar
Bloomfield, M. A. P., Morgan, C. J., Egerton, A., et al. (2014). Dopaminergic function in cannabis users and its relationship to cannabis-induced psychotic symptoms. Biol psychiatry, 75, 470–478.Google Scholar
Budney, A. J., Sofis, M. J., and Borodovsky, J. T. (2019). An update on cannabis use disorder with comment on the impact of policy related to therapeutic and recreational cannabis use. Eur Arch Psychiatry Clin Neurosci, 269, 73–86.Google Scholar
Calabria, B., Degenhardt, L., Briegleb, C., et al. (2010). Systematic review of prospective studies investigating ‘remission’ from amphetamine, cannabis, cocaine or opioid dependence. Addict Behav, 35, 741–749.CrossRefGoogle ScholarPubMed
Cerdá, M., Mauro, C., Hamilton, A., et al. (2020). Association between recreational marijuana legalization in the United States and changes in marijuana use and cannabis use disorder from 2008 to 2016. JAMA Psychiatry, 77, 165–171.Google Scholar
Chen, C. Y., O’Brien, M. S., and Anthony, J. C. (2005). Who becomes cannabis dependent soon after onset of use? Epidemiological evidence from the United States: 2000–2001. Drug Alcohol Depend, 79, 11–22.CrossRefGoogle ScholarPubMed
Chen, C. Y., Storr, C. L., and Anthony, J. C. (2009). Early-onset drug use and risk for drug dependence problems. Addict Behav, 34, 319–322.Google Scholar
Chye, Y., Lorenzetti, V., Suo, C., et al. (2019). Alteration to hippocampal volume and shape confined to cannabis dependence: A multi‐site study. Addict Biol, 24, 822–834.Google Scholar
Coffey, C., and Patton, G. C. (2016). Cannabis use in adolescence and young adulthood: A review of findings from the Victorian Adolescent Health Cohort Study. Can J Psychiatry, 61, 318–327.Google Scholar
Cousijn, J., Wiers, R. W., Ridderinkhof, K. R., et al. (2014). Effect of baseline cannabis use and working‐memory network function on changes in cannabis use in heavy cannabis users: A prospective fMRI study. Hum Brain Mapp, 35, 2470–2482.CrossRefGoogle ScholarPubMed
Curran, H. V., Freeman, T. P., Mokrysz, C., et al. (2016). Keep off the grass? Cannabis, cognition and addiction. Nat Rev Neurosci, 17, 293–306.Google Scholar
Curran, H. V., Hindocha, C., Morgan, C. J. A., et al. (2019). Which biological and self-report measures of cannabis use predict cannabis dependency and acute psychotic-like effects? Psychol Med, 49, 1574–1580.CrossRefGoogle ScholarPubMed
Cuttler, C., and Spradlin, A. (2017). Measuring cannabis consumption: Psychometric properties of the daily sessions, frequency, age of onset, and quantity of cannabis use inventory (DFAQ-CU). PLoS ONE, 12, e0178194.Google Scholar
D’Souza, D. C., Cortes-Briones, J., Creatura, G., et al. (2019). Efficacy and safety of a fatty acid amide hydrolase inhibitor (PF-04457845) in the treatment of cannabis withdrawal and dependence in men: A double-blind, placebo-controlled, parallel group, phase 2a single-site randomised controlled trial. Lancet Psychiatry, 6, 35–45.Google Scholar
D’Souza, D. C., Cortes-Briones, J. A., Ranganathan, M., et al. (2016). Rapid changes in cannabinoid 1 receptor availability in cannabis-dependent male subjects after abstinence from cannabis. Biol Psychiatry Cogn Neurosci Neuroimaging, 1, 60–67.Google ScholarPubMed
Davis, M. L., Powers, M. B., Handelsman, P., et al. (2015). Behavioral therapies for treatment-seeking cannabis users: A meta-analysis of randomized controlled trials. Eval Health Prof, 38, 94–114.Google Scholar
Degenhardt, L., Charlson, F., Ferrari, A., et al. (2018). The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry, 5, 987–1012.Google Scholar
Dutra, L., Stathopoulou, G., Basden, S. L., et al. (2008). A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry, 165, 179–187.CrossRefGoogle ScholarPubMed
EMCDDA. (2021). European Drug Report. Luxembourg: Publications Office of the European Union.Google Scholar
Ferland, J.-M. N., and Hurd, Y. L. (2020). Deconstructing the neurobiology of cannabis use disorder. Nat Neurosci, 23, 600–610.Google Scholar
Flórez-Salamanca, L., Secades-Villa, R., Hasin, D. S., et al. (2013). Probability and predictors of transition from abuse to dependence on alcohol, cannabis, and cocaine: Results from the national epidemiologic survey on alcohol and related conditions. Am J Drug Alcohol Abuse, 39, 168–179.CrossRefGoogle ScholarPubMed
Freeman, A. M., Petrilli, K., Lees, R., et al. (2019). How does cannabidiol (CBD) influence the acute effects of delta-9-tetrahydrocannabinol (THC) in humans? A systematic review. Neurosci Biobehav Rev, 107, 696–712.CrossRefGoogle ScholarPubMed
Freeman, T. P., Craft, S., Wilson, J., et al. (2021). Changes in delta‐9‐tetrahydrocannabinol (THC) and cannabidiol (CBD) concentrations in cannabis over time: Systematic review and meta‐analysis. Addiction, 116, 1000–1010.CrossRefGoogle ScholarPubMed
Freeman, T. P., Hindocha, C., Baio, G., et al. (2020). Cannabidiol for the treatment of cannabis use disorder: A phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial. Lancet Psychiatry, 7(10), pp. 865–874.CrossRefGoogle ScholarPubMed
Freeman, T. P., and Lorenzetti, V. (2020). ‘Standard THC units’: A proposal to standardize dose across all cannabis products and methods of administration. Addiction, 115, 1207–1216.Google Scholar
Freeman, T. P., van der Pol, P., Kuijpers, W., et al. (2018). Changes in cannabis potency and first-time admissions to drug treatment: A 16-year study in the Netherlands. Psychol Med, 48, 2346–2352.Google Scholar
Freeman, T. P., and Winstock, A. R. (2015). Examining the profile of high-potency cannabis and its association with severity of cannabis dependence. Psychol Med, 45, 3181–3189.Google Scholar
Galve-Roperh, I., Palazuelos, J., Aguado, T., et al. (2009). The endocannabinoid system and the regulation of neural development: Potential implications in psychiatric disorders. Eur Arch Psychiatry Clin Neurosci, 259, 371–382.Google Scholar
Gates, P. J., Sabioni, P., Copeland, J., et al. (2016). Psychosocial interventions for cannabis use disorder. Cochrane Database Syst Rev, 2016, CD005336.Google Scholar
Giedd, J. N., Blumenthal, J., Jeffries, N. O., et al. (1999). Brain development during childhood and adolescence: A longitudinal MRI study. Nat Neurosci, 2, 861–863.Google Scholar
Gray, K. M., Sonne, S. C., McClure, E. A., et al. (2017). A randomized placebo-controlled trial of N-acetylcysteine for cannabis use disorder in adults. Drug Alcohol Depend, 177, 249–257.CrossRefGoogle ScholarPubMed
Hall, W., and Lynskey, M. (2020). Assessing the public health impacts of legalizing recreational cannabis use: The US experience. World Psychiatry, 19, 179–186.Google Scholar
Han, B., Compton, W. M., Blanco, C., et al. (2019). Time since first cannabis use and 12‐month prevalence of cannabis use disorder among youth and emerging adults in the United States. Addiction, 114, 698–707.Google Scholar
Hasin, D. S., Kerridge, B. T., Saha, T. D., et al. (2016). Prevalence and correlates of DSM-5 cannabis use disorder, 2012–2013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions–III. Am J Psychiatry, 173, 588–599.Google Scholar
Heilig, M., MacKillop, J., Martinez, D., et al. (2021). Addiction as a brain disease revised: Why it still matters, and the need for consilience. Neuropsychopharmacology, 46, 1715–1723.CrossRefGoogle ScholarPubMed
Hill, K. P., Palastro, M. D., Gruber, S. A., et al. (2017). Nabilone pharmacotherapy for cannabis dependence: A randomized, controlled pilot study. Am J Addict, 26, 795–801.Google Scholar
Hindocha, C., Shaban, N. D. C., Freeman, T. P., et al. (2015). Associations between cigarette smoking and cannabis dependence: A longitudinal study of young cannabis users in the United Kingdom. Drug Alcohol Depend, 148, 165–171.Google Scholar
Hines, L. A., Freeman, T. P., Gage, S. H., et al. (2020). Association of high-potency cannabis use with mental health and substance use in adolescence. JAMA Psychiatry, 77, 1044–1051.CrossRefGoogle ScholarPubMed
Hines, L. A., Morley, K. I., Strang, J., et al. (2016). Onset of opportunity to use cannabis and progression from opportunity to dependence: Are influences consistent across transitions? Drug Alcohol Depend, 160, 57–64.CrossRefGoogle ScholarPubMed
Huestis, M. A., Gorelick, D. A., Heishman, S. J., et al. (2001). Blockade of effects of smoked marijuana by the CB1-selective cannabinoid receptor antagonist SR141716. Arch Gen Psychiatry, 58, 322–328.Google Scholar
Johnson, E. C., Demontis, D., Thorgeirsson, T. E., et al. (2020). A large-scale genome-wide association study meta-analysis of cannabis use disorder. Lancet Psychiatry, 7, 1032–1045.Google Scholar
Lawn W, Mokrysz C, Lees, R et al. (2022). The CannTeen Study: Cannabis use disorder, depression, anxiety, and psychotic-like symptoms in adolescent and adult cannabis users and age-matched controls. J Psychopharmacol. 36, 1350–1361.Google Scholar
Lees, R., Hines, L. A., D’Souza, D. C., et al. (2021). Psychosocial and pharmacological treatments for cannabis use disorder and mental health comorbidities: A narrative review. Psychol Med, 51, 353–364.Google Scholar
Leung, J., Chan, G. C. K., Hides, L., et al. (2020). What is the prevalence and risk of cannabis use disorders among people who use cannabis? A systematic review and meta-analysis. Addict Behav, 109, 106479.Google Scholar
Leung, J., Chiu, C. Y. V., Stjepanović, D., et al. (2018). Has the legalisation of medical and recreational cannabis use in the USA affected the prevalence of cannabis use and cannabis use disorders? Curr Addict Rep, 5, 403–417.Google Scholar
Levin, F. R., Mariani, J. J., Brooks, D. J., et al. (2011). Dronabinol for the treatment of cannabis dependence: A randomized, double-blind, placebo-controlled trial. Drug Alcohol Depend, 116, 142–150.CrossRefGoogle ScholarPubMed
Lintzeris, N., Bhardwaj, A., Mills, L., et al. (2019). Nabiximols for the treatment of cannabis dependence: A randomized clinical trial. JAMA Intern Med, 179, 1242–1253.CrossRefGoogle ScholarPubMed
Loflin, M. J. E., Kiluk, B. D., Huestis, M. A., et al. (2020). The state of clinical outcome assessments for cannabis use disorder clinical trials: A review and research agenda. Drug Alcohol Depend, 212, 107993.CrossRefGoogle ScholarPubMed
Lopez‐Quintero, C., Hasin, D. S., de los Cobos, J. P., et al. (2011a). Probability and predictors of remission from life‐time nicotine, alcohol, cannabis or cocaine dependence: Results from the national epidemiologic survey on alcohol and related conditions. Addiction, 106, 657–669.Google Scholar
Lopez-Quintero, C., Pérez de los Cobos, J., Hasin, D. S., et al. (2011b). Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend, 115, 120–130.Google Scholar
Lorenzetti, V., Chye, Y., Suo, C., et al. (2020). Neuroanatomical alterations in people with high and low cannabis dependence. Aust NZ J Psychiatry, 54, 68–75.CrossRefGoogle ScholarPubMed
Lubman, D. I., Yücel, M., and Hall, W. D. (2007). Substance use and the adolescent brain: A toxic combination? J Psychopharmacol, 21, 792–794.Google Scholar
Marel, C., Sunderland, M., Mills, K. L., et al. (2019). Conditional probabilities of substance use disorders and associated risk factors: Progression from first use to use disorder on alcohol, cannabis, stimulants, sedatives and opioids. Drug Alcohol Depend, 194, 136–142.CrossRefGoogle ScholarPubMed
Mason, B. J., Crean, R., Goodell, V., et al. (2012). A proof-of-concept randomized controlled study of gabapentin: Effects on cannabis use, withdrawal and executive function deficits in cannabis-dependent adults. Neuropsychopharmacology, 37, 1689–1698.Google Scholar
Millar, S. R., Mongan, D., Smyth, B. P., et al. (2021). Relationships between age at first substance use and persistence of cannabis use and cannabis use disorder. BMC Public Health, 21, 1–11.Google Scholar
Miranda, R. Jr, Treloar, H., Blanchard, A., et al. (2017). Topiramate and motivational enhancement therapy for cannabis use among youth: A randomized placebo‐controlled pilot study. Addict Biol, 22, 779–790.Google Scholar
Mokrysz, C., Freeman, T. P., Korkki, S., et al. (2016). Are adolescents more vulnerable to the harmful effects of cannabis than adults? A placebo-controlled study in human males. Transl Psychiatry, 6, e961–e961.CrossRefGoogle Scholar
Nielsen, S., Gowing, L., Sabioni, P., et al. (2019). Pharmacotherapies for cannabis dependence. Cochrane Database Syst Rev, 1, CD008940.Google Scholar
Papinczak, Z. E., Connor, J. P., Feeney, G. F. X., et al. (2019). Testing the biosocial cognitive model of substance use in cannabis users referred to treatment. Drug Alcohol Depend, 194, 216–224.Google Scholar
Pertwee, R. G. (2008). The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: Δ9‐tetrahydrocannabinol, cannabidiol and Δ9‐tetrahydrocannabivarin. Br J Pharmacol, 153, 199–215.Google Scholar
van der Pol, P., Liebregts, N., de Graaf, R., et al. (2013a). Mental health differences between frequent cannabis users with and without dependence and the general population. Addiction, 108, 1459–1469.Google Scholar
van der Pol, P., Liebregts, N., de Graaf, R., et al. (2013b). Predicting the transition from frequent cannabis use to cannabis dependence: A three-year prospective study. Drug Alcohol Depend, 133, 352–359.Google Scholar
Ramaekers, J. G., Mason, N. L., Kloft, L., et al. (2021). The why behind the high: Determinants of neurocognition during acute cannabis exposure. Nat Rev Neurosci, 22, 439–454.Google Scholar
Schettino, J., and Hoch, E. (2015). Treatment of Cannabis-related Disorders in Europe. Luxembourg: Publications Office of the European Union.Google Scholar
Schlag, A. K., Hindocha, C., Zafar, R., et al. (2021). Cannabis based medicines and cannabis dependence: A critical review of issues and evidence. J Psychopharmacol, 35, 773–785.Google Scholar
Skumlien, M., Freeman, T. P, Hall, R. et al. (2022a). The effects of acute cannabis with and without cannabidiol on neural reward anticipation in adults and adolescents, Biological Psychiatry: Cognitive Neuroscience and Neuroimaging (2022), doi.org/10.1016/j.bpsc.2022.10.004.Google Scholar
Skumlien, M., Mokrysz, C., Freeman, T. P. et al. (2022b). Neural responses to reward anticipation and feedback in adult and adolescent cannabis users and controls. Neuropsychopharmacology. 47, 1976–1983.Google Scholar
von Sydow, K., Lieb, R., Pfister, H., et al. (2001). The natural course of cannabis use, abuse and dependence over four years: A longitudinal community study of adolescents and young adults. Drug Alcohol Depend, 64, 347–361.CrossRefGoogle Scholar
von Sydow, K., Lieb, R., Pfister, H., et al. (2002). What predicts incident use of cannabis and progression to abuse and dependence? A 4-year prospective examination of risk factors in a community sample of adolescents and young adults. Drug Alcohol Depend, 68, 49–64.Google Scholar
Teesson, M., Slade, T., Swift, W., et al. (2012). Prevalence, correlates and comorbidity of DSM-IV cannabis use and cannabis use disorders in Australia. Aust NZ J Psychiatry, 46, 1182–1192.Google Scholar
UNODC. (2017). World Drug Report. Geneva: United Nations.Google Scholar
UNODC. (2020). World Drug Report. Geneva: United Nations.Google Scholar
Urban, N. B. L., Slifstein, M., Thompson, J. L., et al. (2012). Dopamine release in chronic cannabis users: A [11c] raclopride positron emission tomography study. Biol Psychiatry, 71, 677–683.Google Scholar
Verweij, K. J. H., Abdellaoui, A., Nivard, M. G., et al. (2017). Genetic association between schizophrenia and cannabis use. Drug Alcohol Depend, 171, 117–121.Google Scholar
Vingerhoets, W. A. M., Koenders, L., van den Brink, W., et al. (2016). Cue-induced striatal activity in frequent cannabis users independently predicts cannabis problem severity three years later. J Psychopharmacol, 30, 152–158.Google Scholar
Volkow, N. (2021). Establishing 5 mg of THC as the Standard Unit for Research. Available at: www.drugabuse.gov/about-nida/noras-blog/2021/05/establishing-5mg-thc-standard-unit-research. Last accessed 31 October 2022.Google Scholar
Volkow, N. D., Han, B., Einstein, E. B., et al. (2021). Prevalence of substance use disorders by time since first substance use among young people in the US. JAMA Pediatr, 175, 640–643.Google Scholar
WHO. (2018). International Classification of Diseases for Mortality and Morbidity Statistics (11th Revision). Geneva: World Health Organization.Google Scholar
Wittchen, H. U., Jacobi, F., Rehm, J., et al. (2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol, 21, 655–679.Google Scholar

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