Kurzgesagt – In a Nutshell
Kurzgesagt – In a Nutshell
Embedded Files
Sources – Quit Weed
Sources – Quit Weed
We thank all the experts who supported us with their critical reading, feedback and corrections:
– Dr. Will Lawn
Department of Psychology, King’s College London
– Dr. Rachel Lees Thorne
Addiction and Mental Health Group, University of Bath
– Dr. Matthew Hill
University of Calgary Cumming School of Medicine
Dr. Will Lawn, who helped us a great deal as a scientific advisor in this video, is running a study about teenage substance use. If you are living in England, are between 12-15 years old, and want to take part in an online survey for research, please contact him through c.res@kcl.ac.uk
Dealing with substance abuse is a difficult task. Thankfully, you’re never alone in it. Whether you want to confront your addiction, help out a friend or family member, or simply ask professionals sensitive questions in confidence, there are helplines, health centers and other resources available:
USA:
SAMHSA substance abuse hotline:
https://www.samhsa.gov/about/contact
Find a Health Center map:
https://findahealthcenter.hrsa.gov/
Simplified guide for quitting weed:
https://www.weedless.org/guide/
UK:
Local drug and alcohol support:
https://www.talktofrank.com/get-help/find-support-near-you
Support for your, or someone else’s drug use:
Germany:
Addiction help hotline for you or someone else:
https://www.guttempler.de/nottelefon/
A directory of all drug and addiction counselling centres:
https://www.dhs.de/service/suchthilfeverzeichnis
Canada:
Self-help guide to change your cannabis use:
https://cannabis-hub.camhx.ca/resources/changing-your-cannabis-use.html
Directory of resources for substance use (not specific to cannabis):
https://www.canada.ca/en/health-canada/services/substance-use/get-help-with-substance-use.html
India:
Nasha Mukt Bharat Abhiyaan (Drug Free India Campaign) Website:
Australia:
Online resources and directory of support organizations:
https://cannabissupport.com.au/tools-for-quitting/
Self-help guide to quitting Cannabis:
– Weed is a serious drug that can have devastating consequences on your life. This is an unpopular thing to say but it is true.
Any recreational drug has a potential to have devastating consequences. We know that this is not special to weed and weed also doesn’t necessarily have devastating consequences for all users. In this video, we talk about a specific group of users who depend on it a lot, use it heavily on a daily basis and are likely to have severe cannabis use disorder. Still, we are aware that the consequences are very personal. How the dependence is going to manifest in different aspects of life can not be determined by a single parameter. Life trajectories of users, even with the same use patterns, can be very different since there are a multitude of other personal and environmental factors in effect. One of the best ways to study this is longitudinal studies that follow users with different use patterns and nonusers for long periods of time and measure the life outcomes. However, longitudinal studies with thousands of people are not the easiest studies to run. Also life outcomes are very difficult to isolate from other factors and it is difficult to nail down the effects to a single parameter like cannabis use. Also, the field is still relatively young and there are not hundreds of longitudinal studies. There are still a lot of open points and it will take time to fill the gaps in research. But it also is part of many people’s lives currently so we took whatever the current research gave us and also put our experiences and observations to make extrapolations to be able to tell this story. We are aware that the story here does not encapsulate the experiences of everyone and there is a lot of variation in life outcomes among heavy users.
– We don’t think it should be illegal because for most people using weed is not problematic or has only mild negative consequences.
We talked about legalization in the previous video. If you are interested in learning more about that, please refer to that video.
We Have To Talk About Weed
– But about 20% of people who have ever tried it develop cannabis use disorder, and some of them become severely addicted.
How the addiction is defined varies across literature but the current term that is well-defined, quantifiable and the most commonly used in literature is Cannabis Use Disorder (CUD). It has 11 criteria and depending on the number of criteria a user experiences, CUD has three levels, mild, moderate and severe. There is not an established terminology of “addiction” corresponding to different levels of CUD. However, addiction, even though it can be stigmatizing at times, is still the mostly used word and it is far more familiar and relatable to most people than CUD is. So “severely addicted” here doesn’t directly translate to severe CUD technically speaking. However, we also thought that satisfying 6+ criteria from the list below would be perceived as a case of severe addiction by the larger audience. On top of that, the research regarding the outcomes of severe CUD is limited so it is very restricting to tell a story specific for that user group.
#Patel J, Marwaha R. Cannabis Use Disorder. [Updated 2024 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538131/
Quote: “Cannabis abuse and dependence were combined in the DSM-5, capturing the behavioral disorder that can occur with chronic cannabis use and named cannabis use disorder defined as:
A problematic pattern of cannabis use leading to clinically significant impairment or distress, as manifested by at least 2 of the following, occurring within 12 months:
Cannabis is often taken in more significant amounts or over a longer period than was intended.
Persistent desire or unsuccessful efforts are attempted to cut down or control cannabis use.
A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its effects.
A craving or a strong desire or urge to use cannabis exists.
Recurrent cannabis use results in failure to fulfill role obligations at work, school, or home.
Continued cannabis use, despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis.
Important social, occupational, or recreational activities are given up or reduced because of cannabis use.
Recurrent cannabis use even in situations in which cannabis is physically hazardous.
Cannabis use continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
The tolerance increases, defined by either (1) a need for markedly increased cannabis to achieve intoxication or desired effect or (2) a markedly diminished effect with continued use of the same amount of the substance.
Having a withdrawal, as manifested by either (1) the characteristic withdrawal syndrome for cannabis or (2) cannabis is taken to relieve or avoid withdrawal symptoms.The criteria have the following specifiers:
In early remission, after full criteria for cannabis use disorder were previously met, none of the criteria for cannabis use disorder has been met for at least 3 months but less than 12 months (with an exception provided for craving).
In sustained remission, after full criteria for cannabis use disorder were previously met, none of the criteria for cannabis use disorder has been met at any time during 12 months or longer (with an exception provided for craving).
Severity is graded as mild, moderate, or severe, depending on whether 2 or 3, 4 or 5, or 6+ of the above criteria are present.”
There are multiple studies reporting different numbers regarding the prevalence and risk of CUD. There are also differences since the definition of CUD has changed between DSM-IV and DSM-5 which made comparison between publications from time periods difficult. We stick to the designation in the following paper since it is the most recent analysis that we could find.
#Leung, Janni et al. “What is the prevalence and risk of cannabis use disorders among people who use cannabis? a systematic review and meta-analysis.” Addictive behaviors 2020
https://www.sciencedirect.com/science/article/abs/pii/S0306460320306092
Quote: “From 1383 records identified, 21 studies were included. Meta-analyses showed that among people who used cannabis, 22% (18-26%) have CUD, 13% (8-18%) have CA, and 13% (10-15%) have CD. Estimates from cohort studies showed that the risk of developing CD increased to 33% (22-44%) among young people who engaged in regular (weekly or daily) use of cannabis. There was a lack of data from cohort studies to estimate the risk of CUD or CA among regular cannabis users.”
#Lopez-Quintero, Catalina et al. “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 and alcohol dependence vol. 115,1-2 (2011): 120-30. doi:10.1016/j.drugalcdep.2010.11.004
https://pubmed.ncbi.nlm.nih.gov/21145178/
Quote: “Consistent with previous estimates from the National Comorbidity Survey (Wagner and Anthony, 2002a), the cumulative probability of transition from use to dependence a decade after use onset was 14.8% among cocaine users, 11.0% among alcohol users, and 5.9% among cannabis users. This probability was 15.6% among nicotine users. Furthermore, lifetime cumulative probability estimates indicated that 67.5% of nicotine users, 22.7% of alcohol users, 20.9% of cocaine users, and 8.9% of cannabis users would become dependent at some time in their life.”
There are more recent studies which have not been included in the meta analysis above. However they also find similar percentages, as in the following paper.
#Lapham, Gwen T et al. “Prevalence of Cannabis Use Disorder and Reasons for Use Among Adults in a US State Where Recreational Cannabis Use Is Legal.” JAMA network open vol. 6,8 e2328934. 1 Aug. 2023, doi:10.1001/jamanetworkopen.2023.28934
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2808874
Quote: “S Of 1463 included primary care patients (weighted mean [SD] age, 47.4 [16.8] years; 748 [weighted proportion, 61.9%] female) who used cannabis, 42.4% (95% CI, 31.2%-54.3%) reported medical use only, 25.1% (95% CI, 17.8%-34.2%) nonmedical use only, and 32.5% (95% CI, 25.3%-40.8%) both reasons for use. The prevalence of CUD was 21.3% (95% CI, 15.4%-28.6%) and did not vary across groups. The prevalence of moderate to severe CUD was 6.5% (95% CI, 5.0%-8.6%) and differed across groups: 1.3% (95% CI, 0.0%-2.8%) for medical use, 7.2% (95% CI, 3.9%-10.4%) for nonmedical use, and 7.5% (95% CI, 5.7%-9.4%) for both reasons for use (P = .01).”
Also the risk of developing CUD partly depends on the dose as well. Not all daily users have necessarily the same likelihood if they have different daily doses. That’s another reason that different numbers are reported across literature.
#Borodovsky, Jacob T et al. “Quantity of delta-9-tetrahydrocannabinol consumption and cannabis use disorder among daily cannabis consumers.” Addiction 2025
https://pubmed.ncbi.nlm.nih.gov/39501796/
Quote: “Design, setting and participants: US adult (aged 18+ years) daily cannabis consumers (n = 4134) completed a comprehensive online survey of cannabis consumption patterns (e.g. frequency, quantity, product types, potencies, administration methods) and Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) CUD criteria.
Measurements: The primary exposure was past-week daily mgTHC consumption, calculated from survey responses to queries about product type, amount and potency consumed and including adjustments for puff size and loss of THC from specific methods of administration. The primary outcomes were (1) number of CUD criteria (range = 0-11) and (2) CUD severity categories: none, mild, moderate, severe.
Findings: Median daily consumption was ~130 mgTHC, with substantial variability (25% ≤ 50 mg and 25% ≥ 290 mg). On average, participants endorsed 2.5 CUD criteria, and 65% met criteria for CUD (39% mild, 18% moderate, 8% severe). Greater daily mgTHC predicted higher CUD criteria count [betalog(mgTHC) = 0.50, 95% confidence interval (CI) = 0.267-0.734] and higher odds of mild [log odds ratio (logOR) = 0.238, 95% CI = 0.184-0.292], moderate (logOR = 0.303, 95% CI = 0.232-0.374) or severe (logOR = 0.335, 95% CI = 0.236-0.435) CUD.
Conclusions: Among daily consumers of cannabis, there appears to be a positive relationship between the daily quantity of cannabis consumed (measured in milligrams of delta-9-tetrahydrocannabinol) and both the risk and severity of cannabis use disorder.”
– That’s actually a stunning amount of people and many who start using weed don’t know what they are in for.
Not everyone is equally aware of the potential physical and mental health effects, and there is generally a reciprocal trend between the perceived risk and the use.
#Leos-Toro, Cesar et al. Cannabis health knowledge and risk perceptions among Canadian youth and young adults. Harm reduction journal. 2020.
https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00397-w
Quote: “Results: Most respondents were aware of a cannabis-related physical health effect (78.0%). Approximately one-third reported having been exposed to public health messaging about cannabis; digital media was reported most frequently. Compared to never users, ever users were less likely to report general likelihood of addiction (p < 0.001) and harm to mental health (p < 0.001). Approximately one-quarter of past 3-month cannabis users reported they were at least "a little" addicted. Respondents who reported using a particular form of cannabis self-administration (e.g., edibles, smokables) were less likely to perceive harm than those who did not use each form (p < 0.001).”
#Harrison et al. Adolescents' Cannabis Knowledge and Risk Perception: A Systematic Review. Journal of Adolescent Health. 2024.
https://www.sciencedirect.com/science/article/abs/pii/S1054139X23004974
Quote: “To systematically review evidence evaluating cannabis-related knowledge and perception of risk in children and adolescents. We systematically searched Medline, PsycINFO, and EMBASE using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. 133 studies from around the world (including ages 10–18 yrs) met inclusion criteria, with 70% meeting grade 2C quality. Increased knowledge and perception of risk of cannabis frequently correlated with lower levels of current use and intent to use. Studies examining correlations over time generally demonstrated increased adolescent cannabis use and decreased perception of risk. Included prevention-based interventions often enhanced knowledge and/or perception of risk in adolescents exposed to the intervention. Studies exploring outcomes relating to legislative changes for recreational marijuana use demonstrated considerable heterogeneity regarding knowledge and perception of risk whereas studies that focused on medicinal marijuana legislative changes overwhelmingly demonstrated a decrease in perception of risk post legalization. Increased knowledge and perception of risk of cannabis in adolescents often correlate with lower levels of current use and intention to use in the future. Further study and implementation of public health and clinically-oriented strategies that seek to increase knowledge among youth about the potential health harms of cannabis use should continue and be prioritized.”
– In the US, daily or near daily weed use has skyrocketed since way before legalization and there are now more daily users of weed than drinkers of alcohol.
#Caulkins, Jonathan P. “Changes in self-reported cannabis use in the United States from 1979 to 2022.” Addiction 2024.
https://onlinelibrary.wiley.com/doi/10.1111/add.16519
Quote#1: “Reported cannabis use declined to a nadir in 1992, with partial recovery through 2008, and substantial increases since then, particularly for measures of more intensive use. Between 2008 and 2022, the per capita rate of reporting past-year use increased by 120%, and days of use reported per capita increased by 218% (in absolute terms from the annual equivalent of 2.3 to 8.1 billion days per year). From 1992 to 2022,there was a 15-fold increase in the per capita rate of reporting daily or near daily use.Whereas the 1992 survey recorded 10 times as many daily or near daily alcohol as can-nabis users (8.9 vs. 0.9 M), the 2022 survey, for the first time, recorded more daily andnear daily users of cannabis than alcohol (17.7 vs. 14.7 M). Far more people drink, but high-frequency drinking is less common. In 2022, the median drinker reported drinking on 4–5 days in the past month, versus 15–16 days in the past month for cannabis. In2022, past-month cannabis consumers were almost four times as likely to report daily or near daily use (42.3% vs. 10.9%) and 7.4 times more likely to report daily use (28.2%vs. 3.8%).”
Quote#2: “Findings: Respondents who reported using daily (i.e., 30 days in the past month) consumed almost twice as much per day of use on average as did those reporting less than daily. We find only modest increases in intensity among those using less than daily, but then a substantial increase (p< 0.001) for those who use daily. Most respondents report that on heavy or light use days their consumption differs from a typical day of use by a factor of 2 or more, but only about 25% of days were described as heavy or light. We estimate those using cannabis 21+ days a month account for 80% of consumption vs. 71% of the days of use.”
– And most daily users consume very high amounts.
#Caulkins, Jonathan P et al. Intensity of cannabis use: Findings from three online surveys. The International journal on drug policy. 2020.
https://www.sciencedirect.com/science/article/abs/pii/S0955395920300815
Quote: “Respondents who reported using daily (i.e., 30 days in the past month) consumed almost twice as much per day of use on average as did those reporting less than daily. We find only modest increases in intensity among those using less than daily, but then a substantial increase (p< 0.001) for those who use daily. Most respondents report that on heavy or light use days their consumption differs from a typical day of use by a factor of 2 or more, but only about 25% of days were described as heavy or light. We estimate those using cannabis 21+ days a month account for 80% of consumption vs. 71% of the days of use.
Discussion
Daily cannabis users consume more intensively than others, including near-daily users. When possible, survey questions should move beyond the presence or absence of use and number of days used.”
– In 2023 1 in 15 adult Americans were suffering from some form of cannabis addiction.
#Bierut LJ, Fang F. Time to Act on a Growing Public Health Threat—Evidence of Elevated Mortality in Cannabis Use Disorder. JAMA Netw Open. 2025.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829919
Quote: “A major concern associated with the rise in cannabis use is the corresponding increase in cannabis use disorder. As cannabis use has increased, the population prevalence of cannabis use disorder has risen in the US. In 2023, 6.8% of individuals aged 12 years and older (approximately 19.2 million people), and approximately 30% of those who reported using cannabis, met criteria for cannabis use disorder. Of those aged 18 to 25 years, 16.6% reported cannabis use disorder.2 The findings of Myran and colleagues1 underscore the severe consequences of these trends, highlighting the elevated risk of mortality associated with cannabis use disorder.”
– In England, cannabis is by far the top drug teenagers seek help for.
#Young people's substance misuse treatment statistics 2022 to 2023: report
Published 25 January 2024
https://www.gov.uk/government/statistics/substance-misuse-treatment-for-young-people-2022-to-2023/young-peoples-substance-misuse-treatment-statistics-2022-to-2023-report
Quote: “Figure 2 shows the substance that young people in treatment report having problems with, and the numbers of each. The vast majority of young people in treatment (87% of all in treatment) said they have a cannabis problem. Nearly half (44%) said they had a problem with alcohol.”
– Weed is usually discussed in the context of teenagers because using any drug while your brain is melting and rebuilding itself is a bad idea.
#Yang, Jack, Maria C. Mejia, Lea Sacca, Charles H. Hennekens, and Panagiota Kitsantas. 2024. "Trends in Marijuana Use among Adolescents in the United States" Pediatric Reports 16, no. 4: 872-879.
https://doi.org/10.3390/pediatric16040074
Quote: “Marijuana has become one of the most frequently used illicit substances among adolescents in the United States (US) [1,2]. Regular or high marijuana usage during adolescence, which constitutes a crucial period for neural development, has been linked to poor cognitive outcomes, such as disadvantaged learning, working memory tests, and attention, even when considering years of school and verbal intelligence [3,4,5,6]. Other detriments associated with marijuana use in adolescents include being 2–3.5 times more likely to report a lower grade point average and a 4-fold increase in adult psychosis diagnoses [7,8]. Research shows that marijuana use negatively impacts brain functioning by decreasing synaptic pruning, which leads to a greater volume of gray matter and overall lowers the efficiency of communication between higher-order areas of the brain [9].”
– Instead we’ll have a frank conversation about how it affects you in your 20s and 30s. We will combine research with our own personal experience of weed addiction – unfortunately we do have plenty of both. Please check out our sources but also know this script is written by someone who used weed daily for 15 years before quitting.
As mentioned above this video focuses only on the heavy users with possibly severe cannabis use disorder and we are aware that there is also variability within those users. Unfortunately there is not yet data regarding the life outcomes of users with severe CUD specifically, which would be the corresponding research to this story. However, this story is very close to our heart and we hope it will be useful for the people who have been through similar things. That’s why we have taken the liberty of sharing our experience next to research in this video.
Becoming Addicted By Accident
– Most people slip into addiction gradually and slowly. They start using weed for a variety of reasons, to experiment, to cope or unwind from stress, because it is fun and easily available. Weed can make you feel more alive and things more exciting. Music sounds better, movies are funnier, food is a delight. It can be great fun with friends and a major source of comfort.
Cannabis addiction does not happen overnight and this makes it even more difficult to catch for some people. Motives for use may also contribute to this.
#Ouellette MJ, Rowa K, Cameron DH, et al. Why Use Cannabis? Examining Motives for Cannabis Use in Individuals with Anxiety Disorders. Behaviour Change. 2023
https://www.cambridge.org/core/journals/behaviour-change/article/why-use-cannabis-examining-motives-for-cannabis-use-in-individuals-with-anxiety-disorders/F57698ACB2D704C0FE31EA88CE39F005
Quote: “Five motives for cannabis use have been identified in the literature: coping (i.e., to manage distress), enhancement (i.e., use for fun, pleasant feeling, or the high), expansion (i.e., to change one's thinking), social (i.e., for social gatherings), and conformity (i.e., due to peer pressure; Simons, Correia, Carey, & Borsari, Reference Simons, Correia, Carey and Borsari1998). Initial research suggests that coping motives play a particularly important role in individuals who experience high levels of anxiety, consistent with the idea of using cannabis to manage negative emotions described by all three models (Boden, Babson, Vujanovic, Short, & Bonn-Miller, Reference Boden, Babson, Vujanovic, Short and Bonn-Miller2013; Buckner, Crosby, Wonderlich, & Schmidt, Reference Buckner, Crosby, Wonderlich and Schmidt2012b). Coping motives have been associated with symptoms of post-traumatic stress disorder (PTSD) as well as social anxiety and obsessive-compulsive symptoms (Boden et al., Reference Boden, Babson, Vujanovic, Short and Bonn-Miller2013; Buckner et al., Reference Buckner, Crosby, Wonderlich and Schmidt2012b; Buckner, Heimberg, Matthews, & Silgado, Reference Buckner, Heimberg, Matthews and Silgado2012c; Spradlin, Mauzay, & Cuttler, Reference Spradlin, Mauzay and Cuttler2017). For example, in Veterans with PTSD, using cannabis to cope with sleep disturbances mediated the relationship between PTSD and cannabis use frequency (Metrik et al., Reference Metrik, Jackson, Bassett, Zvolensky, Seal and Borsari2016). Veterans with PTSD have also been significantly more likely to report using cannabis to cope compared to those without PTSD (Boden et al., Reference Boden, Babson, Vujanovic, Short and Bonn-Miller2013). PTSD symptom severity was also positively associated with cannabis coping motives (Boden et al., Reference Boden, Babson, Vujanovic, Short and Bonn-Miller2013). It has also been suggested that cannabis is used to cope with social anxiety symptoms in an undergraduate population, as individuals with social anxiety are more likely to use cannabis when those around them are using compared to individuals with lower social anxiety (Buckner et al., Reference Buckner, Crosby, Wonderlich and Schmidt2012b). Coping motives have further been shown to mediate the relationship between cannabis misuse and obsessive-compulsive symptom severity in undergraduates (Spradlin et al., Reference Spradlin, Mauzay and Cuttler2017).”
#Lee CM, Neighbors C, Woods BA. Marijuana motives: young adults' reasons for using marijuana. Addict Behav. 2007
https://pmc.ncbi.nlm.nih.gov/articles/PMC2723942/
Quote: “Previous research has evaluated marijuana motives among adolescents and emerging adults using a predetermined set of motives, largely adapted from the alcohol literature. This research was designed to identify marijuana motives from the perspective of the user. Recent high school graduates who reported using marijuana (N = 634) provided self-generated reasons for using. The most frequently reported reasons included enjoyment/fun, conformity, experimentation, social enhancement, boredom, and relaxation. Regression analyses revealed that experimentation was consistently associated with less use and fewer problems whereas enjoyment, habit, activity enhancement, and altered perception or perspectives were associated with heavier use and more problems.”
#Casajuana Kögel, Cristina et al. “The relationship between motivations for cannabis consumption and problematic use.” “Relación entre las motivaciones para consumir y el consumo problemático de cannabis.” Adicciones. 2021.
https://pubmed.ncbi.nlm.nih.gov/31018002/
Quote: “Results: Using cannabis to heighten positive feelings (35%), out of habit (29%) and to cope with negative feelings (25%) were the most frequent motivations. In comparison to other motivations, coping is related to a greater quantity of cannabis used (4 vs 3 joints per day, p = 0.005), higher probability of problematic cannabis use (77% vs 64%, p = 0.05), and greater social vulnerability (unemployment 56% vs 37%, p = 0.001; and low educational level 14% vs 8%, p = 0.042).”
– The frequency with which you are consuming weed is the most obvious thing to look out for. If you are using daily or almost daily this is a clear sign you are developing a problem. As a daily user your risk of cannabis use disorder is up to 30% and certainly a pretty relevant risk, since it might take years before you realize the full weight of it.
There are many risk factors like the age of onset of use (the younger one starts the more likely the addiction), potency, motivation to use and more. Frequency is one risk factor that is a little more accessible and common, and also it is shown in literature that the risk for addiction increases with increasing frequency.
#Le Foll, Bernard et al. “Cannabis use disorder: from neurobiology to treatment.” The Journal of clinical investigation vol. 134,20 e172887. 15 Oct. 2024, doi:10.1172/JCI172887
https://pubmed.ncbi.nlm.nih.gov/39403927/
Quote: “The risk of developing CUD is influenced by various factors (1). A recent meta-analysis of observational studies with general population samples showed that people who have consumed cannabis (lifetime, recent, or regular use) have a 1 in 5 risk of developing CUD (14). The pooled prevalence estimate for CUD was 22% (95% CI: 18%–26%), and the risks were higher for younger people and for those who used cannabis daily or weekly. Modifiable factors influencing the onset of CUD include the frequency and duration of cannabis use. A recent meta-analysis pooling data from six prospective longitudinal studies found a log-linear dose-response relationship between four categorical levels of frequency of use (yearly, monthly, weekly, and daily) and the development of CUD (15). The risk of CUD increased 8-fold from a relative risk [RR] of 2.03 (95% CI, 1.85–2.22) for yearly use to a RR of 16.99 (95% CI, 11.80–24.46) for daily use. Multilevel modeling showed an absolute risk increase (ARI) from 3.5% (95% CI, 2.6–4.7) for past-year use to 36% (95% CI, 27.0–47.9) for daily use, suggesting that one-third of daily cannabis users are expected to develop CUD (15). This study showed not only that relatively infrequent use can result in CUD, but that the risk significantly increases with every additional level of use.”
Trajectories into cannabis use differ, though studies tend to find around five major types of use patterns over time.
#Mahar, A.R., Bancks, M.P., Sidney, S. et al. Trajectory modeling of cannabis use over 30 years identifies five unique longitudinal patterns. Sci Rep 13, 23070 (2023).
https://doi.org/10.1038/s41598-023-50376-x
Quote: “Five trajectory groups, each with linear order best fit the data for probability of current cannabis use, generating the largest improvement in BIC and qualitative assessment of group size and pattern (Fig. 1). Group 1 (59.4% prevalence of the study population assigned to this group) had a zero to very low probability of cannabis use across exams thus named ‘Low’. Group 2 (11.3% prevalence) had a 20%-30% probability of current cannabis use across exams, thus named ‘Moderate’. Group 3 (14.4% prevalence) was named ‘Mod-decline’ due to having a moderately high, 60–70% probability of current cannabis use at age 25, which decreased to a probability of zero by age 40 and beyond. Group 4 (6.2% prevalence) had a very high probability of current use at age 25, 90–100% probability, which decreased over the next 30 years to a probability of near zero by age 55, named ‘High-decline’. Group 5 (8.8% prevalence) had a probability of current cannabis use ≥ 80% during the 30 years of observation and was named ‘High-consistent’.”
#Borodovsky, Jacob T et al. “Quantity of delta-9-tetrahydrocannabinol consumption and cannabis use disorder among daily cannabis consumers.” Addiction. 2024.
https://onlinelibrary.wiley.com/doi/10.1111/add.16700
Quote: “Findings: Median daily consumption was ~130 mgTHC, with substantial variability (25% ≤ 50 mg and 25% ≥ 290 mg). On average, participants endorsed 2.5 CUD criteria, and 65% met criteria for CUD (39% mild, 18% moderate, 8% severe). Greater daily mgTHC predicted higher CUD criteria count [betalog(mgTHC) = 0.50, 95% confidence interval (CI) = 0.267-0.734] and higher odds of mild [log odds ratio (logOR) = 0.238, 95% CI = 0.184-0.292], moderate (logOR = 0.303, 95% CI = 0.232-0.374) or severe (logOR = 0.335, 95% CI = 0.236-0.435) CUD.
Conclusions: Among daily consumers of cannabis, there appears to be a positive relationship between the daily quantity of cannabis consumed (measured in milligrams of delta-9-tetrahydrocannabinol) and both the risk and severity of cannabis use disorder.”
– So if you are not careful about it, what started out as an occasional high becomes more and more normalized. Bit by bit your weekends revolve around weed or shift to activities that you can do stoned. Often other hobbies or obligations become less of a priority. Then it creeps into most weekdays and finally it is an established ritual every day.
Though they don’t all apply to each and every user, some of the factors that turn occasional use to use disorder are the early age of initiation, frequency and duration of use, potency of cannabis. Lack of awareness of these, especially at an early age, can by accident create the perfect basis for the later problematic use. There are also factors like mental health conditions, family and social environment, coping-oriented use and stress as well as genetic and biological factors. But every user has a unique mixture of life events and even though research suggests some strong predictors for development of addiction, they don’t unfold the same way in every one. Also the timeline and the development of the frequency is also inspired by our observations, and more of a narrative tool. We don't claim that everyone starts with weekends bleeding into weekdays, we just observed it to be a common pattern.
#National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. 2017
https://www.ncbi.nlm.nih.gov/books/NBK425740/
Quote: “CONCLUSION 13-2
Anxiety and Depression
13-2(a) There is limited evidence that childhood anxiety and childhood depression are risk factors for the development of problem cannabis use.
13-2(b) There is moderate evidence that anxiety, personality disorders, and bipolar disorders are not risk factors for the development of problem cannabis use.
13-2(c) There is moderate evidence that major depressive disorder is a risk factor for the development of problem cannabis use.
ADHD
13-2(d) There is moderate evidence that adolescent attention deficit hyperactivity disorder (ADHD) is not a risk factor for the development of problem cannabis use.
13-2(e) There is substantial evidence that stimulant treatment of ADHD during adolescence is not a risk factor for the development of problem cannabis use.
Biological Sex
13-2(f) There is moderate evidence that being male is a risk factor for the development of problem cannabis use.
Other Drug Use
13-2(g) There is moderate evidence that exposure to the combined use of abused drugs is a risk factor for the development of problem cannabis use.
13-2(h) There is moderate evidence that neither alcohol nor nicotine dependence alone are risk factors for the progression from cannabis use to problem cannabis use.
13-2(i) There is substantial evidence that being male and smoking cigarettes are risk factors for the progression of cannabis use to problem cannabis use.
Age
13-2(j) There is substantial evidence that initiating cannabis use at an earlier age is a risk factor for the development of problem cannabis use.
13-2(k) There is moderate evidence that during adolescence the frequency of cannabis use, oppositional behaviors, a younger age of first alcohol use, nicotine use, parental substance use, poor school performance, antisocial behaviors, and childhood sexual abuse are risk factors for the development of problem cannabis use.”
#van der Pol, Peggy et al. “Predicting the transition from frequent cannabis use to cannabis dependence: a three-year prospective study.” Drug and alcohol dependence (2013)
https://pubmed.ncbi.nlm.nih.gov/23886472/
Quote: “Methods: A prospective cohort of frequent cannabis users (aged 18–30, n = 600) with baseline and two follow-up assessments (18 and 36 months) was used. Only participants without lifetime diagnosis of DSM-IV cannabis dependence at baseline (n = 269) were selected. Incidence of DSM-IV cannabis dependence was established using the Composite International Diagnostic Interview version 3.0. Variables assessed as potential predictors of the development of cannabis dependence included sociodemographic
factors, cannabis use variables (e.g., motives, consumption habits, cannabis exposure), vulnerability factors (e.g., childhood adversity, family history of mental disorders or substance use problems, personality, mental disorders), and stress factors (e.g., life events, social support).
Results: Three-year cumulative incidence of cannabis dependence was 37.2% (95% CI = 30.7–43.8%). Independent predictors of the first incidence of cannabis dependence included: living alone, coping motives for cannabis use, number and type of recent negative life events (major financial problems), and number and type of cannabis use disorder symptoms (impaired control over use). Cannabis exposure variables and stable vulnerability factors did not independently predict first incidence of cannabis dependence.
Conclusions: In a high risk population of young adult frequent cannabis users, current problems are more important predictors of first incidence cannabis dependence than the level and type of cannabis exposure and stable vulnerability factors.”
– Over time, weed’s nature changes. The joy enhancing effects dissipate, while a comfortable numbness takes over. Weed can become your primary method of coping with life but it doesn’t make you stronger, better or more resilient. Instead it covers up negative emotions by building a snail shell that you can retreat into.
As cannabis use becomes more frequent and routine, it can become increasingly a tool for coping rather than recreational use. Research suggests that people who use cannabis as a coping tool tend to use it more frequently and more heavily and more likely to transition to problematic use. How this will influence the coping motives later on can be different for different people. We extrapolated based on our experiences and observations here. Of course, the scenario we are describing doesn't apply to all users.
#Hyman SM, Sinha R. Stress-related factors in cannabis use and misuse: implications for prevention and treatment. J Subst Abuse Treat. 2009 Jun;36(4):400-13. doi: 10.1016/j.jsat.2008.08.005. Epub 2008 Nov 11. PMID: 19004601; PMCID: PMC2696937.
https://pmc.ncbi.nlm.nih.gov/articles/PMC2696937/#abstract1
Quote: “These findings suggested that smoking cannabis for coping-related reasons is reported more frequently by heavier users than by experimental or occasional users, suggesting that coping motives may be more prominent in chronic use of the drug. More recently, Boys, Marsden, and Strang (2001) examined the profiles of young poly-substance users (between ages 16–22; 96.2% lifetime cannabis users) and found that 97% of cannabis users reported using in the past year to help them relax, 69% to feel better when down or depressed, and 58% to help them stop worrying about a problem. Hathaway (2003) presented experienced, mostly long-term and frequent cannabis users aged 18 to 55 with a list of 20 possible reasons for using cannabis and asked them to rate the importance of each. The author found that cannabis use as a coping mechanism was among the most important reasons for use with relaxation being the top reason and over half of the sample reporting other coping motives (to forget your worries; to blow off steam; to see the world with fresh eyes; to feel less anxious) as at least “important” for their use. Green, Kavanagh, and Young (2003) reviewed the literature examining self-reports of cannabis effects that may be associated with ongoing cannabis use and found that, while there was much variation in cannabis effects, relaxation was the most frequently reported effect and reason for use. Finally, Green, Kavanagh, and Young (2004) used a two-group longitudinal design to examine reasons for cannabis use in adult men with and without psychosis. Their findings indicated that, at baseline and follow-up, those with psychosis most commonly reported using cannabis to positively alter their mood (36% and 42%), to help cope with negative affect (27% and 29%), and for social activity reasons (38% and 29%). Those without psychosis most commonly reported using cannabis to relax (34% and 43%), and for social
activity reasons (49% and 51%)."
#Patrick ME, Peterson SJ, Terry-McElrath YM, Rogan SEB, Solberg MA. Trends in coping reasons for marijuana use among U.S. adolescents from 2016 to 2022. Addict Behav. 2024
https://pmc.ncbi.nlm.nih.gov/articles/PMC10870514/
Quote: “Motivations or reasons for substance use are theorized to be among the most proximal risk factors for subsequent use (Cooper et al., 2016; Cox & Klinger, 1988). Individual reasons for using marijuana, specifically, have become more widely researched in the past few decades (Bresin & Mekawi, 2019; Cooper et al., 2016). Coping reasons (i.e., using marijuana to relieve stress or reduce negative affect) are associated with both frequency of use and marijuana-related consequences (Blevins et al., 2016; Bravo et al., 2019; Buckner et al., 2016; Simons et al., 2016) and riskier patterns of use (i.e. solitary use; Terry-McElrath et al., 2022). Importantly, coping reasons also appear to convey long-term risk. Fox and colleagues (2011) found that adolescents who reported using marijuana to cope with negative affect reported more marijuana use problems and dependence symptoms one year later. Furthermore, Patrick and colleagues (2016) found that coping reasons at age 19/20 were predictive or marijuana use and problems at age 35, suggesting risk is conveyed across developmental transitions. Finally, a latent transition analysis demonstrated that individuals using marijuana to cope had notably high frequencies of use, were at higher risk for continued use and problems, and were likely to continue using for high-risk reasons across young adulthood (Bray et al., 2021).”
#Moitra E, Christopher PP, Anderson BJ, Stein MD. Coping-motivated marijuana use correlates with DSM-5 cannabis use disorder and psychological distress among emerging adults. Psychol Addict Behav. 2015
https://pmc.ncbi.nlm.nih.gov/articles/PMC4586302/
Quote: “Compared to other age cohorts, emerging adults, ages 18–25 years old, have the highest rates of marijuana (MJ) use. We examined the relationship of using MJ to cope with negative emotions, relative to using MJ for enhancement or social purposes, to MJ-associated problems and psychological distress among emerging adults. Participants were 288 community-dwelling emerging adults who reported current MJ use as part of a ‘Health Behaviors’ study. Linear and logistic regressions were used to evaluate the adjusted association of coping-motivated MJ use with DSM-5 Cannabis Use Disorder, MJ-related problem severity, depressive symptoms, and perceived stress. After adjusting for other variables in the regression model, using MJ to cope was positively associated with having DSM-5 cannabis use disorder (OR = 1.85, 95%CI 1.31; 2.62, p < .01), MJ problem severity (b = .41, 95% CI .24; .57, p < .01), depression (b = .36, 95% CI .23; .49, p < .01), and perceived stress (b = .37, 95% CI .22; .51, p < .01). Using MJ for enhancement purposes or for social reasons was not associated significantly with any of the dependent variables. Using MJ to cope with negative emotions in emerging adults is associated with MJ-related problems and psychological distress. Assessment of MJ use motivation may be clinically important among emerging adults.”
– Do you have a problem with weed? Super easy test: Stop doing it for four weeks, starting today. Not tomorrow, today. No matter what you have coming up. If that feels challenging or you can’t make it, this should give you food for thought.
This is not the only way one can check but it is a simple one. Addiction is not only measured by “not being able to quit” though, so this is not a clinical way to decide if you have an addiction or not.
Though there are other simple ways to try as well. If you are avoiding going to places because you will not be able to consume cannabis or putting off responsibilities regularly just to use cannabis, it might be a good idea to reflect on your use pattern.
Withdrawal timeline differs from person to person depending on factors like frequency of use, amount used, use of other substances (including alcohol) and an individual’s physical and mental health. However, a broad timeline is reported in the following paper as a peak of symptoms around 2-6 days and tapering off after three weeks. It is also important to note that there is a large amount of variation in the course and severity of cannabis withdrawal. Some patients report significant impairments to their day‐to‐day lives despite low doses and few CUD symptoms.
#Connor JP, Stjepanović D, Budney AJ, Le Foll B, Hall WD. Clinical management of cannabis withdrawal. Addiction. 2022
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9110555/
Quote: “Symptom onset typically occurs 24–48 hours after cessation and most symptoms generally peak at days 2–6, with some symptoms lasting up to 3 weeks or more in heavy cannabis users. The most common features of cannabis withdrawal are anxiety, irritability, anger or aggression, disturbed sleep/dreaming, depressed mood and loss of appetite. Less common physical symptoms include chills, headaches, physical tension, sweating and stomach pain.”
In a study with cannabis users of ages 16 to 26, researchers found that the withdrawal symptoms taper off after about three weeks. But they add subtle mood symptoms and sleep disorders might persist beyond three weeks.
#Sullivan RM, Wallace AL, Stinson EA, Montoto KV, Kaiver CM, Wade NE, Lisdahl KM. Assessment of Withdrawal, Mood, and Sleep Inventories After Monitored 3-Week Abstinence in Cannabis-Using Adolescents and Young Adults. Cannabis Cannabinoid Res. 2022 Oct;7(5):690-699. doi: 10.1089/can.2021.0074. Epub 2021 Oct 22. PMID: 34678051; PMCID: PMC9587800.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9587800/
Quote: “In this study of nontreatment-seeking and physically healthy adolescents and young adults with no psychiatric comorbidities, regular cannabis-using participants reported significantly elevated withdrawal symptoms and peaking trajectories across 3 weeks of monitored abstinence compared to control participants. Moreover, cannabis-using participants reported more mood symptoms across the study period compared to controls, yet scores do not meet clinical thresholds. Cannabis-using group reported significantly elevated sleep-related withdrawal problems across abstinence, but by week-3 did not differ in overall sleep quality or duration compared to controls. Finally, cannabis using participants did not differ on anxiety symptoms relative to control participants.”
#Kesner AJ, Lovinger DM. Cannabis use, abuse, and withdrawal: Cannabinergic mechanisms, clinical, and preclinical findings. J Neurochem. 2021 Jun;157(5):1674-1696. doi: 10.1111/jnc.15369. Epub 2021 May 16. PMID: 33891706; PMCID: PMC9291571.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291571/
Quote: “These symptoms also typically follow a reliable time course (Allsop et al., 2011; Budney et al., 2003; Hesse & Thylstrup, 2013), with sleep disturbances, somatic symptoms, and decreased appetite more prevalent during the initial several days of abstinence, followed by irritability, restlessness, and anxiety. Aggression and anger are more prominent after the first week or so of abstinence (Budney et al., 2003; Hesse & Thylstrup, 2013). Interestingly, while sleep disruption is strongest early in abstinence, vivid/unpleasant dreams can begin at a similar time point but extend for several weeks following cessation (Budney et al., 2003; Vorspan et al., 2010).”
Forever Tomorrow
– For problematic weed users, life can sometimes progress in slow motion – the addiction keeps you where you are, while your body ages and your friends move forward.
Based on the research regarding the life outcomes, some which we cited below, we extrapolated how these outcomes might have come to be in real life. We partly based it on observations and our own experiences.
#Chan, Olsen et al. “Cannabis Use During Adolescence and Young Adulthood and Academic Achievement: A Systematic Review and Meta-Analysis.” JAMA pediatrics vol. 178,12 (2024): 1280-1289. doi:10.1001/jamapediatrics.2024.3674
https://pubmed.ncbi.nlm.nih.gov/39374005/
Quote: “Results: Sixty-three studies including 438 329 individuals proved eligible for analysis. Moderate-certainty evidence showed cannabis use during adolescence and young adulthood was probably associated with lower school grades (odds ratio [OR], 0.61 [95% CI, 0.52-0.71] for grade B and above); less likelihood of high school completion (OR, 0.50 [95% CI, 0.33-0.76]), university enrollment (OR, 0.72 [95% CI, 0.60-0.87]), and postsecondary degree attainment (OR, 0.69 [95% CI, 0.62-0.77]); and increased school dropout rate (OR, 2.19 [95% CI, 1.73-2.78]) and school absenteeism (OR, 2.31 [95% CI, 1.76-3.03]). Absolute risk effects ranged from 7% to 14%. Low-certainty evidence suggested that cannabis use may be associated with increased unemployment (OR, 1.50 [95% CI, 1.15-1.96]), with an absolute risk increase of 9%. Subgroup analyses with moderate credibility showed worse academic outcomes for frequent cannabis users and for students who began cannabis use earlier.
Conclusions and relevance: Cannabis use during adolescence and young adulthood was probably associated with increases in school absenteeism and dropout; reduced likelihood of obtaining high academic grades, graduating high school, enrolling in university, and postsecondary degree attainment; and perhaps increased unemployment. Further research is needed to identify interventions and policies that mitigate upstream and downstream factors associated with early cannabis exposure.”
#Castellanos-Ryan, N., Morin, É., Rioux, C., London-Nadeau, K., & Leblond, M. (2021). Academic, socioeconomic and interpersonal consequences of cannabis use: a narrative review. Drugs: Education, Prevention and Policy, 29(3), 199–217. https://doi.org/10.1080/09687637.2021.1906846
Quote: “A systematic literature review (Goldenberg et al., 2017) recently reviewed studies of associations between cannabis use and quality of life, defined as a subjective and multidimensional concept that measures physical, psychological, emotional and social well-being. Overall, studies on the topic show that in the general population, recreational cannabis use was weakly associated with a lower quality of psychological life (e.g. self-efficacy, social adjustment, life satisfaction), but the results were inconclusive for physical quality of life (e.g. physical health, pain, motor ability, handicaps). In addition, a high frequency of cannabis use was associated with a lower quality of psychological life compared to occasional use (Goldenberg et al., 2017). A study examining the trajectories of cannabis use from the first year at university over seven years also found that chronic cannabis users (who had a high frequency of use across the seven years) and late increase cannabis users (who consumed little at the start of the study, but had a high frequency of use by the end of the study) had a lower psychological and physical quality of life at the end of the study compared to the other cannabis use groups (which included non-users, low-stable users, those with early but declining use and those who used cannabis through college but not later (Caldeira et al., 2012)). In individuals meeting cannabis use disorder criteria, overall quality of life decreased with increasing dose (quantity) of cannabis used (Goldenberg et al., 2017). However, again, since most of the studies listed were cross-sectional or did not control for quality of life before the start of cannabis use, the direction of the relationship as well as the causality cannot be determined. One longitudinal study did examine the effect of remission from a cannabis use disorder on the quality of psychological life, and found that the change in the level of psychological quality of life did not differ between participants in remission and participants who still had a cannabis use disorder (Rubio et al., 2013).”
Quote#2: “Despite mixed results, results of prospective and longitudinal studies are more consistent than the results of cross sectional studies, with the most pronounced and consistent results concerning cannabis use dependence. For example, a longitudinal study of 947 participants (Cerda et al., 2016) found that users who were dependent on cannabis had more financial difficulties (e.g. self-reported debt and cash flow issues, difficulty to pay for basic expenses, being on welfare benefit, having low credit ratings) than non-users. Similarly, Boden et al. (2017) found that addiction to cannabis increased the risk of not having a job 3 to 5 years later, but the effects were bidirectional since unemployment was also associated with a higher risk of being addicted to cannabis 3 to 5 years later.
There is also support for the negative effects of cannabis use frequency on employment. For example, Fergusson and Boden (2008) conducted analyses on 1003 participants and
found that an increase in the frequency of cannabis use between age 14 and 21 years was associated with a higher frequency of unemployment and dependence on social assistance as well as a lower income between 21 and 25 years, with a particularly high effect among the group consuming the most (400þ times between 14 and 21 years old). Danielsson et al. (2015) studied 42240 Swedish men enrolled in compulsory military service between ages 18 and 20 years in 1969–1970. They found a small effect where cannabis use before enrollment was associated with higher risks of dependence on social assistance (for all levels of consumption) and unemployment (only for the group reporting having consumed cannabis 50þ times) later between 1990 and 1995. In a longitudinal study of 2606 Norwegians, Pedersen (2011) found that the frequency of cannabis use between the
ages of 21 and 28 increased the risk of receiving social assistance in the following two years, especially when consumption was high (50þ times in the past 12 months). However,
after controlling for confounding variables including psychopathology and use of other substances, the strength of the association decreased substantially. A study by Arria et al.
(2013) found that users of cannabis at university differed from non-users, with users more likely to be unemployed compared to employed part-time. However, there was no difference between groups in terms of full-time employment.”
– But youth masks stagnation. For years you don’t notice how much weed might be holding you back, because if you are young, life changes by itself – The outside world takes on the initiative and provides a lot of support for you. You are surrounded by peers, may still have childhood friends, progress through school, start work or university and find new places and friendships.
How the occasional use turns eventually into problematic use is difficult to generalise over all users. The trajectory of the use pattern depends on many parameters which can be interdependent and also confounding. On top of it, there are not a lot of longitudinal studies looking into life outcomes at different points in time in a large representative sample. We tried to paint a picture with the limited data we came across and filled the gaps with our own observations, to be able to tell this story.
Following study is an example of the use pattern trajectories and the life outcomes. Of course it is not possible to make overarching generalisations over all users based on the findings of this study only. We tried to interpret the findings and tried to speculate how these findings might be experienced by the users in real life, partly based on our own observations.
#Epstein M, Hill KG, Nevell AM, Guttmannova K, Bailey JA, Abbott RD, Kosterman R, Hawkins JD. Trajectories of marijuana use from adolescence into adulthood: Environmental and individual correlates. Dev Psychol. 2015 https://pmc.ncbi.nlm.nih.gov/articles/PMC4623873/#S24
Quote: “It is important to note that different patterns of functioning were present at different ages. At age 21, the late-onset, nonuser, and adolescent-limited groups all showed generally similar levels of functioning with regards to positive school and work, positive family relationships, and levels of anxiety. Moffitt (1993, 2003) noted that this equifinality is typical at the peak ages of problem behavior and can make it difficult to distinguish normative rise in substance use that is limited to the adolescent years from enduring and more problematic patterns. Because of this, Cicchetti and Rogosch (2002) noted that follow-up beyond the peak years is necessary to determine whether certain patterns are indeed associated with negative outcomes. When functioning was assessed again at age 33, the multifinality between these three groups became more clear.”
– It is the easiest time to build a healthy social life, the greatest predictor of how happy you will be over the next few decades. You will likely never have fewer responsibilities again, so you can explore and take risks.
#Liz Mineo. The Harvard Gazette. Good genes are nice, but joy is better. 2017.
Quote: “Over the years, researchers have studied the participants’ health trajectories and their broader lives, including their triumphs and failures in careers and marriage, and the finding have produced startling lessons, and not only for the researchers.
“The surprising finding is that our relationships and how happy we are in our relationships has a powerful influence on our health,” said Robert Waldinger, director of the study, a psychiatrist at Massachusetts General Hospital and a professor of psychiatry at Harvard Medical School. “Taking care of your body is important, but tending to your relationships is a form of self-care too. That, I think, is the revelation.”
Close relationships, more than money or fame, are what keep people happy throughout their lives, the study revealed. Those ties protect people from life’s discontents, help to delay mental and physical decline, and are better predictors of long and happy lives than social class, IQ, or even genes. That finding proved true across the board among both the Harvard men and the inner-city participants.”
#Single et al. Cannabis use and social anxiety in young adulthood: A meta-analysis. Addictive Behaviors. 2022.
https://www.sciencedirect.com/science/article/pii/S0306460322000417
Quote: “Young adulthood (ages 18 to 30 years old), a developmental age of exploration, is marked by new experiences and transitions. Cannabis use frequency is highest in young adulthood compared to other age periods. Social anxiety (characterized by fear, shyness, and inhibition in social situations where scrutiny and judgment is possible) is also prevalent during young adulthood. Social anxiety may be a complex predictor of cannabis use frequency and problems (e.g., any negative physical, emotional, or social outcome from use). Social anxiety may act as a risk factor as individuals may use cannabis frequently to manage their fear of negative evaluation and associated unpleasant affective states.”
– Around this time most people naturally tone down their weed consumption or quit entirely.
#Mahar, A.R., Bancks, M.P., Sidney, S. et al. Trajectory modeling of cannabis use over 30 years identifies five unique longitudinal patterns. Sci Rep 13, 23070 (2023).
https://www.nature.com/articles/s41598-023-50376-x
#Epstein M, Hill KG, Nevell AM, Guttmannova K, Bailey JA, Abbott RD, Kosterman R, Hawkins JD. Trajectories of marijuana use from adolescence into adulthood: Environmental and individual correlates. Dev Psychol. 2015 https://pmc.ncbi.nlm.nih.gov/articles/PMC4623873/#S24
Quote: “Research on the predictors and consequences of marijuana use has traditionally followed a variable-driven approach that focuses on average use in the population. According to nationally representative samples, about 15% of eighth-grade students reported ever using marijuana, whereas by young adulthood over half (56%) of individuals report having used at least once in their lifetime. The average age of marijuana initiation is 18 years, after which marijuana use peaks, on average, in the early 20s and then follows a steady decline (SAMHSA, 2012).”
Quote: “Chronic users tended to initiate marijuana use by middle adolescence, between ages 14 and 15, and continued using at a stable rate into adulthood (Brook, Lee, et al., 2011; Brook, Zhang, & Brook, 2011; Caldeira et al., 2012). Prevalence in chronic use trajectories varied between 1.8% and 23.2% of the samples. In studies that identified adolescent-limited trajectories, individuals with adolescent-limited use typically began marijuana use in the early to mid-teen years, peaked in early adulthood, and then dropped steadily to little or no use by the late 20s (Juon et al., 2011; Pahl, Brook, & Koppel, 2011). This group has also been labeled “college-peak users” (Caldeira et al., 2012), and “maturing-out users” (Brook, Lee, et al., 2011). The fourth commonly estimated trajectory was characterized by increasing use and included individuals who initiated use in middle or later adolescence but then continued with a sharp or steady increase in use into their 20s and 30s (Brook, Zhang, et al., 2011; Ellickson et al., 2004). Other, less commonly reported trajectories included occasional, experimental, or light users that all reported using marijuana infrequently. Finally, the last set of trajectories, referred to as “quitters” (Pahl et al., 2011), “early adulthood decliners” (Juon et al., 2011), and “early decliners” (Caldeira et al., 2012), were all similar in that marijuana use ultimately declined to no use.”
– Studies show that for some people weed can worsen social anxiety especially if you start using more and more. And once you feel anxious about socializing, it becomes pretty tempting to just stay home and avoid events or new experiences.
There is a bidirectional and complex relationship between cannabis use and social anxiety. Some users with social anxiety actually use cannabis to manage their anxiety. This might lead to escalated use and more cannabis related problems, while keeping other coping mechanisms at bay. However, this is not necessarily true for all users with social anxiety.
#Bárbara dos Anjos et al. Subjective, behavioral and neurobiological effects of cannabis and cannabinoids in social anxiety. Reviews in the Neurosciences. 2024
https://www.degruyterbrill.com/document/doi/10.1515/revneuro-2023-0078/html
Quote: “One hundred and seventeen (117) original studies were identified. After the exclusion criteria, eighteen (18) studies were selected. The studies investigated the effects of the cannabinoids Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in patients or healthy volunteers submitted to tasks that assessed social anxiety. Results showed that CBD decreases social anxiety, producing an inverted U-shaped curve, with anxiety measurements being reduced at intermediate doses administered orally (300–600 mg), but not at lower or higher doses. THC either reduces (lower doses, 6–7.5 mg) or increases (higher doses) social anxiety measurements."
#Myran, Daniel T. et al. Development of an anxiety disorder following an emergency department visit due to cannabis use: a population-based cohort study. eClinicalMedicine. 2024.
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00034-8/fulltext
Quote: “Our study included 12,099,144 individuals aged 10–105 without prior care for an anxiety disorder in the ED or hospital, of which 34,822 (0.29%) had an incident ED visit due to cannabis. Within 3-years of an incident ED visit due to cannabis, 12.3% (n = 4294) of individuals had an incident ED visit or hospitalization for an anxiety disorder—a 3.7-fold (adjusted Hazard Ratio [aHR] 3.69 95% CI 3.57–3.82) increased risk relative to the general population (1.2%). In secondary analysis, further excluding individuals with prior outpatient care for anxiety disorders, 23.6% of individuals with an ED visit due to cannabis had an incident outpatient visit, ED visit, or hospitalization for an anxiety disorder within 3-years compared to 5.6% of individuals in the general population (aHR 3.88 95% CI 3.77–2.99). The risk of having an incident healthcare visit for an anxiety disorder was higher in individuals with ED visits for cannabis use compared to the general population across all age and sex strata. However, younger males with ED visits for cannabis use (aHR 5.67 95% CI 5.19–6.21) had a greater risk relative to the general population than younger women with cannabis use (aHR 3.22 95% CI 2.95–3.52).”
#Nicholas C. Glodosky and Carrie Cuttler. Motives Matter: Cannabis use motives moderate the associations between stress and negative affect. Addictive Behaviors. 2020.
https://www.sciencedirect.com/science/article/abs/pii/S0306460319307701
Quote: “In line with these findings, those who use cannabis for coping motives (i.e., to cope with stress and other problems) have poorer mental health, greater pathology, and more distress than non-users (Brodbeck, Matter, Page, & Moggi, 2007). In contrast, the association between cannabis use and distress was not found in those who used cannabis predominantly for social reasons (Brodbeck et al., 2007). Similarly, while both coping and conformity motives for cannabis use are associated with social anxiety, only coping motives mediate the link between social anxiety and cannabis related problems (Buckner et al., 2007). Collectively these findings indicate that using cannabis to cope with stress and negative affect is associated with negative outcomes, while other motives for cannabis use may not be associated with such detrimental outcomes.”
#Patel, Tapan A et al. “Prevalence and correlates of cannabis use among individuals with DSM-5 social anxiety disorder: Findings from a nationally representative sample.” Journal of psychiatric research. 2023
https://pubmed.ncbi.nlm.nih.gov/37276644/
Quote: “Cannabis use disorder (CUD) and frequency of use are highly related to social anxiety disorder (SAD). With updates to diagnostic criteria of psychiatric disorders and recent changes in cannabis laws, the present study sought to explore the relationships between cannabis use, CUD, and social anxiety in a large nationally representative sample of individuals with lifetime (N = 1255) and past-year SAD (N = 980). Notably, we found that at the symptom level, at least weekly cannabis use was significantly related to fear or avoidance of social situations interfering with relationships in both samples. Weekly + cannabis use and CUD were significantly associated with lifetime SAD symptom severity, but only weekly + cannabis use was related to SAD severity in the past-year sample. We also found that weekly + cannabis use but not CUD was related to greater odds of seeking treatment for SAD and suicide attempt history. Overall, these data provide an updated examination of cannabis use and SAD using DSM-5 criteria and a large nationally representative sample and also highlight the importance of weekly + cannabis use as a marker of severity and suicide risk in individuals with SAD.”
#Single et al. Cannabis use and social anxiety in young adulthood: A meta-analysis. Addictive Behaviors. 2022.
https://www.sciencedirect.com/science/article/pii/S0306460322000417
Quote: “Results revealed a small, statistically significant positive association between social anxiety and cannabis problems (r = 0.197, k = 16, p = <0.001), and a nonsignificant association between social anxiety and cannabis use frequency (r = 0.002, k = 16, p = 0.929). The association between social anxiety and cannabis use frequency was moderated by the mean age such that samples with older mean ages exhibited a stronger correlation. Additionally, the association between social anxiety and cannabis problems was moderated by clinically significant levels of social anxiety, such that samples with fewer participants who met clinical levels of social anxiety exhibit a stronger correlation. This meta-analysis supports the idea that there is a complex relation between social anxiety and cannabis outcomes during young adulthood.”
#Single et al. Cannabis use and social anxiety in young adulthood: A meta-analysis. Addictive Behaviors. 2022.
https://www.sciencedirect.com/science/article/pii/S0306460322000417
Quote: “Social anxiety disorder (SAD) affects approximately 9–14% of the young adult population (Kessler et al., 2005, MacKenzie and Fowler, 2013) and most individuals develop SAD in adolescence or young adulthood (Grant et al., 2005). SAD is defined as having a fear or anxiety of being negatively evaluated or judged by others across a variety of situations (American Psychiatric Association [APA], 2013). This anxiety of being judged leads to subsequent avoidance of or escape from situations where one fears humiliation or rejection, such as eating in front of others, public speaking, or meeting new people (McGinn & Newman, 2013). Social anxiety is associated with many negative outcomes, such as problems with interpersonal relationships with friends, family, and partners (Rapaport et al., 2005, Sparrevohn and Rapee, 2009); difficulty in educational attainment and success (Aderka et al., 2012, Stein and Kean, 2000); and employment stability and productivity (Wittchen et al., 2000). Certain pursuits that typically occur during the young adulthood period may also be conducive to experiencing social anxiety. For example, it is normative to attend postsecondary institutions or enter the workforce during this stage, and most individuals may be cognizant of the possibility of being judged or evaluated by others.”
– Since weed numbs feelings it’s easy to push away FOMO or guilt about canceling last minute.
#Beyer et al. Brain reward function in people who use cannabis: a systematic review. Frontiers in behavioral neuroscience 2024,
Quote: “A key characteristic of regular cannabis use is altered processing of rewards (Pacheco-Colon et al., 2018). For example, people who use cannabis compared to controls show affective flattening, apathy, anhedonia, and decreased pleasure towards activities that
are not related to cannabis use (Skumlien et al., 2021)”
There is some evidence for the idea that the relationship between marihuana and lack of motivation to be causal, that is, that use of cannabis and lack of motivation are not only correlated, but use of cannabis directly causes lack of motivation.
#Pacheco-Colón I, Limia JM, Gonzalez R. Nonacute effects of cannabis use on motivation and reward sensitivity in humans: A systematic review. Psychol Addict Behav. 2018
https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC6062456&blobtype=pdf
Quote: “Martz et al.(2016) found that continued cannabis use was associated with blunted activity in the nucleus accumbens during reward anticipation even after controlling for an exhaustive set of confounds, including baseline nucleus accumbens activation. Pre-existing differences in accumbens functioning, on the other hand, did not predict later cannabis use. A longitudinal study by Lac and Luk (2018) found similar results: after controlling for confounds, being a cannabis user predicted lower self-efficacy at a later time point, whereas self-efficacy did not predict later cannabis use. Thus, there is evidence suggesting a causal relationship between cannabis use and reduced motivation and reward sensitivity.”
There is also some preliminary evidence that this effect on motivation is caused by an alteration of the sensitivity to reinforcing (a fun event, an amazing new experience) or averse (FOMO, guilt) stimuli.
#Lane, S., Cherek, D., Tcheremissine, O. et al. Acute Marijuana Effects on Human Risk Taking. Neuropsychopharmacol 30, 800–809 (2005).
https://www.nature.com/articles/1300620
Quote: “Specifically, the trial-by-trial data suggest that the increase in risk taking at the highest dose was related to a reorganization of behavior with regard to both reinforced and losing risky trials. Subjects perseverated on the risky option significantly more than under placebo conditions. We interpret this change as indicating differential sensitivity to rewards and losses, a change that was also observed following alcohol administration (Lane et al, 2004).”
– Especially if you do weed alone it can become the central focal point in your life. Reports show that many people with addictions gradually reduce the activities or hobbies they once enjoyed in favor of consuming.
Not engaging in social activities and hobbies is actually one the 11 criteria of CUD.
#American Addiction Centers. Marijuana Use Disorder: Signs of Marijuana Use, Abuse & Addiction. 2024.
https://americanaddictioncenters.org/marijuana-rehab/signs-of-abuse
Quote: “In order to be diagnosed with a cannabis use disorder, a person must manifest at least two of the 11 symptoms that the DSM-5 sets forth, and they must occur in the same 12-month period. The number of symptoms determines whether a person is diagnosed with a mild, moderate, or severe cannabis use disorder. For people concerned about their own marijuana use, or for those concerned about someone else’s use, these 11 criteria can be thought of signs to watch for. The 11 criteria, paraphrased, are as follows:
– Loss of control: using more marijuana or using it for a longer period of time than intended
– Social impairments: not engaging in important work, social, hobbies, or recreational activities because of marijuana use
– Inability to stop: having the desire to quit or to reduce the amount of marijuana used but not being able to do it
– Ignoring risks: ongoing use of marijuana despite dangers that arise around it
– Cravings: Experiencing an urge to use marijuana when not using it
– Frustration of existing issues: ongoing use even though marijuana use is worsening an existing physical or psychological problem
– Troubles in main spheres of life: due to the marijuana use, not being able to perform to one’s familiar standard at home, work, or school
– Tolerance building: over time, needing more marijuana in order to get the desired, familiar effect
– Disregarding problems caused by use: despite the negative impact that the marijuana use is having on relationships, continuing to use the drug
– Withdrawal: when not taking the familiar amount of marijuana or when stopping use completely, the emergence of withdrawal symptoms
– Disproportionate focus: dedicating too much time and too many resources to marijuana use”
#Liebregts, Nienke et al. “The role of leisure and delinquency in frequent cannabis use and dependence trajectories among young adults.” The International journal on drug policy 2015
https://www.sciencedirect.com/science/article/abs/pii/S0955395914002072
Quote: “Our findings reconfirm the importance of setting for cannabis use. Generally, participants consciously choose when and where to use cannabis (cf. Reinarman & Cohen, 2007); preferably at home settings, at the end of the day when their daily obligations were
fulfilled. The two motives, to use cannabis to be more open to experiences or to relax did not differentiate dependence trajectories. However, dependent interviewees, especially DDD, more often used cannabis alone than non-dependent interviewees, for whom it was more often a social activity (T1, 12/23 vs. 6/22; T2, 8/13 vs. 11/31 excluding non-users).
[...]
As might be expected by virtue of its definition, dependent, especially persistent dependent interviewees assigned a more central role to cannabis in their leisure time, by planning their leisure activities around cannabis use, and being inclined to prioritise cannabis over other leisure activities."
The displacement of other leisure activities in favor of substance use does not seem to be a specific feature of cannabis, but rather a general characteristic of addiction that scientists have observed for a long time.
#Cogswell and Negley. The Effect of Autonomy-Supportive Therapeutic Recreation Programming on Integrated Motivation for Treatment among Persons who Abuse Substances. Therapeutic Recreation Journal. 2011.
https://www.bctra.org/wp-content/uploads/tr_journals/32-92-1-PB.pdf
Quote: “Faulkner (1991) further describes how leisure and addiction interact when stating:
‘Addiction is a leisure disease, and dysfunctional leisure is a symptom of addiction. Naturally, there are many other factors involved in the creation of an addictive personality. But the linkage between leisure malfunction and addiction is astounding. Most people take their first drink, fix, or pill during leisure hours and as a part of leisure functioning. In that respect, addiction becomes a function of leisure and “dis-ease” of leisure. Once embarked on the addiction trail, people frequently abandon forms of leisure pursuits which do not permit alcohol and/or drug use. At this stage, dysfunctional leisure becomes a symptom of addiction.’”
– Smoking a joint drops way down their priority list.
The decreasing prevalence of cannabis use with age in young adults is well attested, but its causes have not been established, though increased responsibility is generally thought to play a role.
#Patrick ME, Kloska DD, Vasilenko SA, Lanza ST. Perceived friends' use as a risk factor for marijuana use across young adulthood. Psychol Addict Behav. 2016
https://pmc.ncbi.nlm.nih.gov/articles/PMC5222776/pdf/nihms810684.pdf
Quote: “The majority of research on the decline in the prevalence of substance use in general, and marijuana use in particular, has pointed to social roles and responsibilities of adulthood, including marriage and parenthood (Bachman et al., 2002; Bachman, Wadsworth, O’Malley, Schulenberg, & Johnston, 1997; Chen & Kandel, 1998; Homish, Leonard, & Cornelius, 2007; Leonard & Rothbard, 1999; Leonard & Homish, 2005; Oesterle, Hawkins, & Hill, 2011; Schulenberg & Maggs, 2002; Schulenberg et al., 2005). The current results suggest that, in addition to the important family and social role influences during young adulthood, understating the roles of peer influence and peer selection remains important for understanding the persistence or desistence of substance use into the late twenties. "
– Even without falling out, you may simply become incompatible if your identity becomes tied up with weed, or when your friends have a lot going on and you don’t. This happens a lot without weed, but weed can supercharge it.
A young adult who uses weed is more likely to choose friends who also use weed, even if weed use decreases for their age segment.
#Patrick ME, Kloska DD, Vasilenko SA, Lanza ST. Perceived friends' use as a risk factor for marijuana use across young adulthood. Psychol Addict Behav. 2016
https://pmc.ncbi.nlm.nih.gov/articles/PMC5222776/pdf/nihms810684.pdf
Quote: “Some have concluded that, by the end of young adulthood, marijuana users may have settled into friendships with other users that reinforce the use for all members of the peer group so that, in young adulthood, similarity between peers’ and own use of marijuana may be due primarily to choosing friends with similar substance use (Andrews et al., 2002), rather than socialization within existing friendship groups.
The increasing association between perceived friends’ use and own use of marijuana may also be due to a stronger commitment to marijuana behavior as integral to one’s identity. Marijuana users in their late twenties may be more committed to marijuana use and
therefore their perceived social friends’ use may be a stronger correlate of behavior.”
#Blevins CE, Abrantes AM, Anderson BJ, Caviness CM, Herman DS, Stein MD. Identity as a cannabis user is related to problematic patterns of consumption among emerging adults. Addict Behav. 2018
https://www.sciencedirect.com/science/article/abs/pii/S0306460317304768?via%3Dihub
Quote: “Participants reported using cannabis on an average of 17.9 (SD=11.1) days of the previous month. Correlational analyses revealed that cannabis self-concept was positively associated with frequency of use, use-related problems, several motives for use, descriptive norms, and with using cannabis alone. Multivariate analyses revealed that rates of use, problems, and social and enhancement motives were independently and positively associated (p< .05) with cannabis self-concept, while self-concept was negatively associated with desire to reduce cannabis use.”
– So many problematic weed users focus on a small circle of friends and acquaintances who are also using weed.
#White, Helene R et al. “Divergent marijuana trajectories among men: Socioeconomic, relationship, and life satisfaction outcomes in the mid-30s.” Drug and alcohol dependence 2015.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4936395/
Quote: “Although there were initially group differences across all domains, once pre-existing
confounds and co-occurring other substance use were included in the model, groups only differed in terms of partner and friend marijuana use. Chronic marijuana users reported the highest proportions of both. [...]
It is also important to consider social relationships more broadly as studies have consistently found that drug users, compared to nonusers, are more likely to have drug-using friends (Pandina et al., 2009) and partners (Homish et al., 2007; Smith et al., 2014). There is a lack of longitudinal studies, however, that have specifically explored the association between early trajectories of marijuana use and later substance use by peers and partners. One exception is a study by Brook and colleagues, which found that chronic marijuana users had the greatest number of partners who used marijuana (Brook et al., 2011) and peers who used illicit drugs (Brook et al., 2013). In addition, we are aware of no longitudinal studies that have examined whether chronic marijuana use across adolescence may negatively impact the formation of a positive social support network more generally in later adulthood.”
#Dias, Paulo C et al. “Tell me who your friends are?! The mediating role of friends' use in cannabis abuse.” Trends in psychiatry and psychotherapy. 2022.
https://www.scielo.br/j/trends/a/g3RJwNWnyZJRbNyvRq4bWhJ/?lang=en
Quote: “Method A sample of 529 Portuguese cannabis users comprising 276 males and 244 females aged from 14 to 21 years completed a sociodemographic questionnaire, the Cannabis Abuse Screening Test (CAST), and answered four questions related to cannabis use. Data were analyzed using the PROCESS macro in SPSS version 26.0.
Results Age at onset of cannabis use was negatively related to the number of friends using cannabis, while the number of friends using cannabis had a positive relationship with cannabis abuse. As predicted, the number of friends using cannabis seems to have a mediating role in the relationship between cannabis onset age use and cannabis abuse, since the indirect effect was found to be significant. The pattern of the relationships among the variables observed was found to be similar for both male and female subsets of the sample. However, males reported higher cannabis abuse than females.
Conclusion The results highlight the mediating role of friends’ use of cannabis in the relationship between age at onset of cannabis use and users’ abuse. These results highlight the importance of early intervention in cannabis use. In particular, the pattern of the relationships observed among the studied variables emphasizes the need to monitor and conduct peer training interventions or interventions to promote of social skills.”
– It is harder and takes longer to make new friends in your 30s than in your 20s, so to change your situation you need courage, energy and motivation – things weed addiction makes much harder to muster.
As a general rule, there is a small but significant effect of age in the total number of friends that people have, with older people reporting less friends. We interpret this as it being harder to make friends as you age. However, satisfaction with one’s friendships generally increases with age, and it is better correlated with general life satisfaction.
#Gillespie, B. J., Lever, J., Frederick, D., & Royce, T. (2014). Close adult friendships, gender, and the life cycle. Journal of Social and Personal Relationships
https://journals.sagepub.com/doi/10.1177/0265407514546977
Quote: “The 25,185 respondents consisted of 12,654 (50%) men and 12,531 (50%) women. Respondent gender was coded as 0 ¼ male and 1 ¼ female for regression analyses. The average age for the sample was 42.3 (SD ¼ 13.1; male M ¼ 46.1, SD ¼ 12.9; female M ¼ 38.4, SD ¼ 12.3).
[...]
Overall, the average number of friends diminishes with age for both men and women. For every type of support (i.e., celebrating one’s birthday, talking about one’s sex life, and being able to call or text if in trouble late at night), the numbers were higher among emerging and young adults compared with middle-aged or older adults. Age-related decreases in number of friends can be attributed to a number of factors."
– Worse still, people who feel lonely tend to use more weed to cope – which is linked to even more social isolation. Weed can fill the role of your best friend. It is there when you are lonely, it makes you feel ok in the moment.
#Rhew IC, Cadigan JM, Lee CM. Marijuana, but not alcohol, use frequency associated with greater loneliness, psychological distress, and less flourishing among young adults. Drug Alcohol Depend. 2021
https://pmc.ncbi.nlm.nih.gov/articles/PMC7792981/
Quote: “Greater frequency of marijuana use was associated with higher levels of loneliness, higher levels of psychological distress, and lower levels of flourishing, with the greatest difference observed for daily marijuana users compared to non-users.
[...]
Frequent marijuana use may, then, reflect a pattern of substance use that is less common for social purposes and more common for self-medication purposes to cope with negative affect (Patrick et al., 2019; Skalisky et al., 2019), especially among those with mood and anxiety disorders (Sarvet et al., 2018).”
Using weed to cope with life’s problems is part of a consumption pattern associated with solitary use and more cannabis problems:
#Toni C. Spinella, Sherry H. Stewart, Sean P. Barrett. Context matters: Characteristics of solitary versus social cannabis use. 2019.
http://onlinelibrary.wiley.com/doi/10.1111/dar.12912
Quote: “Compared to individuals reporting their most recent cannabis-using occasion as social, solitary users (n = 55) were significantly more likely to screen positive for psychosis, endorse more symptoms of cannabis abuse/dependence, report using cannabis to cope, and use cannabis on more days within the previous 30 days.”
This pattern can itself lead to loneliness and more cannabis problems:
#Chassagne, J., Raynal, P., Bronchain, J. et al. Smoking Mostly Alone as a Risk Factor for Cannabis Use Disorders and Depressive Symptoms. Int J Ment Health Addiction. 2024.
https://link.springer.com/article/10.1007/s11469-022-00956-1
Quote: “These results suggest that smoking mostly alone constitutes a risk factor for uncontrolled cannabis use and promote the relationship between cannabis use and depressive disorders, potentially through loneliness and social isolation.”
–Your love life can also suffer. Social anxiety and complacency is a great motivator to put off dating and having sexual experiences in your 20s and it doesn’t get much easier as time passes on.
This is partly based on observation and personal experience. We are aware that there is also a group of users for whom weed helps with anxiety and eases social interactions. There are also cases where it is actually used as a treatment. But please keep in mind that here we talk about heavy daily users, not medicinal use. Treatments are mostly in much smaller quantities and supposed to be used with supervision. And even if it helps with self-treatment of anxiety, in the long run one may not want to rely on large amounts of weed to manage social life since the added benefit might not be enough to outweigh the damage in the other areas of life.
– In relationships weed addiction can be extremely disruptive. Reports show that partners of daily users can feel neglected, that couple communication can break down and that trust evaporates. The addicted partner usually doesn’t realize how poorly they are handling relationship issues and can be blindsided when their love leaves them.
#White, Helene R et al. “Divergent marijuana trajectories among men: Socioeconomic, relationship, and life satisfaction outcomes in the mid-30s.” Drug and alcohol dependence vol. 156 (2015): 62-69. doi:10.1016/j.drugalcdep.2015.08.031
https://pmc.ncbi.nlm.nih.gov/articles/PMC4936395/
Quote: “In addition to marital status, it is important to examine relationship quality. Researchers typically have found that greater marijuana use during adolescence and emerging adulthood is associated with lower intimate partner relationship satisfaction, cohesion, and harmony, and more conflict (Brook et al., 2008, 2011; Fergusson and Bowden, 2008), even after controlling for potential confounding variables, such as adolescent interpersonal difficulties and parental relationships (Brook et al., 2008) and early family functioning and participant other drug use (Fergusson and Bowden, 2008).”
#Haydon KC, Salvatore JE. Relationship perceptions and conflict behavior among cannabis users. Drug Alcohol Depend. 2022
https://pmc.ncbi.nlm.nih.gov/articles/PMC9816374/
Quote: “Across these objective indicators, more frequent cannabis use was associated with less effective behavior and parasympathetic response. Interestingly, more frequent cannabis use was associated with greater use of both negative engagement (i.e., demand, criticism, and blame directed at the partner) and conflict avoidance (i.e., unconstructive withdrawal
from conflict).[...]
This may suggest that, controlling for actor cannabis use, partners of more frequent cannabis users were doing more of the emotional “heavy-lifting” during conflict, perhaps recruiting more physiological resources to deal with the challenges of conflict with more frequently-using partners who may themselves be struggling with physiological regulation.[...]
More frequent cannabis use was also associated with less effective behavioral recovery in the moments after conflict.
[...]
The observed discrepancies between cannabis users’ own perceptions of relationship functioning and objective measures underscores the need to go beyond simplistic conclusions about cannabis use being either “good” or “bad” for relationships. Based on the evidence presented here, we posit that cannabis use is not harmful for (and may in fact be “protective” of) relationship perceptions. Although positive relationship perceptions may sustain satisfaction over time (Murray et al., 1996), they may lead individuals to ignore or rationalize evidence that conflicts with their perceptions (Karney et al., 2001). Moreover, our findings indicate that cannabis use may undermine productive engagement in and recovery from conflict. Conflict is an inevitable part of any relationship, and relationships grow through effective resolution of disagreements. Accordingly, chronic unconstructive approaches to disagreements may ultimately undermine relationship health (Overall and McNulty, 2017). Moreover, lack of awareness of these patterns may prevent frequent cannabis users from redirecting toward healthier conflict resolution tactics.”
Relationship dynamics can unfold differently if both parties are using. Concordant users tend to report higher relationship satisfaction compared to discordant couples.
#Crane, Cory A et al. “The couple that smokes together: Dyadic marijuana use and relationship functioning during conflict.” Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors. 2016.
https://psycnet.apa.org/record/2016-36105-001
Quote: “Self-reported marijuana use has been associated with poor relationship functioning and decreased stability over time. The present study examined the behavioral interactions of couples with concordant and discordant patterns of marijuana use during conflict, using individual self-reports and observation by independent coders. Heavy drinking community couples (N = 149) participated in a conflict resolution paradigm. Interactions were recorded and coded by naïve coders. Approximately 30% of the sample reported past year marijuana use. Actor-Partner Interdependence Models and analysis of covariance (ANCOVA) were used to evaluate the individual and interactive effects of dyadic marijuana use on maladaptive relationship functioning. A Robust Actor × Partner Marijuana Use interaction was detected for a range of behavioral outcomes, assessed by both self-report and direct observation, including relationship satisfaction, anger experience, patterns of demand and withdrawal during conflict, constructive behaviors, and overall relationship quality. Specifically, couples in which both partners used or abstained from marijuana displayed more adaptive relationship functioning across indicators relative to couples in which only 1 partner identified as a marijuana user. This pattern was particularly strong for couples in which the female partner used marijuana and the male partner did not. Couples with discordant, rather than concordant, marijuana use displayed distinct conflict resolution behaviors that were consistent with the long-term negative relationship outcomes that have been observed in previous studies. (PsycINFO Database Record”
– And to be frank, in their 30s people want a partner who is ready to share the growing responsibilities of adulthood and wants to build a life together – the older you get, the more unattractive your weed addiction makes you.
We don’t mean to stigmatize users with addiction here. What makes people attractive is very personal and not everyone find heavy use necessarily unattractive. Again we are drawing conclusions based on the CUD criteria (eg. a great deal of time spent obtaining, using, or recovering from effects of cannabis; social, occupational, or recreational activities given up or reduced because of use; continued cannabis use despite knowledge of using causing or exacerbating a medical condition; recurrent difficulties to fulfill major role obligations; recurrent use in hazardous situations; continued use despite interpersonal problems caused by cannabis use) and the literature on discordant cannabis use as cited above. Also, we are aware that people prioritize expectations from relationships differently. However, given that mean marriage and parenthood ages generally fall in 30s, we made an extrapolation regarding the common expectations during that period.
The Achievement Delay Machine
– Long term studies show that heavy weed users are more likely to end up with reduced academic performance, a worse education, lower income, less savings, and less stable employment. Even when compared to people from similar family backgrounds and social class.
#Meier, Madeline H. “Cannabis use and psychosocial functioning: evidence from prospective longitudinal studies.” Current opinion in psychology. 2021.
https://pubmed.ncbi.nlm.nih.gov/32736227/
Quote: “Infrequent adolescent cannabis use, and chronic, frequent adult use, are fairly consistently unrelated to unemployment [12–14,15,16,17]. For example, one study found that adolescent cannabis trajectory from age 12 to 19 was unrelated to age-21 employment [13]. Studies of cannabis trajectories into adulthood have consistently reported that most cannabis users, and even most chronic, frequent users, are generally not disadvantaged in terms of adult employment relative to abstainers [14,15,16,17]. However, when occupational prestige and income are considered, the evidence fairly consistently shows that chronic, frequent adult users are disadvantaged [14,15,16], generally in a dose-response fashion [14], regardless of whether cannabis onset was in adolescence or adulthood [14,15]. Adolescent users who quit are generally no worse off than abstainers in terms of occupational prestige and income in adulthood [15,16].
Chronic, frequent adult cannabis use is consistently associated with financial strain [14,15,16]. One study compared cannabis trajectories from age 15 to 35 on savings/ investments, home ownership, and welfare dependence from age 30 to 35 [15]. The trajectories with the highest levels of cannabis use had the most financial difficulties and differed from abstainers, even after adjustment for confounders [15]. Adolescent/young-adult users who quit were generally no worse off financially in adulthood than abstainers [15]. Relatedly, another study reported that persistent cannabis use from age 18 to 38 showed dose-response associations with financial strain at age 38 (a composite of net worth, troubles with debt and cash flow, difficulty paying expenses, food insecurity, welfare benefit receipt, and credit ratings), even after consideration of age-of-onset of cannabis use, cannabis-related convictions, and alcohol and hard-drug dependence [14].
Moreover, another study of cannabis trajectories from age 15 to 28 (abstainers, occasional users, decreasers, increasers, chronic users) found that the chronic and occasional users had more debt in adulthood and were more likely to have delayed medical attention for financial reasons, in covariate-adjusted models [16].”
#Pisarik C & Schleier R. Career Development in the Age of Legal Marijuana: Issues, Trends, and Solutions. National Career Development Association. 2021
https://www.ncda.org/aws/NCDA/pt/sd/news_article/372229/_PARENT/CC_layout_details/false
Quote: “Among all the stages of the career/lifespan, the emergence into adulthood is a particularly meaningful period given the psychosocial changes that occur and the foundational career tasks at hand (Arnett, 2005). Kelly and Vuolo (2018) examined role transitions marking the emergence to adulthood in a large national sample. The findings indicate that those participants who abstained from marijuana use or dabbled during emerging adulthood were significantly more likely to obtain a bachelor’s degree, secure full-time employment, and earn up to 16% higher wages than those individuals who used marijuana consistently at moderate to heavy use from 16 to 28 years of age. These findings build on previous research suggesting that marijuana use adversely affects academic performance, as well as educational and occupational attainment (Arria, et al., 2015; Fleming, et al., 2012).”
#Kelly BC, Vuolo M. Trajectories of marijuana use and the transition to adulthood. Soc Sci Res. 2018
https://pubmed.ncbi.nlm.nih.gov/29793685/
Quote: “Alongside the rise of emerging adulthood, policy contexts for marijuana have rapidly changed, with increases in availability and the number of daily users. We identify heterogeneous pathways of marijuana use from age 16 to 26, and examine how these pathways differentiate adult role transitions by age 28. Latent class analyses identified five trajectories: abstainers, dabblers, consistent users, early heavy quitters, and persistent heavy users. Dabblers are no different from abstainers on educational and labor market outcomes, and both have higher odds of adult role transitions relative to heavier use classes. Dabblers differ from abstainers on certain family transitions, yet remain distinct from the heavier use classes. Besides parenthood, early heavy quitters and persistent heavy users are similar, suggesting that heavy use is particularly detrimental early during transitions to adulthood. Distinct trajectories of marijuana use may differentiate young people into divergent pathways of transitions to adulthood, which may have long-term implications.”
#El Haddad R, Lemogne C, Matta J, Wiernik E, Goldberg M, Melchior M, Roquelaure Y, Limosin F, Zins M, Airagnes G. The association of substance use with attaining employment among unemployed job seeking adults: Prospective findings from the French CONSTANCES cohort. Prev Med. 2022
https://pubmed.ncbi.nlm.nih.gov/35961621/
Quote: “This study aimed to examine the prospective association between tobacco, alcohol and cannabis use with attaining employment among unemployed job seekers. Data from the French population-based CONSTANCES cohort on 5114 unemployed job seeking adults enrolled from 2012 to 2018 were analyzed. Binary logistic regressions were computed. Odds ratio (OR) and 95%CI of remaining unemployed at one-year of follow-up (versus attaining employment) according to substance use at baseline were obtained. The following independent variables were introduced into separate models: tobacco use (non-smoker, former smoker, light (<10cig/day), moderate (10-19cig/day) and heavy smoker (>19cig/day)), alcohol use according to the Alcohol Use Disorder Identification Test (non-users (0), low (<7), moderate (7–15) and high or very high-risk (>15)) and cannabis use (never used, no use in the previous 12 months, less than once a month, at least once a month but less than once per week, once per week or more). Analyses were adjusted for age, gender and education. At follow-up, 2490 participants (49.7%) were still unemployed. Compared to non-smokers, moderate and heavy smokers were more likely to remain unemployed, with ORs (95%CI) of 1.33 (1.08–1.64) and 1.42 (1.04–1.93), respectively. Compared to low-risk alcohol users, no alcohol users and high or very high-risk alcohol users were more likely to remain unemployed, with ORs (95% CI) of 1.40 (1.03–1.83) and 2.10 (1.53–2.87), respectively. Compared to participants who never used cannabis, participants who use cannabis once a week or more were more likely to remain unemployed, OR (95%CI) of 1.63 (1.33–2.01). Substance use may play an important role in difficulty attaining employment.”
#Barry et al. Adolescent cannabis experimentation and unemployment in young to mid-adulthood: Results from the French TEMPO Cohort study. 2022.
https://www.sciencedirect.com/science/article/abs/pii/S0376871621006967
Quote: “In A-IPW-adjusted analyses, early cannabis experimenters (≤ 16 years) had 1.71 (95% CI: 1.46–2.02) times higher odds of experiencing unemployment compared to late cannabis experimenters (> 16 years) and 2.40 (95% CI: 2.00 – 2.88) times higher odds of experiencing unemployment compared to non-experimenters. Late cannabis experimenters experienced 1.39 (95% CI: 1.17–1.68) times higher odds of being unemployed compared to non-experimenters, and early cannabis experimenters experienced 3.84 (95%CI: 2.73–5.42) times higher odds of experiencing long-term unemployment (defined as unemployed at least twice) compared to non-experimenters.
Conclusions
Participants who ever used cannabis, especially at or before the age of 16, had higher odds of experiencing unemployment, even when accounting for many psychological, academic and family characteristics which preceded cannabis initiation.”
#Liebregts N, van der Pol P, Van Laar M, de Graaf R, van den Brink W, Korf DJ. The Role of Study and Work in Cannabis Use and Dependence Trajectories among Young Adult Frequent Cannabis Users. Front Psychiatry. 2013
https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2013.00085/full
Quote: “Associations between cannabis use, education, and employment have been extensively studied. Longitudinal research has shown that adolescent cannabis use is related to poor educational performance and early school dropout (9); degree attainment and university attendance (10); and reduced occupational expectations, attainment, and stability (11). A review on young adult substance use concluded that many risk and protective factors for adolescents remain for young adults, but, given the changing social contexts, factors such as college attendance and job attainment are specific for young adults (12). Regarding later life outcomes, adolescent cannabis use is related to lower income and higher unemployment in young adulthood (5). Adult past year cannabis users are more likely to quit their job to take another job, to be unemployed between jobs and to have lower levels of employment than non-past year users, including never users (13). French et al. (14) found that weekly or more frequent cannabis use was negatively related to employment, but less frequent use was not. In a longitudinal Norwegian study, cannabis users (use at least once in the past 12 months) reported lower levels of work commitment than less frequent users, regardless of individual characteristics (15). More generally, Arria et al. (11) showed that persistent drug users (at least once in every year studied) were more likely to be unemployed than non-users, and that part-time workers were more likely than full-timers to be drug dependent. Finally, Reed et al. (16) found that high job strains and low job control increased the risk on drug dependence. Together these findings suggest the presence of a reciprocal relationship between (changes in) occupational activities and (changes in) drug use and dependence, with changes in occupational activities leading to changes in drug use/dependence and changes in drug use leading to changes in occupational activities. However, little is known about the mechanisms responsible for these changes. One classical possible mechanism that could underlie this relationship is the “amotivational syndrome,” as it has been proposed that heavy cannabis use would cause (temporary) cognitive impairment including diminished motivation and memory, lack of interest, and concentration problems. However, these symptoms may as well be an outcome of other factors, such as depression, and no clear evidence until now supports this association (9, 17, 18).”
There is also research suggesting that the effect sizes become smaller and associations not significant when the individual differences are accounted for. So it is important to consider the effect sizes and the confounders when discussing the associations between cannabis use and broader life outcomes. However, as cited above, very frequent chronic users seem to be disadvantaged on the life outcomes, even though it is difficult to establish the direction of causality.
#Popovici I, French MT. Cannabis use, employment, and income: fixed-effects analysis of panel data. J Behav Health Serv Res. 2014
https://pmc.ncbi.nlm.nih.gov/articles/PMC3867578/#abstract1
Quote: “Uncertainty exists regarding the direction and magnitude of the association between cannabis use and labor market outcomes. Using panel data from Waves 1 and 2 of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC), the current paper estimates the associations between several patterns of cannabis use during the past year, current employment, and annual personal income. In the single-equation models (Wave 2 data), nearly all patterns of cannabis use are significantly associated with worse labor market outcomes (p<.05). However, when using fixed-effects techniques to address unobserved and time invariant individual heterogeneity, the estimates are generally smaller in magnitude and less likely to be statistically significant vis-à-vis the benchmark estimates. These findings suggest that unobserved individual heterogeneity is an important source of bias in models of cannabis use and labor market outcomes. Moreover, cannabis use may be less detrimental in the labor market than other studies have reported.”
– Many people with weed addiction struggle to show up for work, they’re not productive, they procrastinate and they fail to meet their responsibilities.
#Yang, Kevin H. et al. Cannabis Use, Use Disorder, and Workplace Absenteeism in the U.S., 2021–2022. American Journal of Preventive Medicine, 2024.
https://www.ajpmonline.org/article/S0749-3797(24)00258-7/abstract#%20
Quote: “Cross-sectional data from a U.S. representative sample of full-time employed adults aged ≥18 from the 2021 to 2022 National Survey on Drug Use and Health (N=46,499) were analyzed. The associations between cannabis use recency, past-month cannabis use frequency, CUD severity, and workplace absenteeism (measured by self-reported number of missed days due to illness/injury and skipped work in the last 30 days) were evaluated using negative binomial regression, adjusting for sociodemographic characteristics and other substance use. Data were analyzed in 2023–2024.
Results
An estimated 15.9% of full-time employed adults used cannabis in the past month, with 6.5% meeting CUD criteria. Past-month cannabis use (compared to no lifetime use), more frequent past-month cannabis use (compared to no use in the past month), and each level of CUD (compared to no CUD) were associated with increased incidence of both missing work due to illness/injury and skipping work, with a dose-response relationship observed between CUD severity and skipping work (mild: adjusted incident rate ratio [aIRR]=1.60 [95% confidence interval [CI]=1.24, 2.08]; moderate: aIRR=1.98 [95% CI=1.50, 2.61]); severe (aIRR=2.87 [95% CI=2.12, 3.88]).”
#Mullin CJ, Cservenka A. Cannabis Use and Academic Performance in College Students: The Role of Procrastination. Cannabis. 2024
https://pmc.ncbi.nlm.nih.gov/articles/PMC11225980/
Quote: “These results provide partial support for the hypothesized role of procrastination as a moderator between cannabis use and academic performance, and suggest that the strength of the association between lifetime cannabis use and cumulative GPA varies with the level of procrastination, and that students with higher levels of procrastination may be particularly vulnerable to poorer academic performance at higher levels of lifetime cannabis, relative to students with lower levels of procrastination.”
#Buckner, Julia D et al. “Mental health problems and interest in marijuana treatment among marijuana-using college students.” Addictive behaviors vol. 35,9 (2010)
https://pubmed.ncbi.nlm.nih.gov/20483200/
Quote: “In fact, 80.2% of frequent users and 40.3% of infrequent users in our sample reported at least one problem with procrastination, memory loss, missing days of work/class, and decreased productivity.”
#Lac A, Luk JW. Testing the Amotivational Syndrome: Marijuana Use Longitudinally Predicts Lower Self-Efficacy Even After Controlling for Demographics, Personality, and Alcohol and Cigarette Use. Prev Sci. 2018
https://pmc.ncbi.nlm.nih.gov/articles/PMC5732901/
Quote: “The marijuana amotivational syndrome posits that cannabis use fosters apathy through the depletion of motivation-based constructs such as self-efficacy. The current study pursued a two-round design to rule out concomitant risk factors responsible for the connection from marijuana intake to lower general self-efficacy. College students (N = 505) completed measures of marijuana use, demographics (age, gender, and race), personality (extraversion, agreeableness, conscientiousness, openness, and neuroticism), other substance use (alcohol and tobacco), and general self-efficacy (initiative, effort, and persistence) in two assessments separated by a month. Hierarchical regression models found that marijuana use forecasted lower initiative and persistence, even after statistically ruling out 13 pertinent baseline covariates including demographics, personality traits, alcohol use, tobacco use, and self-efficacy subscales. A cross-lagged panel model involving initiative, effort, persistence, alcohol use, cigarette use, and marijuana use sought to unravel the temporal precedence of processes. Results showed that only marijuana (but not alcohol or tobacco) intake significantly and longitudinally prompted lower initiative and persistence. Furthermore, in the same model, the opposite temporal direction of events from lower general self-efficacy subscales to marijuana use was untenable. Findings provide partial support for the marijuana amotivational syndrome, underscore marijuana as a risk factor for decreased general self-efficacy, and offer implications and insights for marijuana prevention and future research.”
#Okechukwu CA, Molino J, Soh Y. Associations Between Marijuana Use and Involuntary Job Loss in the United States: Representative Longitudinal and Cross-Sectional Samples. J Occup Environ Med. 2019
Quote: “Marijuana use increased for all user groups with most workers who use marijuana using marijuana monthly (2.7% in 2001–2002 and10.8% in 2012–2013). Past year marijuana users in 2001–2002 had higher odds of involuntary job loss in 2003–2004 (OR 1.27; 95%CI 1.13–1.41). Daily marijuana use is associated with higher odds of job loss in adjusted analyses using longitudinal (OR 2.18; 95%CI 1.71–2.77) and cross-sectional data (OR 1.40; 95%CI 1.06–1.86). Income significantly modifies these effects.”
There are however parameters moderating the effects of cannabis use on job outcomes, like social factors or job complexity, as suggested by the following paper.
#Wang et al. Up in Smoke: Reciprocal Effects of Cannabis Use and Job Complexity on Extrinsic Career Outcomes. 2025.
https://onlinelibrary.wiley.com/doi/full/10.1002/hrm.22296
Quote: “Our study contributes to the understanding of the nomological network of cannabis use. Most research on the predictors of cannabis use focuses on socioeconomic factors such as family background, peers, gender, and ethnicity (e.g., Epstein et al. 2015). While some studies consider the impact of employment conditions on cannabis use (e.g., Boden et al. 2017; Hara et al. 2013), such studies tend to focus solely on whether users are employed or unemployed. For example, Hara et al. (2013) showed that workforce participation at the age of 23 was associated with lower cannabis consumption over time, while Teixidó-Compañó et al. (2018) found that individuals who were unemployed used more cannabis than those who were employed. While these findings are informative, they do not account for how the work environment itself, particularly job characteristics, may influence cannabis consumption. Given that most adults spend a substantial portion of their time at work and are impacted directly by the attributes of their jobs, our study extends earlier work by showing that job complexity, an important occupational characteristic, was negatively related to cannabis use, suggesting that employees who perform highly complex jobs are less likely to seek refuge in substance use. Thus, our study fills a critical gap in the literature and shows the value of considering other environmental characteristics that shape employees' substance use. For example, organizational literature often emphasizes the critical role of leadership in influencing employee outcomes, such as motivation and performance. However, to our knowledge, there is no research that examines how leadership might affect employee substance use. It is possible that employees working under abusive supervisors may turn to cannabis as a means to cope (Nandkeolyar et al. 2014). Our study also provides new insights by demonstrating that work characteristics, such as job complexity, can spill over from the work domain into personal space and influence substance use patterns.”
There is also research suggesting daily use patterns don’t effect productivity at work if it is moderate use afterwork. But again, in this script we mainly talk about heavy users with CUD. Therefore, that use pattern is not likely to reflect the profile we talk about in this video.
#Bernerth, J. B., & Walker, H. J. Altered States or Much to Do About Nothing? A Study of When Cannabis Is Used in Relation to the Impact It Has on Performance. Group & Organization Management. 2020.
https://doi.org/10.1177/1059601120917590
Quote: “As more local, state, and national governments change laws regarding the legality of cannabis use, it is essential for organizations to understand how the workplace may be influenced by these changes. The current study begins to answer this question by examining the relationship between three temporal-based cannabis measures and five forms of workplace performance. Using data from 281 employees and their direct supervisors, our results indicate that cannabis use before and during work negatively relate to task performance, organization-aimed citizenship behaviors, and two forms of counterproductive work behaviors. At the same time, after-work cannabis use was not related (positively or negatively) to any form of performance as rated by the user’s direct supervisor. We discuss methodological, theoretical, and practical implications for researchers, organizations, and governmental agencies concerned with cannabis use.”
– The consequences of missed opportunities and bad decisions slowly accumulate. Maybe you skipped networking events, had no ambition and didn’t get promoted, or hopped between entry-level jobs.
These are some extrapolations and examples that we made based on the research cited above and cannabis use disorder criteria (eg. social, occupational, or recreational activities given up or reduced because of use; recurrent difficulties to fulfill major role obligations; recurrent use in hazardous situations; continued use despite interpersonal problems caused by cannabis use) and partly as well personal observations. There is no research specifically looking into each of these parameters otherwise.
– It is also much harder to build up savings since the addiction can cost you thousands each year.
Depending on where you live and how much you consume, the yearly price of an addiction can vary substantially. Broadly speaking, one joint will roughly cost $5 in the UK and/or US. Users who consume one joint per day will spend approximately $1800 each year. “Heavy use” is typically defined as consuming one or more joints per day, so the costs can be substantially higher.
#Deveney R. The Addiction That Costs More Than a New Car. The Recovery Village. 2021
https://www.therecoveryvillage.com/drug-addiction/costs/
Quote: “Estimated Annual Cost of Marijuana Addiction: $7,000+ [...] The cost of marijuana depends on where and how it’s purchased. The average price of marijuana bought on the street ranges from about $170–$250 for an ounce, $35–$45 for an eighth and $10–$15 for a gram. Dispensary prices also vary by location, but their averages are around $170–$375 for an ounce, $30–$60 for an eighth and $7–$20 for a gram.
A typical joint contains about a third of a gram of marijuana, meaning a joint costs roughly $5 depending on the quality and strain of the weed. If a person smokes a joint once a day, that equates to an annual expense of $1,825. Although some may only use marijuana a few times a week, those who are addicted may smoke several times a day, raising the expense upward of $7,000.”
#Murphy E. The Street Cost of Marijuana. Recovered. Accessed June 2025
https://recovered.org/marijuana/the-cost-of-marijuana
Quote: “In the UK, cannabis prices vary based on the quantity and location. Here’s a brief guide on the average costs for different amounts:
1. Ounce of Weed: Prices range from £100 to £300+, influenced by quality, legality, and location. High-quality weed typically costs between £200 to £300+. Prices may be higher in areas where cannabis is illegal due to black market risks.
2. Gram of Weed: A gram’s cost varies from £5 to £15, depending on the quality and location. It’s crucial to purchase from trusted sources and understand the legal status of cannabis in your area.
3. Pound of Weed: A kilogram (or approximately 2.2 pounds) of cannabis in the UK can cost between £1,000 to £3,000, with prices differing by region. For example, London averages £2,500 to £3,000, while Glasgow ranges from £1,400 to £1,800.”
#EUDA. Herbal cannabis market in Europe. June 2025.
https://www.euda.europa.eu/media-library/herbal-cannabis-market-europe_en
– In your 20s you transition from being useless to being good at something. And so in your 30s expectations from others and yourself change sharply. People tend to cut you a lot of slack when you are young, but this has an expiration date. The older you get, the worse it feels to compare yourself to peers that are moving on in life and start achieving things. And it is not just career goals, if you spend a decade or two using weed all the time you grow less as a person. You probably traveled less, went out less, met fewer people, had fewer interesting experiences and in a way, lived less than your peers. Which also really becomes noticeable in your 30s.
This part is mostly based on our experience and observation. We are aware that it is not the same for everyone. There are many people in their 20s already who have achieved a great deal and far away from being useless, who had to shoulder a lot of responsibilities or didn't get so much slack from life. Here we mostly refer to the fact that in general people take on more responsibilities as they transition to adulthood and late 20s is the time that it happens to most people. Transition to adulthood which is marked by the conventional milestones like leaving parents house, getting a job, marriage and having kids, statistically more likely to happen during this time, even though it has been pushed to older ages in the last decades. Otherwise, the discussion of the definition of adulthood and the parameters defining the transition is beyond the scope of this video. It is a much more broad topic and for the interested viewer, we leave one review as an introductory reading.
#Skirbekk, Vegard et al. “Diverging trends in the age of social and biological transitions to adulthood.” Advances in life course research. 2025.
https://www.sciencedirect.com/science/article/pii/S1569490925000346
We are also aware that travelling, going out, collecting experiences do not only depend on the cannabis addiction, but also the economical and social factors. It might be that users with more means at their disposal might have travelled, gone out etc more compared to non-users without the means. Or even with the means available, an accompanying depression might be playing into the unwillingness. So there are many potential factors that can contribute or exacerbate the effect we describe here, it is not trivial to isolate a broad range of life outcomes to weed as a singularity. Again, this story doesnt encapsulate the experiences of all types of heavy users but glimpses of several different ones, including the ones from us.
– In some studies, long term chronic weed users had significantly lower life satisfaction, from their motivation and pursuit of personal goals, social and love life to careers and options.
While studies show that many chronic weed users report lower life satisfaction than non-users on various axes (career, social life etc.), whether this is a consistent and/or generalizable effect is still somewhat of an open question. Additionally, while cannabis use often correlates with lower life satisfaction, it is not always clear which is the cause and which is the effect. In other words, it can be hard to tell if people have lower life satisfaction because they use cannabis, or if they have lower life satisfaction and then use cannabis e.g. to cope. The quote from the first publication we list here gives a nice overview of our current understanding of the issue.
#Deligianni ML, Studer J, et al. Longitudinal Associations Between Life Satisfaction and Cannabis Use Initiation, Cessation, and Disorder Symptom Severity in a Cohort of Young Swiss Men. Int J Environ Res Public Health. 2019
https://pmc.ncbi.nlm.nih.gov/articles/PMC6518131/
Quote: “Only a few studies have explored the relationship between life satisfaction and cannabis use [6,10,11,18,19,20,21,22,23,24,25,26], and these studies mainly used cross-sectional designs, or, when using longitudinal designs, only tested the prospective association of cannabis use on later satisfaction with life. Prospective studies showed that cannabis does not have a positive impact on satisfaction with life among young adults, but has rather the opposite effect [6,21,26]. To our knowledge, only two longitudinal studies investigated associations between life satisfaction and later cannabis use, and those results were inconsistent. A recent longitudinal study conducted in Australia suggests that lower life satisfaction during early adolescence is associated with the onset of cannabis use in young adulthood [21]. In contrast, a more recent study among disadvantaged Australians failed to support any significant associations between life satisfaction and later cannabis use [27]. Nevertheless, some authors proposed that cannabis use might be motivated by unsatisfactory life conditions [20]. Therefore, consensus is lacking regarding the influence of life satisfaction on cannabis use.”
#Gruber AJ, Pope HG, Hudson JI, Yurgelun-Todd D. Attributes of long-term heavy cannabis users: a case-control study. Psychol Med. 2003
https://pubmed.ncbi.nlm.nih.gov/14672250/
Quote: “Background: Although cannabis is the most widely used illicit drug in the United States, few recent American studies have examined the attributes of long-term heavy cannabis users.
Method: Using a case-control design, we obtained psychological and demographic measures on 108 individuals, age 30-55, who had smoked cannabis a mean of 18000 times and a minimum of 5000 times in their lives. We compared these heavy users to 72 age-matched control subjects who had smoked at least once, but no more than 50 times in their lives.
Results: We found no significant differences between the two groups on reported levels of income and education in their families of origin. However, the heavy users themselves reported significantly lower educational attainment (P < 0.001) and income (P = 0.003) than the controls, even after adjustment for a large number of potentially confounding variables. When asked to rate the subjective effects of cannabis on their cognition, memory, career, social life, physical health and mental health, large majorities of heavy users (66-90%) reported a 'negative effect'. On several measures of quality of life, heavy users also reported significantly lower levels of satisfaction than controls.
Conclusion: Both objective and self-report measures suggest numerous negative features associated with long-term heavy cannabis use. Thus, it seems important to understand why heavy users continue to smoke regularly for years, despite acknowledging these negative effects. Such an understanding may guide the development of strategies to treat cannabis dependence.
[...]
Turning from demographic to self-rated measures, we asked the heavy users specific questions about the effects of cannabis on six aspects of functioning (Table 2). When given a choice of ‘positive effect’, ‘no effect’, or ‘negative effect’, substantial majorities of the heavy users reported negative effects on every index; interestingly, the percentage of subjects reporting negative effects was just as great among current heavy users as among former users (see Table 2). Similarly, on 10 measures of quality of life, where subjects rated their satisfaction as poor, fair, or good, we found that both current and former heavy users consistently reported lower levels of satisfaction than the controls, with these differences reaching significance in the case of diet, exercise and quality of spiritual life (Table 3)."
#Arria AM, Caldeira KM, Bugbee BA, Vincent KB, O'Grady KE. Marijuana use trajectories during college predict health outcomes nine years post-matriculation. Drug Alcohol Depend. 2016
https://pmc.ncbi.nlm.nih.gov/articles/PMC4724514/
Quote: “Relative to the Non-Use group, the Chronic, Late-Increase, and Early-Decline groups each fared significantly worse on the SWLS [Satisfaction with Life Scale], mental health visits, and emotion days, but did not differ significantly on GHQ. The Low-Stable group had significantly worse (i.e., lower) scores on the SWLS and more mental health visits than the Non-Use group, but slightly better (i.e., lower) GHQ scores. The College-Peak group had better SWLS and GHQ scores than the Non-Use group, but did not differ on emotion days or mental health visits.”
#Tartaglia S, Miglietta A & Gattino S. Life Satisfaction and Cannabis Use: A Study on Young Adults. Journal of Happiness Studies. 2016
https://link.springer.com/article/10.1007/s10902-016-9742-0
Quote: “Cannabis is the illicit substance most used by young adults and adolescents in rich nations. Cannabis use may have negative consequences on mental and physical health and has been associated with low wellbeing indexes (i.e., life satisfaction). The present study aims to investigate the relationship of life satisfaction with cannabis use in young adults compared with personality and sociodemographic variables. Previous studies have found relationships between the Big Five traits and cannabis use as well as a gender gap. Males have been shown to have a higher consumption of cannabis than females. We conducted a survey by means of a self-report questionnaire on a sample of 600 young adults (average age 22.20 years) and performed a regression analysis to test the relationships of sociodemographic variables, personality, and life satisfaction with cannabis use. The results confirmed the gender gap and showed an association between cannabis use and conscientiousness, agreeableness, openness and life satisfaction. Life satisfaction was negatively related to cannabis use, which suggests that this behaviour may be motivated by coping with unsatisfactory life conditions.”
The Prison of Weed
– What makes weed addiction so devious is how at first it can seem to improve your mental health. It can calm anxiety or depressive feelings, make you more relaxed and feel less lonely.
Since the acute intoxication has relaxing effects, it might feel like it is helping with anxiety and related symptoms at first glance. There are also studies looking into the potential of medicinal cannabis to help with anxiety and mood disorders. However, even for medicinal cannabis, let alone the heavy use we talk about in this video, the research does not evidently show the therapeutic effects in the long term. The temporary relief does not necessarily translate into long-term change. Also, side effects of long term recreational use might outweigh the short-term benefits, which might create more problems while trying to remedy a single one.
#Sharpe, L., Sinclair, J., Kramer, A. et al. Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties. J Transl Med. 2020.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7531079/
Quote: “Background
Cannabis has been documented for use in alleviating anxiety. However, certain research has also shown that it can produce feelings of anxiety, panic, paranoia and psychosis. In humans, Δ9-tetrahydrocannabinol (THC) has been associated with an anxiogenic response, while anxiolytic activity has been attributed mainly to cannabidiol (CBD). In animal studies, the effects of THC are highly dose-dependent, and biphasic effects of cannabinoids on anxiety-related responses have been extensively documented. A more precise assessment is required of both the anxiolytic and anxiogenic potentials of phytocannabinoids, with an aim towards the development of the ‘holy grail’ in cannabis research, a medicinally-active formulation which may assist in the treatment of anxiety or mood disorders without eliciting any anxiogenic effects.
Objectives
To systematically review studies assessing cannabinoid interventions (e.g. THC or CBD or whole cannabis interventions) both in animals and humans, as well as recent epidemiological studies reporting on anxiolytic or anxiogenic effects from cannabis consumption.
Method
The articles selected for this review were identified up to January 2020 through searches in the electronic databases OVID MEDLINE, Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO.
Results
Acute doses of CBD were found to reduce anxiety both in animals and humans, without having an anxiogenic effect at higher doses. Epidemiological studies tend to support an anxiolytic effect from the consumption of either CBD or THC, as well as whole plant cannabis. Conversely, the available human clinical studies demonstrate a common anxiogenic response to THC (especially at higher doses).
Conclusion
Based on current data, cannabinoid therapies (containing primarily CBD) may provide a more suitable treatment for people with pre-existing anxiety or as a potential adjunctive role in managing anxiety or stress-related disorders. However, further research is needed to explore other cannabinoids and phytochemical constituents present in cannabis (e.g. terpenes) as anxiolytic interventions. Future clinical trials involving patients with anxiety disorders are warranted due to the small number of available human studies.”
#Sorkhou, Maryam et al. “Cannabis use and mood disorders: a systematic review.” Frontiers in public health. 2024.
https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1346207/full
Quote: “Concerning the effects of cannabis use on mood disorders, a complex relationship exists, characterized by proposals of both harmful and therapeutic effects in animal and human populations. Evidence indicates that a significant number of people report relief of depressive symptoms during acute cannabis intoxication. A recent meta-analysis found that approximately 34% of people using medical cannabis reported the alleviation of mood symptoms, potentially including attenuation of cannabis withdrawal, as their primary reason for using cannabis (16). However, long-term, or heavy cannabis use is also associated with the exacerbation of mood symptoms (17, 18). This paradox raises questions about how cannabis might impact the development and progression of mood disorders.”
#LaFrance, Emily M et al. “Short and Long-Term Effects of Cannabis on Symptoms of Post-Traumatic Stress Disorder.” Journal of affective disorders. 2020.
https://www.sciencedirect.com/science/article/pii/S0165032720306364?via%3Dihub
Quote: “Method: Data from 404 medical cannabis users who self-identified as having PTSD were obtained from Strainprint®, a medical cannabis app that patients use to track changes in symptoms as a function of different strains and doses of cannabis across time. This sample collectively used the app 11,797 times over 31 months to track PTSD-related symptoms (intrusive thoughts, flashbacks, irritability, and/or anxiety) immediately before and after inhaling cannabis. Latent change score models were used to examine changes in symptom severity and predictors of these changes (gender, dose, cannabis constituents, time). Multilevel models were used to explore long-term consequences of repeatedly using cannabis to manage these symptoms.
Results: All symptoms were reduced by more than 50% immediately after cannabis use. Time predicted larger decreases in intrusions and irritability, with later cannabis use sessions predicting greater symptom relief than earlier sessions. Higher doses of cannabis predicted larger reductions in intrusions and anxiety, and dose used to treat anxiety increased over time. Baseline severity of all symptoms remained constant across time.
Limitations: The sample was self-selected, self-identified as having PTSD, and there was no placebo control group.
Conclusions: Cannabis provides temporary relief from PTSD-related symptoms. However, it may not be an effective long-term remedy as baseline symptoms were maintained over time and dose used for anxiety increased over time, which is indicative of development of tolerance.”
– But weed acts on your brain’s reward system and the effects can flip without you noticing. Weed can damage your ability to regulate your emotions and can worsen anxiety or depressive feelings and can escalate into serious mental disorders. Which you might think that you can self medicate against by doing even more weed.
For both depression and anxiety, current evidence suggests that the relationship with cannabis use is a “two-way street”. Meaning that using cannabis can increase your risk of developing depressive feelings and anxiety, but also that people who already suffer from them are more likely to start using cannabis to cope.
#Cannabis and mental health. Government of Canada. 2025.
https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/health-effects/mental-health.html
Quote: “Risks to mental health
If you use cannabis socially, to relax, or to cope with poor mental health, it's important to understand the long-term risks. These are some of the ways daily or near daily cannabis use can affect your mental health.
Developing anxiety and depression
Daily or near daily cannabis use over time can increase your chances of developing disorders related to anxiety and depression. Long-term daily or near daily use can also negatively impact your brain's dopamine system, which gives you feelings of pleasure and joy. This can make you feel:
fatigued
low in mood
unmotivated
Worsening anxiety and depression
Some people use cannabis to provide relief from stress or from feeling anxious or depressed. However, cannabis use has not been found to improve mental health over time. Daily or near daily cannabis use actually contributes to poor mental health, and if you use cannabis this frequently you could:
become dependent on cannabis
have trouble regulating your emotions
experience anxiety and depression more often
You're more likely to recover from long-term anxiety and depression if you reduce or stop using cannabis.”
#Langlois C, Potvin S, Khullar A, Tourjman SV. Down and High: Reflections Regarding Depression and Cannabis. Front Psychiatry. 2021
https://pmc.ncbi.nlm.nih.gov/articles/PMC8160288/
Quote: “The evidence from longitudinal studies suggest that there is a bidirectional relationship between cannabis use and depression, such that cannabis use increases the risk for depression and vice-versa. This risk is possibly higher in heavy users having initiated their consumption in early adolescence. Clinical evidence also suggests that cannabis use is associated with a worse prognosis in individuals with major depressive disorder. The link with suicide remains controversial. Moreover, there is insufficient data to determine the impact of cannabis use on cognition in individuals with major depression disorder. Preliminary evidence suggesting that the endogenous cannabinoid system is involved in the pathophysiology of depression. This will need to be confirmed in future positron emission tomography studies. Randomized controlled trials are needed to investigate the potential efficacy of motivational interviewing and/or cognitive behavioral therapy for the treatment of cannabis use disorder in individuals with major depressive major disorder. Finally, although there is preclinical evidence suggesting that cannabidiol has antidepressant properties, randomized controlled trials will need to properly investigate this possibility in humans.”
#Cuttler, Carrie et al. “A naturalistic examination of the perceived effects of cannabis on negative affect.” Journal of affective disorders. 2018.
https://www.sciencedirect.com/science/article/pii/S0165032718303100#sec0002
Quote: “Finally, examination of whether repeated use of cannabis to manage states of negative affect results in any appreciable change in baseline (pre-cannabis use) symptoms over time indicated that baseline ratings of anxiety and stress remained fairly stable across tracked sessions, while baseline ratings of depression significantly increased over time/sessions. The value of the regression coefficient indicates that for every additional tracked session over time, one would predict a 0.008-unit increase in baseline ratings of depression (i.e., after 125 treatment sessions, one would predict a 1-unit increase in baseline depression ratings on a 0 to 10 scale). This is consistent with recent evidence indicating that using cannabis to cope with distress is associated with more cannabis-related problems and increased symptoms of depression (Bonn-Miller et al., 2014, Moitra et al., 2015). Chronic cannabis use decreases CB1 receptor availability in cortical areas implicated in mood disorders (Hirvonen et al., 2012), and a growing body of preclinical evidence indicates that genetic or pharmacological CB1 receptor blockade produces a phenotype that is strikingly reminiscent of the symptom profile of major depression (see Gorzalka and Hill, 2011 for review). Collectively these results suggest that chronic use of cannabis to cope with symptoms of depression may increase susceptibility for depression by altering the endocannabinoid system. Fortunately, alterations in CB1 receptor availability in chronic cannabis users are reversible after only a short (∼2 day) period of abstinence, with no significant differences after 28 days of abstinence (D’ Souza et al., 2016). Finally, it is worthwhile to note that there is evidence that antidepressant medications are effective in the short-term, but that longer duration of use may actually increase vulnerability to relapse upon discontinuation (Fava, 2003). Thus, similar to more conventional pharmacological treatments, cannabis may temporarily mask symptoms of negative affect but may not effectively reduce these symptoms in the long-term.”
#Choi NG, Moore J, Choi BY. Cannabis use disorder and substance use treatment among U.S. adults. J Subst Use Addict Treat. 2024
https://pubmed.ncbi.nlm.nih.gov/39151799/
Quote: “There is some evidence that cannabis use may lead to the onset of depression and suicidality especially among young adults; however, strong evidence points to the inverse association that depression may lead to the onset of or increase in cannabis use frequency (Feingold & Weinstein, 2021; Gobbi et al., 2019; Patel et al., 2023). A systematic review found evidence of high prevalence and a 3-fold comorbid association between CUD [Cannabis Use Disorder] with major depression and CUD with generalized anxiety disorder (Onaemo et al., 2021). CUD was also found to be associated with higher risk for psychotic than nonpsychotic subtypes of bipolar disorder (Jefsen et al., 2023). Co-morbid CUD and mental disorders have clinically significant adverse consequences as they are associated with a poorer prognosis for CUD, greater symptom severity and recurrence of, and poorer treatment adherence for mental disorders (Bahorik, Leibowitz, et al., 2017; Gorelick, 2019; Tourjman et al., 2023).”
#Wallis D, Coatsworth JD et al. Predicting Self-Medication with Cannabis in Young Adults with Hazardous Cannabis Use. Int J Environ Res Public Health. 2022
https://pmc.ncbi.nlm.nih.gov/articles/PMC8834899/
Quote: “Using cannabis to reduce psychological and physical distress, referred to as self-medication, is a significant risk factor for cannabis use disorder. To better understand this high-risk behavior, a sample of 290 young adults (ages 18–25; 45.6% female) were recruited from two U.S. universities in January and February of 2020 to complete a survey about their cannabis use and self-medication. Results: seventy-six percent endorsed using cannabis to reduce problems such as anxiety, sleep, depression, pain, loneliness, social discomfort, and concentration. When predicting reasons for self-medication with cannabis, logistic regression models showed that lower CUDIT-R scores, experiencing withdrawal, living in a state where cannabis was illegal, and being female were all associated with higher rates of self-medication. Withdrawal symptoms were tested to predict self-medication with cannabis, and only insomnia and loss of appetite were significant predictors. To further explore why young adults self-medicate, each of the original predictors were regressed on seven specified reasons for self-medication. Young adults experiencing withdrawal were more likely to self-medicate for pain. Participants living where cannabis is legal were less likely to self-medicate for anxiety and depression. Living where cannabis is illegal also significantly predicted self-medicating for social discomfort—though the overall model predicting social discomfort was statistically non-significant. Finally, female participants were more likely to self-medicate for anxiety. These results suggest widespread self-medication among young adults with likely CUD and underscore the complexity of their cannabis use. The findings have implications for understanding why young adults use cannabis in relation to psychological and physical distress and for accurately treating young adults with cannabis use disorder.”
#Asselin A, Lamarre OB, Chamberland R, McNeil SJ, Demers E, Zongo A. A description of self-medication with cannabis among adults with legal access to cannabis in Quebec, Canada. J Cannabis Res. 2022
https://pubmed.ncbi.nlm.nih.gov/35619155/
Quote: “Objective
Cannabis is increasingly used for medical purposes, particularly in countries like Canada where cannabis was recently legalized for recreational use. We aimed to assess self-medication with cannabis post-cannabis legalization among adults in the Canadian province of Quebec.
Methods
This is a cross-sectional online survey of a self-selected convenience sample conducted in Quebec, Canada, from November 2020 to January 2021. Individuals aged ≥ 21 years who endorsed using cannabis bought in legal recreational cannabis stores to self-medicate a health condition were included. Data were analyzed using descriptive statistics and stratified according to sex, age, and the type of cannabis use (exclusively medical versus medical and recreational use).
Results
Four hundred eighty-nine participants were included. The median age was 34 years, and 48% were women. About 25% reported exclusive medical use of cannabis. Treated conditions included anxiety (70%), insomnia (56%), pain (53%), depression (37%), and many others. Reasons for not consulting in cannabis clinics included lack of information (52%), the complexity of the process (39%), accessibility of cannabis clinics (23%), and others.
Tetrahydrocannabinol (THC) dosage > 20% was reported by 32%. Smoking was the main route of use (81%). Possession of prescribed drugs was reported by 56%. Professionals consulted for information on cannabis included recreational cannabis store agents (36%), physicians (29%), and others.
Overall, significant differences were observed for many of the comparisons according to sex, age, and the type of cannabis use.
Conclusions
Many conditions are self-medicated with cannabis. The use of high doses of cannabis, smoking as a preferred method of use, and concurrent use of other medications may pose some risks to individuals. Addressing the reported barriers to medical access to cannabis is urgently needed.“
Even though the direction of the causality, or the causality itself, is not yet experimentally proven, self-medication emerges as the most compelling hypothesis for the association between cannabis use and anxiety disorders.
#Beletsky, Alexander et al. “Cannabis and Anxiety: A Critical Review.” Medical cannabis and cannabinoids. 2024.
https://pubmed.ncbi.nlm.nih.gov/38406383/
Quote: “Results: While several case-control and cohort studies have reported no correlation between CU/CUD and AD or state anxiety (N = 5), other cross-sectional, and longitudinal studies report significant relationships (N = 20). Meta-analysis supports anxiety correlating with CU (N = 15 studies, OR = 1.24, 95% CI: 1.06-1.45, p = 0.006) or CUD (N = 13 studies, OR = 1.68, 95% CI: 1.23-2.31, p = 0.001). PATH analysis identifies the self-medication hypothesis (N = 8) as the model that best explains the association between CU/CUD and AD or state-anxiety. Despite the support of multiple large cohort studies, causal interpretations (N = 17) are less plausible, while the common factor theory (N = 5), stress-misattribution hypothesis, and reciprocal feedback theory lack substantial evidential support.
Conclusion: The association between cannabis and anxiety is best explained by anxiety predisposing individuals toward CU as a method of self-medication. A causal relationship in which CU causes AD incidence is less likely despite multiple longitudinal studies suggesting so.”
[...]
“There are contradictory data on the role of CU/CUD in AD or state-anxiety. While there is a clear association between CU/CUD and AD, the direction of causality remains unclear, with studies reporting contradictory relationships as well as effects that become insignificant with covariate adjustment. The most compelling evidence lies in favor of the self-medication hypothesis, with the common factor theory, stress-misattribution hypothesis and reciprocal feedback theory lacking substantial evidential support. Inferring causality from the CU: AD correlation is problematic given the inconsistency of associations, relatively small strengths of association, lack of specificity of effect and lack of expected increased AD incidence due to increased CU.”
– This can impair your coping skills, making you fragile and easily overwhelmed, unable to deal with stress, increase anxiety or depressive symptoms, worsen your mood, cause mood swings and irritability. The addiction can hold back a dam of bottled up negative feelings that is ready to crash into you and the people around you, at any time. Until eventually it doesn’t work anymore. Especially during a mental health crisis, weed can make things much worse for you.
Cannabis use can have different effects depending on the person, the type of mental illness they are experiencing, and the cannabis dose. In people who suffer from schizophrenia, there is a correlation between cannabis use and worsening symptoms. For psychosis, the evidence supports an increased risk of psychosis associated with cannabis use. There is still an ongoing debate on whether cannabis use is generally the cause of these negative effects, or whether cannabis use is caused by mental illness. In different people, one or the other might be true.
For both depression and anxiety, current evidence suggests that the relationship with cannabis use is a “two-way street”. Meaning that using cannabis can increase your risk of developing depressive feelings and anxiety, but also that people who already suffer from them are more likely to start using cannabis to cope.
#Lowe DJE, Sasiadek JD, Coles AS, George TP. Cannabis and mental illness: a review. Eur Arch Psychiatry Clin Neurosci. 2019
#Solmi M, De Toffol M et al. Balancing risks and benefits of cannabis use: umbrella review of meta-analyses of randomised controlled trials and observational studies. BMJ. 2023
https://pmc.ncbi.nlm.nih.gov/articles/PMC10466434/
Quote: “Regarding harmful outcomes, among all meta-analytical associations supported by at least suggestive evidence in observational studies and moderate certainty in randomised controlled trials, converging evidence supports an increased risk of psychosis associated with cannabinoids in the general population. Specifically, cannabis use was associated with psychosis in adolescents (highly suggestive credibility, convincing certainty in main sensitivity analyses) and adults (suggestive credibility, suggestive certainty), and with psychosis relapse in people with a psychotic disorder (weak credibility, suggestive certainty). Use of cannabinoids in adult non-clinical and clinical populations was associated with positive (high certainty) and negative (moderate certainty) psychotic symptoms in randomised controlled trials.”
#Choi NG, Moore J, Choi BY. Cannabis use disorder and substance use treatment among U.S. adults. J Subst Use Addict Treat. 2024
https://pubmed.ncbi.nlm.nih.gov/39151799/
Quote: “There is some evidence that cannabis use may lead to the onset of depression and suicidality especially among young adults; however, strong evidence points to the inverse association that depression may lead to the onset of or increase in cannabis use frequency (Feingold & Weinstein, 2021; Gobbi et al., 2019; Patel et al., 2023). A systematic review found evidence of high prevalence and a 3-fold comorbid association between CUD [Cannabis Use Disorder] with major depression and CUD with generalized anxiety disorder (Onaemo et al., 2021). CUD was also found to be associated with higher risk for psychotic than nonpsychotic subtypes of bipolar disorder (Jefsen et al., 2023). Co-morbid CUD and mental disorders have clinically significant adverse consequences as they are associated with a poorer prognosis for CUD, greater symptom severity and recurrence of, and poorer treatment adherence for mental disorders (Bahorik, Leibowitz, et al., 2017; Gorelick, 2019; Tourjman et al., 2023).”
#Beletsky, Alexander et al. “Cannabis and Anxiety: A Critical Review.” Medical cannabis and cannabinoids. 2024.
https://pubmed.ncbi.nlm.nih.gov/38406383/
Quote: “Results: While several case-control and cohort studies have reported no correlation between CU/CUD and AD or state anxiety (N = 5), other cross-sectional, and longitudinal studies report significant relationships (N = 20). Meta-analysis supports anxiety correlating with CU (N = 15 studies, OR = 1.24, 95% CI: 1.06-1.45, p = 0.006) or CUD (N = 13 studies, OR = 1.68, 95% CI: 1.23-2.31, p = 0.001). PATH analysis identifies the self-medication hypothesis (N = 8) as the model that best explains the association between CU/CUD and AD or state-anxiety. Despite the support of multiple large cohort studies, causal interpretations (N = 17) are less plausible, while the common factor theory (N = 5), stress-misattribution hypothesis, and reciprocal feedback theory lack substantial evidential support.
Conclusion: The association between cannabis and anxiety is best explained by anxiety predisposing individuals toward CU as a method of self-medication. A causal relationship in which CU causes AD incidence is less likely despite multiple longitudinal studies suggesting so.”
In addition to that, a regular heavy user is likely to experience withdrawal, which can also manifest as anxiety, irritability, mood disorders.
#Cleveland Clinic. Marijuana (Weed) Withdrawal. Retrieved July 2025.
https://my.clevelandclinic.org/health/diseases/marijuana-weed-withdrawal
Quote: “What are the symptoms of marijuana withdrawal?
The most common marijuana withdrawal symptoms include:
Anger, irritability and aggression.
Nervousness and anxiety.
Restlessness.
Decreased appetite, which may lead to weight loss.
Depressed mood.
Insomnia.
Disturbing dreams and nightmares.”
– On the flipside there is research that shows that addicted people who give up weed experience a noticeable improvement in their mental health.
It is still relatively new research and there are not dozens of papers, but current evidence points to improvements in depressive symptoms upon abstinence of as short as one month. But again, how quickly different mental health aspects recover depends on the level of use and can also be different among users with similar use patterns, depending on other aspects of social environment and support. Since depressive symptoms often precede cannabis use, it is difficult to isolate the effects of confounding parameters. But the important point we wanted to stress here is that it is never too late to quit and there is no point-of-no-return beyond which there are no health benefits.
#Lucatch, AM; Kloiber, SM et al. Effects of Extended Cannabis Abstinence in Major Depressive Disorder. Canadian Journal of Addiction. 2020
https://doi.org/10.1097/CXA.0000000000000090
Quote: “Background:
Individuals with major depressive disorder (MDD) have higher rates of problematic cannabis use than the general population. Recent meta-analyses have found a link between cannabis use and increased risk for depression, suicidal behavior, and suicidal ideation. Few studies to date have examined the effects of cannabis use in individuals diagnosed with MDD.
Objectives:
We examined the effects of cannabis abstinence on clinical symptoms of depression in adults with comorbid cannabis use disorder (CUD) and MDD.
Method:
Participants with comorbid CUD and MDD (n = 11) underwent 28 days of cannabis abstinence. Mood symptoms were assessed weekly using the Hamilton Depression Rating Scale, the Beck Anxiety Inventory, the Snaith Hamilton Pleasure scale. Abstinence was biochemically verified using weekly urine assays for 11-nor-9-carboxy-Δ9-tetrahydrocannnabinol (THC-COOH), a metabolite of THC, and participants were rewarded with a contingent bonus if abstinence was confirmed.
Results:
72.7% of study completers achieved abstinence. In all participants, including those who relapsed, urinary THC-COOH was significantly reduced throughout the study (P = 0.002). Participants exhibited significant improvements in depressive symptoms (43.7% reduction from baseline; P = 0.008), especially anhedonia (88.7% reduction from baseline; P < 0.001).
Scientific significance:
Findings from this study suggest that extended abstinence from cannabis is associated with improvement of depressive symptoms, particularly anhedonia, in individuals with MDD and CUD. Our results indicate that addressing problematic cannabis use in the treatment of individuals with MDD can improve clinical outcomes.”
#Sorkhou, Maryam et al. “Effects of 28 days of cannabis abstinence on cognition in major depressive disorder: A pilot study.” The American journal on addictions. 2022.
https://onlinelibrary.wiley.com/doi/abs/10.1111/ajad.13305
Quote: “Methods: We evaluated the effects of 28 days of cannabis abstinence on cognition in MDD patients with comorbid CUD facilitated by contingency management, motivational interviewing, psychoeducation, and coping-skills training (N = 11). Primary outcomes included Baseline to Day 28 changes in verbal memory and learning, while secondary outcomes included Baseline to Day 28 changes in working memory, visuospatial working memory (VSWM), visual search speed, mental flexibility, response inhibition, attention, manual dexterity, and fine motor movement.
Results: Eight participants (72.7%) met the pre-specified criteria for cannabis abstinence and three participants significantly reduced their cannabis use (≥90%). Visual search speed, selective attention, and VSWM improved over the study period. These improvements were not associated with changes in cannabis metabolite levels from baseline to endpoint.
Discussion and conclusions: Our findings suggest that 28 days of cannabis abstinence may improve select cognitive domains in patients with MDD and comorbid CUD.
Scientific significance: This is the first study to longitudinally examine the effects of cannabis on cognition in MDD.” [MDD: major depressive disorder]
#Rodas JD, Sorkhou M, George TP. Contingency Management for Treatment of Cannabis Use Disorder in Co-Occurring Mental Health Disorders: A Systematic Review. Brain Sci. 2022
https://pmc.ncbi.nlm.nih.gov/articles/PMC9855987/#abstract1
Quote: “Amongst individuals with a mental health disorder, a comorbid diagnosis of cannabis use disorder (CUD) is associated with numerous adverse consequences, including more severe symptom profiles, poorer treatment response, and reduced psychosocial functioning. Contingency management (CM), a method to specifically reinforce target behavior attainment (e.g., substance use abstinence), may provide an effective intervention in treating cannabis use in patients with a dual diagnosis of CUD and a mental health disorder. A systematic search examining the effects of CM on cannabis use, clinical, cognitive, and psychosocial outcomes in patients with a mental health disorder on PubMed, PsycINFO, and EMBASE databases up to November 2022 was performed. Six studies met inclusion criteria for our review. We found CM to be efficacious in producing cannabis use reductions and abstinence amongst individuals with a psychotic-spectrum or major depressive disorder. Additional longitudinal studies with larger sample sizes, other psychiatric populations, and longer follow-up periods are needed to evaluate the sustained effects of CM.”
#Rabin RA, Barr MS et al. Effects of Extended Cannabis Abstinence on Cognitive Outcomes in Cannabis Dependent Patients with Schizophrenia vs Non-Psychiatric Controls. Neuropsychopharmacology. 2017
https://pmc.ncbi.nlm.nih.gov/articles/PMC5603819/
Quote: “Cross-sectional studies of the effects of cannabis on cognition in schizophrenia have produced mixed results. Heavy and persistent cannabis use in schizophrenia is a common clinical problem, and effects of controlled abstinence from cannabis in these patients have not been carefully evaluated. The present study sought to determine the effects of cannabis abstinence on cognition in patients with schizophrenia and co-occurring cannabis dependence. We utilized a 28-day cannabis abstinence paradigm to investigate the state-dependent effects of cannabis on select cognitive outcomes in cannabis-dependent patients with schizophrenia and non-psychiatric controls. Nineteen patients and 20 non-psychiatric male cannabis-dependent participants underwent 28 days of cannabis abstinence. Cognition was assessed on day 0, 14, and 28 using a comprehensive neuropsychological battery. Clinical symptoms were assessed weekly. Abstinence was facilitated by contingency reinforcement confirmed by twice weekly urinalysis. Forty-two percent of patients and 55% of controls achieved end-point abstinence (p=0.53), which was biochemically-verified (day 28 urinary THC-COOH <20 ng/ml). In this preliminary study, schizophrenia-abstainers demonstrated improvements in Hopkins Verbal Learning Test-Revised (HVLT-R) performance over time [F(2,14)=4.73, p<0.03] (d=1.07). Lesser improvements on HVLT-R were observed in non-psychiatric control abstainers (d=0.66), and with abstinence on other cognitive test measures, in both patients and controls. Verbal memory and learning may improve in schizophrenia and control subjects with cannabis abstinence, but larger more definitive studies are needed. Our findings underscore the importance of developing effective interventions for cannabis use disorders in schizophrenia.”
There are also studies with adolescent users showing improvements in depressive symptoms.
#Arias AJ, Hammond CJ, Burleson JA, Kaminer Y, Feinn R, Curry JF, Dennis ML. Temporal dynamics of the relationship between change in depressive symptoms and cannabis use in adolescents receiving psychosocial treatment for cannabis use disorder. J Subst Abuse Treat. 2020.
https://pubmed.ncbi.nlm.nih.gov/32811625/
Quote: “Aims: Cannabis use disorder (CUD) and depression frequently co-occur in youth. How depressive symptoms change over the course of CUD treatment and how they impact substance use treatment outcomes is unknown. In the current study, we examine the temporal relationships between cannabis use and depression in adolescents receiving evidence-based treatments for CUD as part of a multisite clinical trial.
Design: Six hundred adolescents (age 12-18) with a CUD were randomly assigned to substance use treatment from one of five evidence-based psychosocial interventions. We assessed self-reported cannabis use frequency and depressive symptoms at baseline (BL) and again at 3-, 6-, 9, and 12-months. A bivariate latent change model assessed bidirectional effects of baseline levels and time-lagged changes in depressive symptoms and cannabis use on depression and cannabis use outcomes.
Findings: Depressive symptoms (72%) and major depressive disorder (MDD) (18%) were common at BL. Both depression and cannabis use decreased over time and change in cannabis use was significantly associated with change in depressive symptoms (b = 1.22, p = .003). Time-lag analyses showed that within-subject change in depression (from one time point to the next) was predicted by previous depression (b = -0.71, p < .001) but not cannabis use (p = .068), and change (decrease) in cannabis use was predicted by previous (greater) depressive symptoms (b = -1.47, p < .001) but not cannabis use (p = .158), respectively.
Conclusion: These findings indicate an enduring relationship between decreasing cannabis use and decreasing depression among adolescents lasting for 9-months after receiving psychosocial interventions for CUD. The presence of depressive symptoms did not appear to interfere with substance use treatment or attenuate improvements in cannabis use frequency. A decrease in cannabis use was not contingent upon a reduction in depressive symptoms. These findings are limited by the possibility of regression to the mean for both cannabis use and depressive symptoms, and the lack of a nonintervention control group.”
#Cooke ME, Gilman JM, Lamberth E, Rychik N, Tervo-Clemmens B, Evins AE, Schuster RM. Assessing Changes in Symptoms of Depression and Anxiety During Four Weeks of Cannabis Abstinence Among Adolescents. Front Psychiatry. 2021
https://pmc.ncbi.nlm.nih.gov/articles/PMC8280499/
Quote: “Objective: To test the effect of 4 weeks of continuous cannabis abstinence on depressive and anxious symptoms.
Methods: Healthy, non-treatment seeking adolescents who used cannabis at least weekly (n = 179) were randomized to either 4 weeks of cannabis abstinence achieved through a contingency management paradigm (CB-Abst) or cannabis use monitoring without an abstinence requirement (CB-Mon). Abstinence was assessed by self-report verified with quantitative assay of urine for cannabinoids. Anxiety and depressive symptoms were assessed weekly with the Mood and Anxiety Symptom Questionnaire (MASQ).
Results: Symptoms of depression and anxiety decreased throughout the study for all participants (MASQ-AA: stnd beta = −0.08, p = 0.01, MASQ-GDA: stnd beta = −0.11, p = 0.003, MASQ-GDD: stnd beta = −0.08, p = 0.02) and did not differ significantly between randomization groups (p's > 0.46). Exploratory analyses revealed a trend that abstinence may be associated with greater improvement in symptoms of anxiety and depression among those using cannabis to cope with negative affect and those with potentially hazardous levels of cannabis use.
Conclusions: Among adolescents who use cannabis at least weekly, 4 weeks of cannabis abstinence was not associated with a significant change in anxiety or depressive symptoms compared to continued use. For recreational cannabis users who may be concerned about reducing their use for fear of increased symptoms of anxiety and depression, findings suggest that significant symptom worsening may not occur within the first 4 weeks of abstinence. Further studies are needed in clinical populations where anxiety and depression symptoms are measured more frequently and for a longer period of abstinence. Future studies are also needed to determine whether there are subgroups of adolescents who are uniquely impacted by sustained cannabis abstinence.”
#Schuster RM, Gilman J, Schoenfeld D, Evenden J, Hareli M, Ulysse C, Nip E, Hanly A, Zhang H, Evins AE. One Month of Cannabis Abstinence in Adolescents and Young Adults Is Associated With Improved Memory. J Clin Psychiatry. 2018
https://pmc.ncbi.nlm.nih.gov/articles/PMC6587572/
Quote: “Objective:
Associations between adolescent cannabis use and poor neurocognitive functioning have been reported from cross-sectional studies that cannot determine causality. Prospective designs can assess whether extended cannabis abstinence has a beneficial effect on cognition.
Methods:
Eighty-eight older adolescents who used cannabis regularly were enrolled in the hospital laboratory and a local high school between July 2015 and December 2016. Participants were randomly assigned to four weeks of cannabis abstinence, verified by decreasing 11-nor-9-carboxy-Δ9-tetrahydrocannabinol urine concentration (MJ-Abst; n=62), or a monitoring control condition with no abstinence requirement (MJ-Mon; n=26). Attention and memory were assessed at baseline and weekly for four weeks with the Cambridge Neuropsychological Test Automated Battery.
Results:
Among MJ-Abst, 55 (88.7%) met a priori criteria for biochemically-confirmed 30-day continuous abstinence. There was an effect of abstinence on verbal memory, p=0.002, that was consistent across four weeks of abstinence, with no time by abstinence interaction, driven by improved verbal learning in the first week of abstinence. MJ-Abst had better memory on average and at weeks 1, 2, 3 than MJ-Mon, and only MJ-Abst improved in memory from baseline to week 1. There was no effect of abstinence on attention: both groups improved similarly, consistent with a practice effect.
Conclusions:
This study suggests that cannabis abstinence is associated with improvements in verbal learning that appear to occur largely in the first week following last use. Future studies are needed to determine whether the improvement in cognition with abstinence is associated with improvement in academic and other functional outcomes.”
– Here is the thing. All the negatives we talked about, missing your life as it flies by, social isolation and not even getting close to living up to your potential are not happening some time in the future but today. No matter your age. If you find yourself addicted or in danger of becoming addicted, there is a way out. It is not fun and it will be hard. You need to quit. And the earlier you do, the better your life will be.
Dealing with substance abuse is a difficult task. You may not want to tackle it on your own and a little support can make a big difference. Whether you want to confront your addiction, help out a friend or family member, or simply ask professionals sensitive questions in confidence, there are helplines, health centers and other resources available:
USA:
SAMHSA substance abuse hotline:
https://www.samhsa.gov/about/contact
Find a Health Center map:
https://findahealthcenter.hrsa.gov/
Simplified guide for quitting weed:
https://www.weedless.org/guide/
UK:
Local drug and alcohol support:
https://www.talktofrank.com/get-help/find-support-near-you
Support for your, or someone else’s drug use:
Germany:
Addiction help hotline for you or someone else:
https://www.guttempler.de/nottelefon/
A directory of all drug and addiction counselling centres:
https://www.dhs.de/service/suchthilfeverzeichnis
Canada:
Self-help guide to change your cannabis use:
https://cannabis-hub.camhx.ca/resources/changing-your-cannabis-use.html
Directory of resources for substance use (not specific to cannabis):
https://www.canada.ca/en/health-canada/services/substance-use/get-help-with-substance-use.html
India:
Nasha Mukt Bharat Abhiyaan (Drug Free India Campaign) Website:
Australia:
Online resources and directory of support organizations:
https://cannabissupport.com.au/tools-for-quitting/
Self-help guide to quitting Cannabis:
Google Sites
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