Many people will tell you that cannabis is not addictive. Or that it’s only psychologically addictive, not physically, and therefore a cannabis addiction is not nearly as ‘real’ as, say, a heroin addiction.
However, in actuality the difference between a physical and psychological addiction is non-existent. All addiction is both physical and psychological due to the fact that psychological compulsions are reflected in the physical neural pathways of the brain.
Additionally, even though an addiction may be thought to not be physical – for example, to cannabis or video games – abstinence from the stimulus can still lead to physical withdrawal symptoms such as anxiety, night sweats and general discomfort.
Try as we might to find a distinction between physical addiction and psychological addiction, the truth is that the mind and body cannot be separated and both must be considered when trying to understand and treat compulsive behaviours.
All addiction is physical and psychological
When people talk of the distinction between a physical addiction and a psychological addiction, what they are really referring to is the distinction between physical withdrawal symptoms that accompany physiological dependence and the dopamine-led process of compulsive behaviour that happens in the brain.
Without a doubt, some substances – like alcohol, opiates and benzodiazepines – can leave unregulated, long-term consumers with severe withdrawal symptoms that include all manner of physical and mental problems, from flu-like symptoms to intense anxiety and cravings, cognitive problems and pain.
In fact, the theory used to be that avoiding these severe withdrawal symptoms was the reason people would go back to their drug of choice. It was known as the Tolerance-Withdrawal-Addiction theory. However, that theory doesn’t stand up when you consider how common relapses are even once the patient has got over the withdrawal symptoms and is seemingly free of physical dependence.
What was missing was the consideration of the effects habits have on the neural pathways of the brain. Put simply, while the patient may have been free from physiological dependence on a substance, the brain was still wired in a way that made the behaviour highly attractive in terms of dopaminergic reward.
Therefore, every addiction is both physical and psychological. Even addictions that are thought to be only psychological – like cannabis and video games – have a physical aspect to them, even if the withdrawal symptoms are not as severe as they are with say opiate addiction.
Is cannabis addiction real?
People argue that because cannabis does not produce severe physical withdrawal symptoms when long-term users stop consuming, that it is only psychologically addictive. This downplays the seriousness of a cannabis habit and implies it should be easy to get over. However, many people find this is not the case.
The truth is that cannabis, especially when smoked, can be very habit forming. The main psychotropic compound in cannabis, THC, exerts its effects by acting like a neurotransmitter and stimulating receptors in the brain and body.
Many of the effects of cannabis can be attributed to THC’s direct stimulation of the CB1 receptor – think euphoria, pain-relief, increased appetite, red eyes, among other effects. However, acute (short-term) CB1 stimulation also leads to increased dopamine production.
(Chronic cannabis use can lead to the downregulation of dopamine production, meaning you need more THC for the same effects. This is known as building tolerance.)
By acutely increasing levels of dopamine in an area of the brain called the nucleus accumbens, cannabis shares an activity that all “drugs of abuse” have in common. Effectively, this makes consuming cannabis a rewarding and reinforcing behaviour that can result in an addiction.
With all this in mind, it’s safe to say that cannabis can very well be addictive to some people – just like any psychologically rewarding behaviour. It’s also fair to say that abstaining from cannabis after long-term unregulated use can lead to withdrawal symptoms such as anxiety, irritability, nausea and night sweats – signs of physical dependence.
Cannabis is not intrinsically addictive. In fact, neither is heroin or any other substance. Rather, it is the brain of the consumer which determines whether an addiction will form.
When an addiction does form, whether to cannabis or any other rewarding behaviour, it should be considered both physical and psychological because the two cannot be separated as the psyche is reflected in the neural pathways of the brain.
This is what the latest science on addiction is teaching us. Therefore, it’s vitally important that it becomes common knowledge, especially when it comes to cannabis addiction, which is often underappreciated because of a wide-spread notion that cannabis addiction is not real.
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