rozroz
Well-Known Member
Definition of Addiction from the American Society of Addiction Medicine
Public Policy Statement: Definition of Addiction
Short Definition of Addiction:
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death. I dunno, not too worried about a cannabis death.
http://www.asam.org/quality-practice/definition-of-addiction
Addiction is a huge forest with many different trees. My tree is the cannabis nut tree.
you address the mental addiction to Cannabis mostly as a "regular" physical addiction.
it's a very complicated personal issue with people who mentally depend on being high all day (again, not medical MJ users), most of them won't admit it and live with themselves withing their logical explanation to why this is not addictive, really. (NOT saying you are one of them).
It is important to realize that even the formal psychiatric diagnostic criteria do not speak of cannabis addiction. Even the research looking at withdrawals is thread-bare and controversial among researchers (this does still remain within relevant diagnostic criteria in the DSM-V as we see below!).
Cannabis use disorder (the main formal diagnosis that replaced the old 'cannabis dependence or cannabis abuse' diagnoses in the DSM-IV) requires at least two out of the following twelve criteria to be met:
A problematic pattern of cannabis use leading to clinically significant impairment or distress, as manifested by at least 2 of the following, occurring within a 12-month period:
Note that points 2 and 3 of the withdrawal criteria here are very relevant in the OP's case. If you stop using cannabis to treat depressive conditions that existed before the use of the cannabis, then there is an obvious differential diagnosis that should be made here that the underlying depressive symptoms were caused by something pre-existing and hence are not withdrawal symptoms, but simply the results of cessation of treatment of a symptom with medication!
- Cannabis is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts 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.
- Craving, or a strong desire or urge to use cannabis.
- Recurrent cannabis use resulting in a failure to fulfill major 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 in situations in which it is physically hazardous.
- Cannabis use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis.
- Tolerance, as defined by either a (1) need for markedly increased cannabis to achieve intoxication or desired effect or (2) markedly diminished effect with continued use of the same amount of the substance.
- Withdrawal, as manifested by either (1) the characteristic withdrawal syndrome for cannabis or (2) cannabis is taken to relieve or avoid withdrawal symptoms.
Let's stop and consider the final criterion, withdrawal:
- Cessation of cannabis use that has been heavy and prolonged (ie, usually daily or almost daily use over a period of at least a few months).
- Three or more of the following signs and symptoms develop within approximately 1 week after cessation of heavy, prolonged use:
- Irritability, anger or aggression
- Nervousness or anxiety
- Sleep difficulty (ie, insomnia, disturbing dreams)
- Decreased appetite or weight loss
- Restlessness
- Depressed mood
- At least one of the following physical symptoms causing significant discomfort: abdominal pain, shakiness/tremors, sweating, fever, chills, or headache
- The signs or symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.
A number of other DSM-V diagnoses relate to cannabis, with diagnoses relating to cannabis related anxiety, psychosis, delirium and sleep disorders. However, these all have the same exclusionary criteria suggesting that if the titular symptom existed prior to the cannabis use, that the diagnosis of the cannabis disorder is precluded.
I hope this clears up where clinicians stand on this topic! Of course, philosophically we can talk about addiction too, but the above are the criteria by which medical professionals, insurers etc operate!
good stuff. read many articles this week regarding all this.
your point to my case, is that i can sustain being high a few nights a week, and already feel that slight withdrawal symptoms right after. yea, i know that, and that's the "price" i pay each week.
many times before getting high, i consider the effects i will have, and sometimes i make myself choose not to be high. not an easy decision!
It really makes it clear how significant the barriers are with medical cannabis for mental health doesn't it?! There is so much confusion in the community about addiction and cannabis. There is so much more confusion out there about cannabis and mental health.
There is less confusion in the letter of the literature as quoted above (although I really want to see studies demonstrating that there is a statistically significant number of people with 'cannabis withdrawals' as described above that are not explained by pre-existing symptoms that justifies including this criterion!!!), but even so, there is still great confusion among practitioners who IME are still inclined to hastily make cannabis-related diagnoses without paying attention to the exclusionary criteria (this is a big problem throughout clinical psych practice when applying the DSM and is not limited to drug related diagnoses!).
This is where we need to see progress. It starts with more careful undergrad education of psych professionals and it is especially important that the best practice in the field and new research is effectively communicated throughout clinician's careers, even long after they have left college!
interesting stuff.
the main problem is that the % of regular stoners (mostly younger people) who live with this, and making it their agenda, that it's perfectly ok being high all the time, it's no harm, it makes life better.. this is uncontrollable.