Unseen Dangers of Marijuana
Story by Spencer Clifton & Caya Berndt | Design by Sarah Stewart
Weed culture is everywhere in the Pacific Northwest. Weed socks. Weed shirts. Pot brownies. Stoner movie guides. Hemp products. CBD oil in coffees, sodas and bath bombs. While the growing expansion of cannabis products and culture may have been widely accepted, this is not the only thing that is growing as a result of the cannabis craze.
In 2012, Washington became one of the first states to decriminalize and legalize marijuana, drawing thousands of stoners away from their down-low pot dealers and towards legal cannabis suppliers. In 2019, the CDC reported 48.2 million people used cannabis at least once and in a recent study conducted by the CDC, three out of 10 regular marijuana users develop what is called marijuana use disorder.
Addicted To Weed?
One of the allures of cannabis is that many users believe that the substance may not contain addictive properties. Sharon Garrett, research coordinator and project director at the University of Washington’s Addictions Drug and Alcohol Institute (ADAI), says this is inaccurate.
“I think a lot of people don’t think you can’t develop an addiction to cannabis,” says Garrett. “But you can.”
Substance use is complex. The American Psychiatric Association defines substance use disorders as a condition in which there is, “Uncontrolled use of a substance despite harmful consequences.”
Garrett explains that one of the consequences of heavy use is developing a tolerance, leading to the person needing to consume more of the substance to get the same effect. Others may find it difficult to quit, or they may experience cravings. She adds chronic use of the substance can lead to problems with work, school, daily duties or relationships.
All of these things, she continues, characterize addiction across all drugs–including those who suffer from cannabis use disorder.
Lillianne Jones* and Alexandria Smith*, former marijuana addicts and current representatives for Marijuana Anonymous World Services (MAWS), explain how their story of cannabis addiction greatly impacted their personal and professional lives.
“I spent all my money on pot; all my extra money,” says Smith. “I wasn't able to get up for my job in the morning. I started to get really bad side effects of depression, and not being able to get motivated. [I] started skipping school, [I] wasn't able to get money to support myself … I wanted all my money to go to pot.”
Marijuana dependence may not be stigmatized compared to other substance dependency due to the addiction rates of cannabis. Garret explains, “Addiction rates are much lower, or have been traditionally, so it hasn’t been a substance that’s gotten a lot of attention.”
That isn’t to say that cannabis use disorder isn’t cause for concern. “I started to feel like I was in my own privately defined world,” says Smith. “I started to get some really dark thoughts. [I] started to go to therapy, and for me, [the scariest thing was] it really made me feel like I wasn't living a life of purpose.”
Smith is not the only individual struggling with cannabis dependency. Marijuana use has been on the rise, especially among users under the age of 25, according to a study published by the National Institute of Drug Abuse.
Marijuana usage manifests in dependence, and the difference between dependence and addiction is important to understanding marijuana’s unique risks.
This is where it gets a little nerdy. The major components in marijuana are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the psychoactive component of marijuana–the mind-altering, intoxicating element.
However, your body also produces its own cannabinoids that attach to cannabinoid receptors located throughout your nervous system, immune system and brain, which is what these chemicals react with when you ingest marijuana. These receptors influence everything, from our mood to our decision-making abilities, even our memory, appetite and consciousness.
According to VICE, when you ingest or inhale THC or other cannabinoids, those override your body’s naturally-occurring cannabinoids and latch into your cannabinoid receptors instead. Eventually, after enough use, your body gets used to these high levels of cannabinoids, which blunts its ability to produce its own endocannabinoids. In other words: if you smoke enough weed for a long-enough time, your body forgets how to make its own substance. That’s dependence.
With a growing body of research demonstrating the harmful effects of long-term cannabis use, many users are turning to substance treatment to treat their dependency.
Smith and Jones turned to MAWS for help combating their own marijuana addiction. Jones explains that MAWS was “one addict helping another,” and helped her navigate marijuana addiction. “I heard my story come out of other people's mouths and other people that are like a 70-year-old black gay lawyer, or [a] 15-year-old kid on the track team,” she says. “It’s this really unifying human identification with each other.”
After relying on MAWS, Smith and Jones are now over 10 years sober. They continue to give thanks for MAWS by acting as volunteers and sponsors for addicts in the program.
Smith explains that sponsorship can be an important aspect of an addict's recovery because, “It's this relationship it's built on hope and faith in a person's best self, and not have a person defined by their addiction.”
Kicking The Stigma
Weed enthusiasts are, well, enthusiastic about cannabis and it’s dizzying array of products. And it’s not as though that enthusiasm isn’t earned.
For many people who live with chronic conditions, legalization may come as a relief. Marijuana has long held the interest of doctors and scientists for its medicinal benefits. Studies, such as one done by the Harvard Medical School, have shown evidence that marijuana could be effective for treating chronic conditions such as joint pain, Post-Traumatic Stress Disorder (PTSD), Crohn’s disease and gastroesophageal reflux disease (GERD).
This attitude towards marijuana, especially in comparison to other substances, could be a reason why certain people refuse to get help for marijuana dependency or even believe its existence. “I think part of the reason that it's not taken seriously [has to do] with the proliferation of the cannabis culture and the legalization,” says Jones. “It's just this kind of ‘oh no big deal.’”
In addition to the avoidant attitude towards marijuana dependency, marijuana has changed considerably over the years.
Increasing Potency
One thing’s for sure, this isn’t your grandfather’s weed. One of the factors that may be contributing to the rise in cannabis dependency and poisoning cases has been the fact that today’s weed is so much more potent than the buds of the past.
Garrett expresses concern over the potency of these new strains. “In the 90s, almost all cannabis flowers had less than 10% THC,” she explains. “So now, you get a flower and it’s not uncommon for it to have 20%.”
She explains it’s not just the THC levels that are in the flower, but the way it’s consumed that can make a difference in how users experience the substance. High-concentrated cannabis products, such as concentrated cannabis oil or dabs which may contain up to 80% THC, overload your body’s system and increase the risk for developing a tolerance.
Alex Sirotzki with the Washington Poison Center paraphrased Jason Kilmer with the University of Washington in his assessment of this increased potency. “Comparing cannabis from the 60s or 70s to now is like comparing light beer to Everclear.”
Dependency isn’t the only health risk associated with smoking stronger weed. As state regulations have loosened and usage has increased, medical and behavioral health professionals have noticed an increase in patients reporting alarming conditions linked to weed consumption. One of them is a dangerous illness known as cannabinoid hyperemesis syndrome (CHS), which causes severe abdominal pain, nausea and uncontrollable vomiting.
Trisha Kango, a medical scribe for the Yakima Valley Hospital Emergency Room, has witnessed these cases firsthand. “What is most commonly seen in the emergency department is when they just cannot control their vomiting. They can’t keep down water so they need to come to the ED to get help,” she says.
She explains the serious complications from CHS, such as dehydration, electrolyte imbalance and damage to the esophagus due to trauma from repeated vomiting. She notes that while it wasn’t a common occurrence, it was usually the same patients coming back multiple times.
“You usually see it in people who have been smoking marijuana or taking edibles for a number of years and they are totally fine until one fine day they just can’t tolerate it,” she says. “After a while, after they get better. They do it again thinking it won’t happen this time, and the same thing happens again. So, it is kind of like a vicious cycle.”
Sirotzki also reported an increase in marijuana exposure-related calls to the WA Poison Center. 2020 saw a 20% increase in marijuana exposures for adults, and a 44% increase for children compared to 2019. Both Sirotzki and Kango agreed that the steady increase in these numbers is related to marijuana’s legalization.
Sirotzki also suggests there is a connection between the stresses of the COVID-19 pandemic and the increase in Poison Center calls.
However, Sirotzki also raised concerns about the supposed psychological benefits of cannabis due to a growing number of reports of marijuana-induced psychosis.
“One of the things we are learning over time is that there is [...] a fairly significant correlation between using cannabis in the development of psychosis disorders, including schizophrenia,” he says.
However, that doesn’t mean that marijuana use is causing psychosis. “What we think is happening,” he explains. “Is that for folks who have who are at risk of developing psychosis, so say they have a genetic predisposition, there is a greater likelihood that cannabis may act as a bit of a catalyst for those symptoms of psychosis, and bring on those effects earlier than they otherwise would have.”
*name has been changed due to the sensitivity of the content
