Adults who have a medical marijuana card and use cannabis to treat symptoms of a medical condition are not the people who typically develop cannabis use disorder. The reason is that they use cannabis to combat pain or muscle spasms, inhibit vomiting or nausea, modify sleep disorders, or other conditions that interfere with everyday functioning.
That’s not to say however that cannabis can’t be misused or abused. Indeed, teenagers are particularly prone to misuse, even though cannabis, in particular delta 9- THC, cannot be used legally by young people under the age of 21 in every US state. Nevertheless, with adult/recreational use now legal in 19 states and more adults choosing to explore cannabis as an over-the-counter medication for chronic conditions that haven’t responded to other treatments, healthcare providers should find ways to have a conversation with their patients about cannabis and be educated about state laws, practice acts, and patient access to cannabis products.
Like misuse of alcohol and opioids among other substances, clinicians should be aware of “cannabis use disorder”. This condition falls under the Criteria for Substance Use Disorder in the DSM-5 which includes 11 criteria (See below). People who meet 2-3 criteria within a 12-month period would be diagnosed with a mild cannabis use disorder. Those who met 4-5 criteria would be classified as having a moderate disorder and people who meet 6 or more criteria would be diagnosed with a severe cannabis use disorder.
1. Hazardous use: using cannabis in ways that are dangerous (driving under the influence, blacking out)
2. Social or interpersonal problems related to use: using cannabis has caused relationship problems or conflicts with others
3. Neglected major roles to use: using cannabis has led to failure in meeting responsibilities
4. Withdrawal: when cannabis use is stopped there are withdrawal symptoms
5. Tolerance: a tolerance to cannabis has developed, so more is needed to achieve the same effect
6. Used larger amounts/longer: cannabis consumption is larger or for longer periods of time
7. Repeated attempts to control use or quit: there have been unsuccessful attempts to cut back or quit using cannabis
8. Much time spent using: a lot of time is spent using cannabis
9. Physical or psychological problems related to use: using cannabis has led to physical or mental health problems
10. Activities are given up: cannabis use has interfered with participation in previously enjoyable activities.
11. Craving: cravings for cannabis is experienced
If you, a family member, friend, or patient is struggling with substance misuse, contact the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.