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Chemical reality…

One of the most misunderstood areas of mental health

is substance abuse and addiction. It’s easily misunderstood, because there are many different substances and behavioral addictions that have multiple side effects that affect the abuser/addict in different ways from person to person. From the point of view of mental health, an important common denominator of all addiction/abuse is that the victim is engaged in paradoxical thinking. When she is trying to figure out what is going wrong with her relationships, career or emotional and/or physical health, she is trying to do that with a brain affected by chemical changes caused by an addiction. Too often she cannot see that smoking cannabis, spending most of the day on FaceBook or drinking a half bottle of wine every evening is a major source of her problem. Patients show up at counseling pointing the finger at all sorts of causes without looking in the mirror of their addiction.

One of the reasons alcoholism is confusing is because it is not addiction if a person “binge drinks,” but binge drinkers are “alcoholics.” Getting screaming drunk every once in awhile is not a biological addiction, though it is a psychological dependency. In addiction, you NEED the addictive substance to not go into withdrawal. With binge drinking, alcohol hasn’t taken over a chemical process in your brain. However, binge drinking IS self abuse—a serious psycho-emotional disorder for which you need help, if only to not kill yourself accidentally.

Another confusion is if a person consumes alcohol on a weekly basis, she can be addicted without realizing it. Alcohol stays in the body for four days, so she can maintain a low-grade addiction by only drinking a couple beers or a glass of wine every fourth day. In other words, if you drink two glasses of wine a week, it is possible you are “addicted” to alcohol. Not horribly, obviously, but biologically your body may NEED the alcohol, whether or not society sees you as an alcoholic. This type of consistent weekly drinking can affect mental health not only because alcohol is a depressant that can aggravate depression, but because experiencing mild withdrawal starting every few days creates anxiety. You drink to quell anxiety not realizing that a low-grade withdrawal caused you to feel anxious in the first place.

Another common illusion is that alcohol masks pain. Many people drink because “I have a bad back,” or a “sore neck” and welcome what they perceive to be the pain mitigation effects of alcohol. In fact, if the patient is alcohol free, she may not experience pain at all. For people who drink daily, chronic morning withdrawal causes various symptoms, one of which is to jangle the nervous system. If you have chronic pain, the last thing you need is jangled nerves from alcohol. The pain you perceive is not solely caused by the bad back, but from withdrawal which causes the perception of pain in a weak area of the body. Then, the patient gives the addiction what it craves causing pain to go away, not because it is mitigating pain, but because it is mitigating withdrawal. I’ve seen this many times with other drugs too. Upon giving up Oxycodone or cannabis, pain often goes away on its own. So do other maladies, as alcohol consumption contributes to cardio myopathy, atrial fibrulation and ventricular tachycardia among other disorders.

The most misunderstood drug on the market is cannabis. I’m so glad it’s legal now in Washington! Its illegality created an area of societal and scientific ignorance and its effects on the brain cause a delusion that makes you believe it’s benign when it is not. Most people realize that one joint is equivalent to chain smoking five cigarettes in terms of carcinogenic effects, but most people do not know its long-term use has been proven to lower IQ by as much as eight points.

They also do not know that cannabis is highly addictive. One common myth is that it is not, however, cannabis is not only addictive, it is strongly habit forming. When a person tries to quit or cut back she not only has to go through an emotionally-painful withdrawal, but has to struggle to change a behavioral habit as well, e.g. “I smoke everyday when I get home from work.” This habit formation is quite strong and is the same as with alcohol. Cannabis is different than alcohol in that it is “secondarily” not “primarily” addictive, hence the erroneous belief of it not being addictive. THC which causes the “intoxication” (notice the word toxic in intoxication) is not the addictive substance, whereas with alcohol the toxic substance is the addictive substance, hence its status as a primary addiction.

Cannabis induces a “secondary” addiction by triggering the reward chemical in the brain. The reward chemical is an opioid designed by nature to reward us when we enact a behavior that enhances the species chances for survival, such as eating, making love or getting an A on a math test. However, cannabis triggers so much of the reward chemical that tiny normal amounts no longer seem motivating, and we become addicted to our own inner (endogenous) opioid. We continue the behavior of smoking cannabis because we are told by our brains it’s a good thing. Unfortunately, that rewarding message is a misperception caused by the drug making it one of the hardest addictions to quit.

Exogenous (outer) opioids are highly-addictive drugs like heroin, opium or Oxycontin. But an opioid is an opioid, so whether it’s endogenous or exogenous, it’s highly addictive. However, since a cannabis user has become addicted to her own internal opioid, it feels normal, because it is an experience we used to have daily. It doesn’t feel like say heroin, it feels like “me.” We lose interest in doing things we would normally do to trigger the reward chemical, because cannabis works so much more easily and gives us larger amounts without having to do anything other than toke on a pipe. That’s why users become less motivated when using cannabis: it interferes with motivation process while providing the illusion we are doing something for which we deserve to be rewarded. We feel like we’re doing more when, in fact, we’re probably doing less.

This is also the reason most people who use cannabis regularly become dissatisfied with life in general. I listen to complaints about “my lousy job” or “my lousy neighbors” or “my lousy husband” from cannabis users. They are not receiving a big enough dose of the reward chemical to feel joy about most areas of life because cannabis has taken over the reward process. Like other addictive drugs, tolerance is created. So unless you increase your dosage over time, increasing dissatisfaction arises. You have made the internal process of receiving satisfaction (reward) dependent on a drug, coincidentally causing less motivation to change. When we feel dissatisfied we need the motivation to change or we’ll stay dissatisfied. Consequently, many cannabis users feel stuck, because they do not have the motivation to change. They lose their joy in life. After all, it seems like they’re already doing so much! This is why it also decreases the effectiveness of counseling that’s primary purpose is to motivate change.

The saddest side effect of cannabis is a sense of alienation from others. Tracey Helton Mitchell, the author of the memoir “The Big Fix: Hope After Heroin,” says “Being on opioids makes you feel disconnected not only from children but all people,” she said. “I just felt disconnected to them, as if the opioids had built a wall between me and them.” Cannabis triggers endogenous opioids. That feeling you get of being disconnected from others is not real. It’s an effect of cannabis triggering excessive inner opioid.

I wish I had known this before I got trapped in the cannabis cycle for over 25 years. I remember repeating “I want to want something” not understanding the connection between my marijuana habit and feeling dissatisfied and disinterested in life. Anything I tried to do just didn’t “turn me on” the way pot did. Now that I understand the biochemical effect of cannabis all I can do is regret time lost and try to help others retrieve a connection with their families, their selves and the joy of being alive.—MR

More information:

“What Chemicals Are in Marijuana and Its Byproducts,” Charles Ksir, PhD
“DrugFacts: Is Marijuana Medicine?” National Institute on Drug Abuse, July 2015
“DrugFacts: Marijuana,” National Institute on Drug Abuse, Dec 2012
“What’s Wrong With Marijuana?” the Trumpet, Feb 2013
“Additional Marijuana Facts,” University of Southern California, May 2015
“Cannabis in the workplace,” National Cannabis Prevention and Information Center, Oct 2011
“Study: Young Adults’ Casual Marijuana Use Causes Brain Changes,” CommonHealth, Apr 2014
“Don’t Harsh Our Mellow, Dude,” The New York Times, June 2014
“Denver coroner: Man fell to death after eating marijuana cookies,” The Denver Post, April 2014
“‘Dabbing’ the new drug of choice for teens?” ABC 15 Arizona, Sept 2013
“Concentrates 101: What’s on the market, from kief and CO2 oil to BHO,”, Jun 2015
“Officials warn of dangers with earwax marijuana,” KCRA, Nov 2013
“Mixing Marijuana with tobacco creating ‘Respiratory Cripples,’” St. Lucia News
“Some Emerging Facts On Establishing Indispensable Issues of Weed Names,”
“20 Cannabis Strains High in THC,”
“Marijuana Supply, Sales and Seizures—Potency,” CEDRO
Mehmedic et al, 2010 (graph)
“Cannabis Substance Profile and Its Health Impact,” UNODC
Mehmedic et al, 2010 (graph)
“Psychoactive Drugs Notes—Marijuana” Sinsemilla, M. Plonsky PhD
“DrugFacts: Marijuana,” National Institute on Drug Abuse, Jan 2014
“Does marijuana use affect driving?” National Institute on Drug Abuse, March 2016
“Dose related risk of motor vehicle crashes after cannabis use,” NCBI
“Marijuana Use Increases Risk of Traffic Crashes and Deaths,” Potsdam University
“Fatal Road Crashes Involving Marijuana Double After State Legalizes Drug,” AAA NewsRoom, May 2016
“More Colorado drivers in fatal crashes positive for pot, study says,” The Denver Post, May 2014
“Percentage of California Drivers Testing Positive for Marijuana, Involved in a Fatal Crash,” FARS 2005–2013
“Dose related risk of motor vehicle crashes after cannabis use,” NBCI, Feb 2004
“Stoned Drivers Are Killing More and More Innocent Victims,” CNS NEWS, Oct 2013
“DrugFacts: Marijuana,” National Institute on Drug Abuse, March 2016
“Marijuana Use and Panic Psychopathology Among a Representative Sample of Adults,” NCBI, Apr 2010
“Marijuana: Know the Facts,” ONDCP
“How long does cannabis stay in the body after smoking?”
“Marijuana as Medicine: Consider the Pros and Cons,” Mayo Clinic, Aug 2006
“Smoked Marijuana as cause of lung injury,” NCBI, Jun 2005
“Does Marijuana Cause Cancer?” Jann Gumbiner, PhD, Psychology Today, Feb 2011
“Regional brain abnormalities associated with long-term heavy cannabis use,” NCBI, Jun 2008
“Casual marijuana use linked to brain abnormalities in students: Dramatic effects of small time use; more ‘joints’ equal more damage,” ScienceDaily, Apr 2014
“How Marijuana May Drive the Brain into Psychosis,” LiveScience, Jan 2012
“The Cannabis-Psychosis Link,” Psychiatric Times, Jan 2012
“Effects Of Marijuana: Smoking Pot Burns Out Sperm Count For Men By A Third, Harming Fertility,” Medical Daily, Sep 2015
“Acute, short-term, and chronic effects of marijuana on the female primate reproductive function,” NCBI
“DrugFacts: Marijuana,” National Institute on Drug Abuse, Dec 2012
“Understanding the harmful effects of marijuana use,” AWAREmed, Dr. Akoury, June 2015
“Why Isn’t the Marijuana Plant FDA-Approved Medicine,” NIDA, Dec 2014
“Neurobiological effects of early life cannabis exposure in relation to the gateway hypothesis,” Maria Ellengren, Karolinska University, Feb 2007
“What are marijuana’s effects on general physical health?” NIDA, Mar 2016
“Recreational marijuana use and acute ischemic stroke: A population-based analysis of hospitalized patients in the United States,” NCBI, May 2016
“What are marijuana effects?” NIDA, Mar 2016
“Drop in IQ linked to heavy teenage cannabis use,” Nature magazine, Aug 2012
“How does marijuana produce its effects?” NIDA, Mar 2016
“Persistent cannabis users show neuropsychological decline from childhood to midlife,” NCBI, Oct 2012
“Heavy, persistent pot use linked to economic, social problems at midlife,” ScienceDaily, Mar 2016
“Marijuana and the developing brain,” American Psychological Association, Nov 2015
“Why Isn’t the Marijuana Plant FDA-Approved Medicine,” NIDA, Dec 2014
“Persistent cannabis users show neuropsychological decline from childhood to midlife,” PNAS, Aug 2012
“Regular marijuana usage robs men of sexual highs,” NewScientist, Aug 2009
“Localization and Function of Cannabinoid Receptors in the Corpus Cavaernosum,” European Urology, Sexual Medicine, Feb 2010
“Impact of Cannabis Use on Male Sexual Health,” by Rany Shamloul MD and Anthony J. Bella MD, Jan 2011
“Cannabis Use and Sexual Health,” International Society for Sexual Medicine, Aug 2009
“Does Marijuana Affect Sex Drive?”, March 2011
“National Study Shows “Gateway” Drugs Lead to Cocaine Use,” Columbia University, Nov 1994
“Addiction Related Statistics,” In Balance Intensive Outpatient
“Marijuana,” NIDA New York “Medical Marijuana in the Workplace,” NCBI, Journal of Occupational and Environmental Medicine, May 2015 Swann study in 2000 on fatally injured drivers on THC
“The Big Fix: Hope After Heroin, Tracy Helton Mitchell, 2015
“The health and psychological consequences of cannabis use,” Department of Health Australia, 1994

November 21st, 2016 | Permalink

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