Treatment for Marijuana Abuse

Assessment and Diagnosis

• The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders includes symptoms of dependence such as irritability, insomnia, and headaches during withdrawal, which are used to diagnose cannabis use disorder, affecting approximately 10% of cannabis users worldwide 1, 2

Evidence-Based Treatment Approaches

Special Considerations

Comorbid Conditions and Adolescents

• Cannabis use may have a deleterious effect on adolescent brain development and well-being, with evidence suggesting associations between cannabis use and adverse psychosocial events in youth, including major depression and suicidal ideation, and people who initiate cannabis use at a young age may have an elevated risk for developing cannabis use disorder 1

Harm Reduction Approaches

• The World Health Organization recommends that primary health care providers facilitate access to information, health care, and entry to drug treatment in communities with high prevalence of substance use 3
• Public prevention and education efforts should be implemented, particularly in jurisdictions where cannabis has been legalized or decriminalized, as recommended by the American Medical Association 4

Treatment Intensity and Duration

• The National Institute on Drug Abuse suggests that short duration psychosocial support modeled on motivational principles should be offered as initial treatment in non-specialized settings, and individuals who do not respond to short-duration psychological support should be referred for specialized treatment 3

Withdrawal Management

• The American Academy of Addiction Psychiatry recommends that cannabis withdrawal should be conducted in a supportive environment, with no specific medication currently FDA-approved for cannabis withdrawal, and symptomatic medication may be used for relief of withdrawal symptoms such as agitation and sleep disturbance 3

Pitfalls to Avoid

• The American Society of Addiction Medicine advises avoiding the use of dexamphetamine for the treatment of cannabis use disorders, and not relying solely on short-term interventions for severe cases; referral to specialized treatment may be necessary 3