How is marijuana addiction treated?

By Dana Byerly 04/02/14
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Road to Recovery

Many adults who seek treatment for marijuana abuse or dependence have been chronic users for more than 10 years and have attempted to quit more than six times.  Almost 10 percent of those who try marijuana develop a dependence compared to 15 percent who try cocaine and 24 percent who try heroin.  Because there are a greater number of people who use marijuana, however, dependence is twice as high as any other recreational drug.  

Success rates for treating marijuana dependence are minor compared to treatments for other drugs, though.  Approximately half of all users who seek treatment achieve an initial two-week period of abstinence, and among those who reach that goal, half of them will resume use again within a year.  Other behavioral-based approaches to treatment boast success rates for one-year abstinence somewhere between 10 and 30 percent.

Recovery comes in four phases, according to the American Psychiatric Association.  The first, or acute, phase focuses on alleviating the symptoms of withdrawal and lasts approximately two weeks. This is followed by an extended period of abstinence known as the post-acute withdrawal phase.  

During this time, the brain is steadily returning to normal, and the focus is on changing addictive behaviors and managing lifestyle changes.  Withdrawal episodes generally last for a few days at a time, with each instance lessening in severity, and those who manage through the post-acute phase will gain confidence with each passing day of success.  It is important for those in recovery/remission to expect post-acute withdrawal symptoms for up to two years, though.   

Treatment

The most effective methods of treatment the last few years have been demonstrated not through pharmacology but through prevention, intervention, behavioral therapy and contingency management -- a voucher-based system that rewards drug-free behavior. 

There are currently no medications approved for treating marijuana abuse but an increasing number of studies are being conducted.  Quetiapine, an effective antipsychotic drug, has shown promise in the treatment of other substance use disorders.  Because of this, many believe its effects of sedation, anxiety relief, mood stabilization and appetite stimulation will work just as well on the symptoms of marijuana withdrawal.  

Occasionally, antipsychotic drugs are needed to treat prolonged marijuana-induced psychosis, but those are in rare instances where marijuana was used to alleviate symptoms of depression or anxiety.  There have been a few instances where other drugs have been used to treat marijuana with relative success, but due to the low number of studies involving pharmacologic remedies, this is not viewed by industry professionals as a viable method of treating marijuana addiction. 

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Dana Byerly is on staff at The Fix, and has written for the San Antonio Express-News and The Oklahoman among others. She last wrote about federal classification of marijuana. She can be found on Twitter.

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