Overview

Cannabis abuse is defined as a destructive pattern of cannabis use, which can turn into significant problems with work, friends, family, and one's health. The ICD-10 describes it as "a cluster of psychological, behavioral, and cognitive phenomena," particularly describing how cannabis use can develop a high priority for the user, over other behaviors which have since lessened in priority. The most compelling factor in determining an abusive pattern of use is the individual's desire, which is usually quite strong, and sometimes overpowering, to take the drug.

Medical Treatment

Adverse effects of cannabis intoxication are usually not life-threatening, and therefore usually do not come to the attention of the individual's physician. According to Phillip W. Long, M.D., there is "no adequately documented case of a fatality." Pure marijuana abuse does not usually require inpatient services or pharmacological treatment, or detox therapy.

However, several outpatient methods of treating abuse are available. The physician or therapist may want to monitor the individual's urine for continued drug use. The active chemicals in cannabis can stay in the urine for roughly 21 days after taking the drug. However, the most accurate positive period is up to 5 days after cannabis use.

Other types of drugs may be necessary to treat side effects of, or underlying problems that were being masked by cannabis abuse. For example, antianxiety drugs may be needed if the individual was using cannabis to relieve anxiety. In rare cases, antipsychotics may be needed tp treat cannabis-induced psychosis. If the individual was using cannabis to alleviate depression, antidepressant may be considered as substitution therapy.

Symptoms

• Cannabis Tolerance. Cannabis tolerance is a sign of cannabis abuse. The need for more cannabis to get the same level of intoxication is a sign that the body is tolerating the drug more and more. Tolerance can also be using the same amount of cannabis and getting less of an effect. This is another sign the body is getting used to the drug, and therefore not becoming intoxicated by it.
  
• More Use Than Intended. Another sign of cannabis abuse is using more than intended, in the form of taking a larger amount, or over a longer period of time. Sometimes, the user is not aware of this increase in their quest for their "high." The user might claim to have only used a small amount, but in reality the amount of the drug taken was much larger. This coincides with tolerance, as the need for more of the drug is usually triggered by the body's increased tolerance of it.
  
• Unsuccessful Efforts to Control or Cut Down Cannabis Use. Persistent desire or unsuccessful efforts at cutting down or controlling cannabis use is a sign of abuse.
  
• Time Spent. Another sign of cannabis abuse is smply a marked increase in the amount of time an individual spends either using the drug, or recovering from its effects.
  
• Reduction in Activities. Cannabis abuse is also marked by a decrease in, or lack of interest in social, occupational, and recreational activities. The individual may spend less time with their friends and family as a result of their drug use. The user's work may suffer, and the individual may take less interest in other recreational activities.
  
• Continued Use. Another sign an individual is abusing cannabis is when the use of the drug continues despite knowing the health risks. The individual may already know of having a recurrent physical or psychological problem likely to be have been worsened by cannabis use, and continues to use it anyway.

Psychosocial Treatment

Follow-up treatment is key to ensuring an individual's recovery. The patient should be encouraged to avoid people, places, and things that might trigger cannabis use again. THey should also be taught to recognize these triggers, and formulate a plan of support to keep them from falling back into a pattern of use, and eventually abuse again.

Sometimes, heavy cannabis users suffer from other problems, such as chronic anxiety, depression, or insecurity. In these cases, the drug abuse is a symptom, and therapy should focus on the underlying problem, and why drug abuse became a symptom of that problem.

based

1. The ICD-10 Classification of Mental and Behavioural Disorders
2. World Health Organization, Geneva, 1992