The Daily Show is just plain wrong on pot being non-addictive
April 21, 2015
In the 420 bit from this week, Jessica Williams asserts that marijuana is “a non-addictive proven medical treatment“.
Marijuana is most certainly addictive.
In 2012, 17.5% of all substance abuse treatment admissions had marijuana as their primary abused drug. Alcohol alone was 21.5%, heroin 16.3% and cocaine 6.9%.
Daily marijuana smokers use 3 times a day on average and have little variability from day to day.
Pregnant women are unwilling or unable to stop smoking pot almost daily. Increasing numbers of pregnant women are seeking help to discontinue pot use.
At least one woman found out her hyperemesis during pregnancy was the pot, not morning sickness.
Marijuana is addictive in adolescents.
When adolescents stop smoking weed, their memory gets better.
About six percent of High School seniors are smoking pot almost every day.
Clinical trials of medications to help people who are addicted to marijuana stop using are far from rare.
Francophones are addicted to pot.
Yes, Dutch people are addicted to pot.
Many Cases of cannabis hyperemesis syndrome are unable to stop smoking pot, even though it is severely incapacitating them.
About 37% of frequent pot users will transition to dependence in three years.
Oh, and pot users are not awesome, friendly and mellow, actually nondependent users are impulsive and hostile on the day they use pot compared with nonsmoking days.
DrugMonkey 
April 21, 2015 at 1:32 pm
Exactly. I support more research and even support medical legalization and at least reduced penalties for non-medical use (mainly because I think we as a society need to focus on harder drugs).
It’s one thing to identify potential clinical benefits of any substance and another to ignore the scientific literature on potential harm, when the harm has a societal and economic cost associated with it. I do not savor the idea of interacting with a significant, stoned selection of the population (imagine the normal frustration of the DMV amplified by being served by a stoner). And there appear to be significant developmental issues related to white matter integrity which may harm children. My gut feeling (informed somewhat from the literature) is that developing brains and those with addictive personalities/tendencies have no business smoking weed.
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April 21, 2015 at 1:42 pm
That’s just like your opinion, man.
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April 21, 2015 at 1:53 pm
those with addictive personalities/tendencies
Beware the circular argument when you bring this up. Yes, there are definitely individual liabilities conferred by genes, environment and the interaction of the two. But this is a favored tactic of the denialist to pretend that cannabis exposure itself is immaterial to the development of addiction to marijuana.
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April 21, 2015 at 4:23 pm
“Beware the circular argument”
I get it – I’m certainly biased by direct experience.
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April 21, 2015 at 4:38 pm
I was forced to go to go to drug rehab after getting caught with some hash. I was never addicted but I’m sure lawmakers look at my enrollment and use it to justify the current legal status of cannabis. Beware the circular argument.
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April 21, 2015 at 4:48 pm
The results of almost every single one of the studies you cite simply mean that some people like to use marijuana and do so. While some fraction might be called addicted to it, to me they don’t suggest that marijuana is as strongly addictive as alcohol, nicotine, etc.
Of the studies that suggest that something more than “smoking pot is fun” is going on, here’s why I think they don’t necessarily indicate that MJ is strongly addictive:
1. “17.5% of all substance abuse treatment admissions had marijuana as their primary abused drug.” OK, but how many of those admissions were due to a court mandate? Or to parents freaking out about their kids’ pot smoking and committing them to an institution, even if their pot smoking isn’t the main problem?
2. “Pregnant women are unwilling or unable to stop smoking pot almost daily.” Actually it says right in the abstract that 70% of pregnant women don’t consider pot to be harmful. If they don’t think it’s harming their baby, then they are most likely not trying to stop. Which means that they are not showing the classical addiction behavior of trying to stop and failing. As for “Increasing numbers of pregnant women are seeking help to discontinue pot use,” again, is that because court-ordered drug treatment is an increasingly common alternative to incarceration?
3. Adolescents, the French and the Dutch get addicted: actually, the studies say that some of these groups crave marijuana, and use it out of habit or to cope. All of these things describe my relationship to chocolate, yet I am not addicted to it.
4. Some people can’t stop using pot despite the fact that it makes them throw up a lot. Yeah, they have a problem. They are also a tiny fraction of MJ users.
5. “Marijuana is addictive.” That study says that there are cannabis withdrawal symptoms. That’s it. I also suffer from withdrawal symptoms when I stop drinking coffee, yet I do not suffer from caffeine addiction. Neither do the subjects of this study necessarily suffer from cannabis addiction.
6. Pot users are hostile. I’m sorry, but this just doesn’t square with my experience. We need more data before I’m willing to believe this surprising claim. For instance, has anyone looked at emergency room trauma visits attributable to different drugs?
In general, most of these studies don’t look at how severe the “addiction” to cannabis is. To me, addiction means it’s ruining your life or killing you and you still can’t stop it. I’m willing to believe that some people reach this stage with marijuana (perhaps more than with caffeine), but I think it’s unlikely that it’s anywhere near as common for MJ as it is for alcohol, cocaine, nicotine and opiates.
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April 21, 2015 at 5:05 pm
“To me, addiction means it’s ruining your life or killing you and you still can’t stop it.”
Well, your definition isn’t one that is medically accepted. Haven’t you ever heard of or met a functional alcoholic?
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April 21, 2015 at 6:14 pm
The conditional probability of alcohol dependence is actually low (4%ish apples to apples with cannabis 7-9%ish and cocaine 15%ish). Much of this is because of the base rate- dang near everyone in the US is exposed to alcohol and large numbers imbibe frequently. Marijuana is less so but still beats everything other than nicotine by some margin.
This was the infamous thread comparing nicotine and cannabis withdrawal. I suggest you read the papers discussed and a few more by Budney before you conclude that you know all you need to know about comparative effects.
http://drugmonkey.scientopia.org/2010/11/08/drugfacts-2010-repost-comparing-cannabis-and-nicotine-withdrawal/
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April 21, 2015 at 6:29 pm
Court orders also account for numerous referrals for alcohol treatment, btw. Also for methamphetamine, heroin and other drugs. I happen to know a judge who spends a lot of his time making such referrals and I’m here to tell you that court mandates don’t mean those people *aren’t* addicts by any means. Judges have their own approaches, of course, but they have some understanding of patterns of addiction, particularly the judges that are smart, thoughtful and give a shit about their professional work- like the one I know.
Are these people not “truly addicted”? maybe. I suggest to you, however, that there is no reason to think there is a distortion specific to cannabis. Also, are you really suggesting that some sort of uneven distortion of “true” referrals accounts for the entire population but for zero of, say, heroin referrals?
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April 21, 2015 at 6:31 pm
I am curious Grumble.
Do you have your own definition of major depression? ADHD? obesity? diabetes?
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April 21, 2015 at 7:06 pm
I’m assuming that the addictive nature of weed in people (not cells or rodents) in everyday life is assessed sans nicotine? The majority of weed smokers still mix it with nicotine to keep it burning, so how is that handled in human studies? Probably a noob question, but not even close to being in my wheelhouse.
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April 21, 2015 at 7:08 pm
“Judges have their own approaches, of course, but they have some understanding of patterns of addiction, particularly the judges that are smart, thoughtful and give a shit about their professional work- like the one I know.”
Check out this wonderful n = 1 I have that totally supports my point.
So you believe that most judges have some understanding of the patterns of addiction, and furthermore have that influence and inform their decisions regarding the law? Because I think your n = 1 is an outlier, not near the median.
Please note, I’m not disputing any of your mary jane, addiction, or other drug data. What I am disputing is that the one good judge you know is at all representative of that population (but only with my own anecdata, so in the end neither of us have any real solid evidence).
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April 21, 2015 at 7:38 pm
Dave that is highly regional. Also there have been studies showing remarkably little nicotine yield in some blunt smokers. But yes, a complication.
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April 21, 2015 at 7:39 pm
I only deploy the judicial anecdote to show that your assumptions about all of them are unbased.
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April 21, 2015 at 9:47 pm
The definition of any psychiatric illness has a large subjective component, as the interminable fights over what goes into the DSM illustrate. So while you may scoff at my definition of addiction because it is different from yours, in fact there is lots of room for disagreement.
As far as I am concerned, not being able to stop taking a substance is only one component of addiction. The most important component is that you can’t stop even though you know that your drug-related behavior is harming you and others. That’s why I say I’m not addicted to caffeine even though I can’t stop drinking it. I’d even go so far as to say that PP’s “functional alcoholic” isn’t really addicted, or has an addiction that is similar to nicotine addiction: it doesn’t really get in the way of your everyday life now, but you know very well it has a high chance of killing you in the long run.
As far as cannabis is concerned, we don’t see overdoses (like for opiates, alcohol and stimulants), the long term health effects don’t seem to be as bad as those of nicotine or alcohol, and even those who seem to be dependent on the drug (crave it, have withdrawal symptoms) seem to be able to cope fairly well. That suggests that the misery caused by cannabis over-use and dependence is not as great as it is for alcohol, opiates and stimulants. It could be that as many or more people who use cannabis go on to become dependent on it as on alcohol, opiates and stimulants, but if it doesn’t impact their day-to-day functioning in any meaningful negative way, who cares?
In general, I think this is what’s missing from studies of drug use in humans: quantifiable measures of how badly drug use harms the user. It’s much easier to measure withdrawal, craving, and so on. But these are just parts of the puzzle, and without the missing pieces it’s impossible to assess whether cannabis addiction is anywhere near as problematic to people and society as other forms of addiction. So, the debate over whether cannabis is addictive is probably misplaced: I think those who say “it’s not addictive” in support of legalization would be comfortable with the idea that “it’s as addictive as caffeine, and just as harmless.” I don’t claim to know whether, in fact, cannabis is just as harmless as caffeine, but I suspect that at least it’s not as harmful as, say, cocaine. As far as I know (I could be wrong), this question hasn’t really been explicitly asked by scientists – but to really inform the debate over legalization, it’s the one that needs to be answered.
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April 21, 2015 at 11:18 pm
It’s fine to say addiction doesn’t equal a drug *problem* but trying to redefine addiction to suit yourself is just asking for stupid semantic discussions like this one.
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April 22, 2015 at 9:24 am
Okay, what is the objective definition of “addiction”? The problem is that the word gets thrown around with so many different meanings. It doesn’t help that the idea of real, physical, addiction gets conflated with the subjective idea of “psychological addiction”, where people like Bill Clinton can supposedly be psychologically addicted to sex.
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April 22, 2015 at 9:58 am
The discussion isn’t semantic. I wasn’t clear above that it’s not that my definition of addiction is different from the accepted definition — it’s that the accepted DSM definition is open to interpretation, and as far as I understand it, the DSM-defined behaviors that are consistent with cannabis addiction are neither as common nor as extreme as those that comprise addiction to other substances.
In fact, I don’t think the papers you cite demonstrate that cannabis use results in addiction as defined by the DSM. Tolerance and withdrawal – fine, that seems to happen. The other criteria just don’t match up:
“often taken in larger amounts or over a longer period than intended.” Some of those papers report people smoking a very even number of joints every day: exactly 1 or 2. How is this more than intended?
“persistent desire or unsuccessful efforts to cut down or control substance use” I didn’t see that in any of the studies. (You’ll argue that the numbers of users seeking treatment demonstrates this, but this is an indirect measure that is influenced by other factors, such as courts and families pressuring people into treatment. I’d be more convinced by direct measures, such as interviews.)
“A great deal of time is spent in activities necessary to obtain the substance (such as visiting multiple doctors or driving long distances), use the substance (for example, chain-smoking), or recover from its effects” Nope.
“Important social, occupational, or recreational activities are given up or reduced because of substance use.” Not this either.
“The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance.” No.
So, not only is the title of your post completely wrong, but your interpretation of the data in the studies you cite is wrong as well: for instance, you can’t conclude that “Marijuana is addictive in adolescents” from a study that simply shows that adolescent marijuana users experience withdrawal symptoms. You need to also show that the other DSM criteria are met as well.
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April 22, 2015 at 10:11 am
JB- are you contesting the idea that one could become addicted to sex?
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April 22, 2015 at 10:15 am
are neither as common nor as extreme as those that comprise addiction to other substances.
The direct comparison with nicotine shows you incorrect. but even if true, I am unclear on what severity has to do with addiction per se.
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April 22, 2015 at 10:23 am
We treat nicotine addiction. We don’t treat caffeine addiction. The difference in severity is not a difference in tolerance and withdrawal. It’s a difference in the severity of the negative impact of long-term drug use on the user – which directly impacts the “severity” of specific DSM symptoms, such as trying to quit but failing (lots of people for nicotine because everyone knows smoking kills you; very few for caffeine because everyone knows coffee is harmless). Does that answer your question?
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April 22, 2015 at 10:27 am
@JB: Here is the DSM-IV definition: https://www.danya.com/dlc/bup/pdf/Dependence_DSM.PDF
There are some minor changes in the DSM-V.
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April 22, 2015 at 11:00 am
The relevant question is whether marijuana is more or less addictive then The Daily Show, and whether they are synergistic in effect. Experiments Must Be Done!
Without a better consensus as to what human flourishing means, defining complex patterns of behavior as disease is fraught with deep problems (all the moreso when it’s done from the outside- no matter how well meaning your judgefriends may be). It’s not just addiction that is tricky this way, it’s also true for depression and mild cognitive impairment. Arguably, it’s not even a problem of poor understanding of the mind- go ahead and ask a group of people if NFL players are “obese” and watch the ensuing debate.
Do we want to define things according to easy criteria that a physician can check off in 2 minutes allowed by insurance reimbursement? Or do we want to define things in terms of the overall balance of benefits and harms?
Marijuana is addictive in the former sense. It can be in the later sense… but so can The Daily Show. And chocolate donuts. And sex. Is it worth pathologizing those things?
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April 22, 2015 at 11:15 am
When they get pathological, yes Becca. Just like with depression and anxiety.
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April 22, 2015 at 11:21 am
“When they get pathological, yes”
Which is precisely why severity, misery etc need to be considered. Because an addiction DOESN’T need to be pathologized if the symptoms aren’t severe enough to immiserate the addict.
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April 22, 2015 at 11:30 am
The DSM is heavy on life-interference criteria, Grumble. Dependence is only a part.
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April 22, 2015 at 12:35 pm
We don’t treat caffeine addiction. The difference in severity is not a difference in tolerance and withdrawal. It’s a difference in the severity of the negative impact of long-term drug use on the user – which directly impacts the “severity” of specific DSM symptoms, such as trying to quit but failing (lots of people for nicotine because everyone knows smoking kills you; very few for caffeine because everyone knows coffee is harmless). Does that answer your question?
Absolutely not. In fact it makes my point more acute. Why, in all that is holy, if I were to say “caffeine is terribly addictive” there would be essentially zero complaint and significant agreement but if I say the same thing about cannabis….this outraged resistance emerges?
Why can you not simply say “Yes you are one hundred percent correct that marijuana is addictive, The Daily Show is terribly incorrect on this and more people exposed means more addicts” and only then go on to make your points about how the relatively minimal impact (as you see it) on life quality means you think….[insert whatever]?
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April 22, 2015 at 12:42 pm
How is this more than intended?
because they themselves (treatment seekers and even non-treatment seekers) say they really should cut back.
I’d be more convinced by direct measures, such as interviews.
so concentrate on the treatment seeking populations used in research studies. They go to lengths to get populations that are by all ways one can tell, trying to stop or cut down.
Nope.
Yep.
“Important social, occupational, or recreational activities are given up or reduced because of substance use.” Not this either.
are you denying it occurs with pot smokers (you are wrong on this, it does) or that this shouldn’t be part of the diagnosis of pathology (again, wrong)?
“The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance.” No.
same as above, you are wrong and wrong no matter which way you intended it.
You need to also show that the other DSM criteria are met as well.
there are other studies that make this point more emphatically. Happy Reading
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April 22, 2015 at 12:52 pm
“Why, in all that is holy, if I were to say “caffeine is terribly addictive” there would be essentially zero complaint and significant agreement but if I say the same thing about cannabis….this outraged resistance emerges? ”
When drinking caffeine causes the termination of parental rights *even in the absence of harm to the offspring*, calling it “addictive” will be meant with resistance. That’s what I mean by “pathologizing”… we make something radically more harmful by how we treat it in society.
This should not be the fate of The Daily Show. Or chocolate donuts. Or sex. Or marijuana.
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April 22, 2015 at 12:59 pm
You don’t fight public policy you disagree with by denying the scientific reality, becca. In this, the pot fans / drug war opponents are climate denial and antivaccers on steroids.
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April 22, 2015 at 1:10 pm
Obesity researchers who describe chocolate donuts as addictive are helping neither public policy nor scientific progress. They may, however, be helping their grants get funded as their pet issue will seem more alarming.
Ditto you, DM.
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April 22, 2015 at 1:18 pm
Is marijuana addictive and bad for you? Yes. Saying otherwise really is science denialism.
Should it be illegal? For anyone under 21, with a developing brain, absolufukkenlutely.
But for adults, prohibition creates a hundred fold more problems than it solves.
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April 22, 2015 at 1:24 pm
“are you denying it occurs with pot smokers ”
All I was denying was that the studies you cited mean what you said they mean, as none of them addressed the bulk of the DSM bullet points.
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April 22, 2015 at 1:34 pm
How is being one of the few substance abuse researchers who forthrightly proclaims addiction to be a minority outcome among all who sample drugs, including IV heroin, being “alarming”, becca?
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April 22, 2015 at 1:35 pm
They do, Grumble, you just don’t get past the abstract level. Citations matter too.
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April 22, 2015 at 3:26 pm
In this, the pot fans / drug war opponents are climate denial and antivaccers on
Perfectly possible to be a drug war opponent while not a pot fan, just fyi. I’d much rather that people ruin their lives by getting addicted to pot than by being jailed for being addicted to pot while simultaneously supporting the Zetas.
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April 22, 2015 at 3:42 pm
YEEEEEESSSSS!!!!!!!!!! Michele Leonhart finally forced to resign!!!!!!!
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April 22, 2015 at 4:06 pm
She lives!!!!
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April 22, 2015 at 4:21 pm
“Obesity researchers who describe chocolate donuts as addictive are helping neither public policy nor scientific progress. They may, however, be helping their grants get funded as their pet issue will seem more alarming.
Ditto you, DM.”
Thank you becca.
I can’t believe DM is still defending the drug war. Even after the #blacklivesmatter movement?
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April 22, 2015 at 4:26 pm
“She lives!!!!”
And it’s
Isabel 2 (pot legalization & resignation of Leonhart)
vs
Drugmonkey 0
But keep floundering , dude!
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April 22, 2015 at 4:29 pm
Michele Leonhart answering the question: Is crack cocaine worse than marijuana?
Answer: All illegal drugs are BAAAAAAD!!!!
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April 22, 2015 at 4:38 pm
LOONABEL!!!!!
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April 22, 2015 at 4:50 pm
Glad to know you are okay, Isabel, we missed you.
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April 22, 2015 at 6:07 pm
@DM
The problem is that *everything* you like could be said to be “psychologically addictive” because you’ll be sad if you don’t get enough of it to please you. Yes, that could include sex, but only in a very banal way with no biological significance.
This is different from physical addiction because there liking has nothing to do with it. My mother (and apparently millions of others) smoked not because they liked the taste (my mother in particular always said she hated the flavor) but because whenever they tried to quit they suffered real biological symptoms of withdrawal.
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April 22, 2015 at 6:40 pm
Unbelievable. Still abusive assholes. Yet I am the one who has been consistently expressing logic (notice how many commenters here are now expressing my former arguments) and my views have prevailed.
Haha sore losers.
Did you watch the video? It is a nice analogy to the discussion here.
I was long denounced here as a racist who watched foxnews solely because I once stood up for scapegoated lower class white people and was subsequently attacked for years.
Meanwhile DM is viewed as a great ally to African Americans and even after Ferguson he still supports the drug war and police state. It boggles the mind.
Good thing I don’t give a shit what anyone here thinks;)
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April 22, 2015 at 7:33 pm
Sadly, I think this is a Loonabel Bot.
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April 22, 2015 at 9:24 pm
JB- yes everything rewarding has the potential, I repeat potential, for addiction. That is because addiction is a disruption of reward. Primary pharmacology, and therefore many acute withdrawal symptoms, is/are not even the central problem. If they were, then all addiction would be solved with a one month inpatient detox.
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April 23, 2015 at 2:24 am
“Sadly, I think this is a Loonabel Bot.”
Lol probably. For the most part Isabel has ceased to exist.
(her work is done, apparently)
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April 25, 2015 at 2:59 am
The comments in response to this post are, to me, a clear illustration of how the marijuana movement has gone awry.
If you remember back to when California prop 215 was enacted, it was activists, health care providers and scientists who were advocating the potential benefits of marijuana as a therapeutic for certain conditions. It was about giving patients choices in their treatment and access to all available options; even those considered alternative to the scope of standard medical practice
Today, evidence clearly shows that some patients can benefit from medical marijuana for conditions such as chemotherapy associated nausea and spasticity in multiple sclerosis. And the opinion of the general public is now widely supportive of access to medical marijuana. However, as this policy change was achieved, the movement has now shifted from access to medical marijuana towards general legalization. I have no qualms with legalization from a public policy standpoint, but there is a fallacy in denying or attacking scientific studies to achieve this goal. The claims being made about the how benign marijuana have become quite outlandish. I believe it is the obligation of any scientist who studies pharmacology to not deny or undermine credible evidence, or capriciously redefine established medical criteria in order to push an agenda. We already have enough non-scientists in the media who are recklessly doing this.
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April 25, 2015 at 11:58 am
Exactly POB. Policy decisions should be taken in full consideration of all the evidence, not by denying inconvenient facts. It makes for better policy, ultimately.
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April 25, 2015 at 3:57 pm
Parsing out the exact level and nature of harm caused by marijuana use is certainly of importance in attempting to mitigate those harms. But it is disingenuous in the extreme to pretend that the level and nature are anywhere remotely near justifying prohibition, especially in light of the obvious and extreme harms caused by prohibition itself. The way that you continually pretend that there is still some sort of legitimate public policy debate about marijuana prohibition that needs to be informed by scientific studies is grotesque.
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April 25, 2015 at 7:59 pm
If you are talking to me, when did I ever say jack squatte about “prohibition”? Nice try.
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April 26, 2015 at 4:45 pm
[…] The Daily Show is just plain wrong on pot being non-addictive Ebola: The road to zero Scientists Perturbed by Loss of Stat Tool to Sift Research Fudge from Fact (related thoughts here) Space geckos show their playful side on zero-gravity mission Atomic Labs Across the U.S. Race to Stop Iran […]
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April 26, 2015 at 5:37 pm
Good lord, don’t antagonize the stoners – that lot is worse than sea lions.
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April 26, 2015 at 6:20 pm
I strongly support legalization because it’s the only way to get marijuana cultivation out of the wild lands (in Forest Service, BLM, and other jurisdictions). That certainly doesn’t mean I think people should be using marijuana. Especially my students, who are supposed to be learning things.
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April 27, 2015 at 3:32 pm
Barbara,
I’m sure your students will be fine. If they are interested they will learn. But you make an excellent point about the often tragic environmental destruction that has followed in the wake of the drug war.
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April 27, 2015 at 7:12 pm
The would learn better if they would stop smoking weed though, right Isabel?
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