Individuals who report having resolved a problem with cannabis use appear to have done so at younger ages than those who resolved problems with alcohol or other drugs, report investigators from the Recovery Research Institute at Massachusetts General Hospital.
“Very little has been known about recovery from cannabis use problems, and this is the first study to examine that on a national basis.”
While study participants also were much less likely to use any formal sources of assistance or support in resolving problems with cannabis than those whose problems were with other substances, that finding was less common in those who resolved a cannabis problem more recently, which may reflect the increased availability and potency of cannabis in recent years.
“Very little has been known about recovery from cannabis use problems, and this is the first study to examine that on a national basis,” says John F. Kelly, PhD, director of the Recovery Research Institute, who led the study published in the March issue of the International Journal of Drug Policy.
A Unique Place in Policy
“Compared with alcohol and other drugs, cannabis holds a unique place in federal and state policies – continuing to be illegal federally but with medical and recreational use legalized at the state level,” he adds. “Due to this increased availability and the proliferation of a for-profit cannabis industry, understanding the needs of individuals with cannabis problems will be increasingly important.”
Mass General made substance use disorders (SUDs) a strategic priority in 2014, recognizing that for a variety of conditions substance use complicates even the most skilled medical care and leads to poorer outcomes. Since then, Mass General has worked to redefine how patients with SUDs and addiction are identified, access care, and receive treatment in medical and surgical units, the Emergency Department, and outpatient and community clinics.
The current study analyzes data from the National Recovery Survey, conducted by Dr. Kelly’s team. A nationally representative sample of nearly 40,000 U.S. adults who participate in the Knowledge Panel of the market research company GfK were asked “Did you used to have a problem with drugs or alcohol, but no longer do?”
Of more than 25,000 respondents, a little over 2,000 indicated they had resolved such a problem and were sent a link to the full study survey, which asked a variety of questions such as the specific problem substances and details regarding how and when they had resolved their problem. As reported in a paper published last year in Drug and Alcohol Dependence, more than half of all respondents reported resolving their problem with no assistance.
The current study focused on participants who indicated having resolved a cannabis problem, who made up around 11 percent of respondents, reflecting around 2.4 million U.S. adults. Compared with those resolving problems with alcohol or other drugs, those resolving cannabis problems reported starting regular use – once a week or more – at younger ages but also resolving the problem at younger ages, an average of 29 compared with 38 for alcohol and 33 for other drugs.
Resolving Cannabis Issues
Cannabis-primary respondents were even less likely to have used formal treatment or support services than were those resolving problems with illicit drugs – 18 percent versus 42 percent – but were more likely to have participated in drug courts than those who had resolved alcohol problems – 24 percent versus 8 percent. Cannabis users also reported “addiction careers” – the years between their first use and problem resolution – that were significantly shorter than those of the alcohol group – 12 years versus 18 years, which may reflect the greater physical and mental health impairment associated with alcohol and the continuing illegality of cannabis.
“We did expect that the cannabis-primary individuals would be less likely than the illicit drug group to use formal treatment; but very little is known about the magnitude or nature of such differences,” says Dr. Kelly. “That may be due to fewer physiological and other life consequences compared with the impairments caused by drugs like alcohol or opioids. For example, while there is a documented withdrawal syndrome related to cannabis dependence, withdrawal from opioids or alcohol is notoriously more severe and often requires medically-managed detoxification.”
Given the increased levels of THC – the psychoactive component of cannabis – in products available today, the team investigated whether the use of formal support services had changed over time. Indeed, they found that utilization of outpatient services was more common in those resolving their problems within the past 5.5 years, while use of inpatient services was actually more common in those who resolved their problem around 20 years previously.
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