Tuesday, February 12, 2008

Pot withdrawal comparable to quitting smoking?

Marijuana may be more addictive than is generally thought:

Research by a group of scientists studying the effects of heavy marijuana use suggests that withdrawal from the use of marijuana is similar to what is experienced by people when they quit smoking cigarettes.

Abstinence from each of these drugs appears to cause several common symptoms, such as irritability, anger and trouble sleeping - based on self reporting in a recent study of 12 heavy users of both marijuana and cigarettes.

“These results indicate that some marijuana users experience withdrawal effects when they try to quit, and that these effects should be considered by clinicians treating people with problems related to heavy marijuana use,” says lead investigator in the study, Ryan Vandrey, Ph.D., of the Department of Psychiatry at the Johns Hopkins University School of Medicine.

Marijuana is the most widely used illicit drug in the United States. Admissions in substance abuse treatment facilities in which marijuana was the primary problem substance have more than doubled since the early 1990s and now rank similar to cocaine and heroin with respect to total number of yearly treatment episodes in the United States, says Vandrey.

The small sample size renders this more of a suggestive case study than a reliable scientific trial.

That rehabilitation numbers are now comparable to those of cocaine and heroin is potentially misleading, as an order of magnitude more Americans smoke pot than use cocaine. The absolute numbers may be similar, but the rates of admission into substance abuse programs due to use of the different drugs are not.

Still, the increase in treatment meshes with the secular rise in THC levels (the compound that influences the release of dopamine in the brain during a high) that has characterized US and European pot over the last half-century.

I'm more interested in this:

Interestingly, the study also revealed that half of the participants found it easier to abstain from both substances than it was to stop marijuana or tobacco individually, whereas the remaining half had the opposite response.

As both forms of smoking increase the amount of dopamine that is released in the brain, might substitution inherently be counter-productive for many people who are trying to kick pleasureable 'bad' habits?

It's plausible that the standard 21mg cessation patch, which releases into the user the nicotine equivalent of one pack of smokes over a 24-hour period, may get its hit-or-miss reputation for the same reasons underlying the split found in this study. The patch, and substitution as an aid to giving up other addictive activities more generally, may be more effective than trying to go cold-turkey for most people*. But it might actually further entrench regular use among others.

I wonder how that disparity might be genetically influenced. I suspect that answer will be revealed, among countless other, in the coming years thanks to the revolutionary advances in DNA sequencing that are occuring as we speak.

Marijuana also appears to increase the incidence of periodontal problems:

In a study of more than 900 young adults, researchers found that heavy tokers were 1.6 times more likely to have at least mild periodontal disease, compared to those who had never smoked grass. ...

As a group, their risk of having at least one site with more severe gum disease was triple that of the group who never used the illicit drug, say the researchers, whose work is published in Wednesday's issue of the Journal of the American Medical Association.

This suggests that regular marijuana use shares some consequences of regular tobacco use. That isn't surprising given the similarities in the way both are consumed.

Weed seems to be following a path similar to that of cigarettes before it: Originally thought to be innocuous, but appearing less and less so as time goes on.

*The consensus from what I've read seems to be that patches tend to be about twice as effective as resolving to go 'cold turkey' is, but there's the question of how much more resolve in takes in the first place to actually buy the expensive patches versus simply saying "I quit".



11 comments:

Anonymous said...

I've been both a pot smoker and a cigarette smoker. Quitting pot, I was depressed and anxious for a day, day and a half. Plus, I quit the first time I tried to. Cigarettes, I quit, and quit and quit... It is far easier to quit pot.

Audacious Epigone said...

Anon,

Thanks for the self-report. Were you a daily pot smoker?

Rob said...

Yeah, I was. One possibility for the withdrawals being equal is that nicotine is water soluble(pretty sure) and THC is fat soluble, so pot takes about a month to clear, so withdrawals are over a longer period of time.

I've heard giving canabinoid blockers to potheads cause withdrawl symptoms, so maybe the subjective difference is the time it takes to clear out.

Maybe when withdrawal kicks in, it has been so long that there's no instinctual feeling that its causal.

I concede that pot may be addictive, and it is certainly not a good thing. It maybe doesn't cause lung cancer, but still causes lung disease, and potheads tend to be lower functioning.

I tend to think it should be decriminalized, but is a bad thing.

Audacious Epigone said...

Rob,

Yes, you're right about the solubility of nicotine and THC.

That the withdrawal symptoms are potentially more delayed with pot meshes well with the study's seemingly surprising findings. Obviously the conductors were looking for a connection, whereas pot smokers might not make such a mental connection after a week of not smoking sees them feeling irritable.

Rob said...

It's been noted that the faster a drug works, the more addictive it is: even controlling for the type of drug.

People who snort cocaine get addicted faster than people who drink it as tea, and smoking it causes addiction even faster.

I wouldn't be a bit surprised if difficulty quitting were related to how quickly the drug clears: faster clearance = harder to quit. But I dunno, that may be well-accepted.

Anonymous said...

I was a daily pot smoker too, and packed it in 19 months ago. No real cravings, as when I tried to give up tobacco. It was more somthing I anticipated as being hard, like a psychological dependence. Once I got past the first bit, no problem

Steve, UK

Anonymous said...

Just a comment about the idea that the patch works for quitting smoking, along with the gums, inhalers, and everything else. These things just change the delivery system of the drug that you are addicted to, it may get you to stop smoking during treatment, but once treatment is over there is around a 6-7% quit rate at a year out, and the same study found that 6-7% of the people in the study were addicted to the gum or patch. Mr. Obama has been chewing his nicotine gum for 13 months. I got all of this at whyquit.com, as I am going through quitting smoking now, I have found it was a lot easier to quit cold turkey than through the patch, after the first 3 days it gets better, on the patch you reach a plateau of suffering with a constant influx of nicotine in your system. Other than that, I have found that my weed smoking has gone down since I stopped smoking, but that I have quit pot for months and years before with little immediate withdrawal symptoms, though Rob may have it, I may have had issues a few weeks later but never noticed...

Audacious Epigone said...

Anon,

While I've had plenty of problems in plenty of areas throughout my life, substance use has never been one of them (I have an ugly family history of alcoholism, and decided in elementary school that I'd never touch any illicit or addictive substance). You sharing your experience is thus even more appreciated that it would otherwise be. Thanks for it.

John said...

I know that normal cigarettes have lots of chemicals and addictive substances but I'm not sure the properties of Pot.

Sugar is one substance that makes one to continue smoking forever and ever. That is one reason why smokers tend to continue smoking and find it hard to quit. If you're rolling your pot then the addiction and hook is there with the paper used.

Anonymous said...

I have been a daily pot smoker for 10 years. I have also been a tobacco user during that time. My tobacco addiction is directly affected by my marijuana use. If I don't smoke pot I don't really have a desire to use tobacco. I get insomnia, night sweats and serious irritability/nervousness when I don't use pot. In my experience quitting tobacco has had a lot less side effects. I think it really depends on the person. For those who are able to quit pot with no side effects...I am a little jealous. For me the marijuana addiction is much much stronger. Apparently this is "only psycological". Unfortunately the withdrawal effects still manifest in physical ways.

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