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Medical professionals examine cannabis use disorder

Cannabis use disorder (CUD) goes beyond unmotivated stoner stereotypes or the fear-based “reefer madness” that equates psychosis with casual cannabis use. (Getty Images)
Cannabis use disorder (CUD) goes beyond unmotivated stoner stereotypes or the fear-based “reefer madness” that equates psychosis with casual cannabis use. (Getty Images)
Linda Ball EVERCANNABIS Correspondent
The temporary effect of cannabis on most consumers is rarely a problem, which is part of its appeal to those who use it for fun or to treat health conditions. But mental health professionals say that some regular users may suffer longer-term problems that could negatively affect their health, relationships and employment. Cannabis use disorder (CUD) goes beyond unmotivated stoner stereotypes or the fear-based “reefer madness” that equates psychosis with casual cannabis use. The actual disorder is now a defined condition listed in the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, the guidebook mental health professionals use to diagnose and evaluate their patients. The condition is defined as cannabis abuse and dependence which includes a problematic pattern of cannabis use leading to clinically significant impairment or distress, manifested by at least two of the following within a 12-month period: · Cannabis consumed in larger amounts or over a longer period than what was intended; · A persistent desire or unsuccessful efforts to cut down or control cannabis use; · Spending a considerable amount of time on activities necessary to obtain, use or recover from its effects; · Craving or a strong desire or urge to use cannabis; · Recurrent cannabis use resulting in failure to fulfill role obligations at work, home or school; · Continued use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of cannabis; · Important social, occupational, or recreational activities being given up or reduced because of cannabis use; · Recurrent cannabis use in situations in which it’s physically hazardous; · Use continuing despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis; · Tolerance as defined by a need for more to achieve the intoxication or desired effect or a markedly diminished effect with continued use of the same amount; · Withdrawal as manifested by the characteristic withdrawal syndrome for cannabis or if it is taken to relieve or avoid withdrawal symptoms. Diana Cockrell, a substance use disorder professional with the Washington State Health Care Authority said this disorder is real, and the spectrum can range from mild, moderate to severe. She said in the case of “wake and bakers,” who have a habit of starting their day with cannabis, it’s hard to know what they would do without this center of gravity in their life, similar to chronic alcohol abusers who start drinking in the morning and don’t stop. This constant partaking can certainly disrupt their lives. Cockrell’s specialty is in adolescents in the developmental period. The human brain is still wiring itself until around age 25, so several studies have shown that cannabis use in those under 25 can be harmful to brain development. Tasks such as socialization and making friends organically can be compromised in younger cannabis users because they don’t always learn how to feel the required emotions. Cockrell said critical thinking skills can also be altered with adolescent consumption. She said that adverse childhood experiences can cause an adolescent or even an adult to be prone to excessive use. Risk factors include genetics (a history of addiction in the family), a person coming out of a traumatic situation, chronic neglect, emotional or sexual abuse, household mental illness, parental divorce or harmed from a loved one. “It’s like a switch that goes from recreational use to over-use,” Cockrell said. Resiliency factors can make a huge difference in helping with adverse childhood experiences, such as having a community around the child, teen or adult at risk that cares about them, individuals they can trust, a good school climate, and a family they can trust. Children need to understand how to interact positively with others, manage their emotions and communicate feelings which benefit from a supportive community of family and friends. With cannabis, Cockrell said it’s not so much a physical addiction, rather more of a lack of emotional regulation, which can cause some to feel cannabis anxiety. If an individual starts cannabis use too young, it can result in lower education attainment, employment issues and loss of interest in things that society regards as normal. Even adults have triggers that can accelerate use, such as especially emotional circumstances. “We all escape on purpose, but sliding into coping, matters that take us away from being authentic, is not healthy,” she said. In states where cannabis is legal, in adults aged 26 or older, the number of people who said they used cannabis in the past month rose by 23 percent compared to states where recreational use isn’t legal, but problematic cannabis use rose by 37 percent after recreational legalization, according to JAMA Psychiatry. In the 12 to 17-year-old group, CUD rose by 25 percent compared to those in the same group in other states from 2.18 percent to 2.72 percent, but in the 13- to 15-year-old range, frequency and cannabis disorder didn’t change. Similar to what Cockrell said, the report said heavy use is linked to physical and psychological problems, lower educational attainment, decline in social class, unemployment and vehicle crashes.
Linda Ball is a freelance journalist who has covered a variety of topics over 18 years, including the environment, city hall, culture, education, and now the rapidly-changing cannabis industry.
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