Abstract
The need for public health awareness and evidence-based clinical care for marijuana use and its disorders remains a major health care priority in the United States and beyond. Indeed, marijuana has been the most widely used illicit substance in the United States for the past 30 consecutive years, with approximately 25 million people in the United States (8.6% of the population) having used marijuana in the past year. The overarching aim of the present chapter is to provide an overview of marijuana use and its disorders. The chapter is organized into seven sections. First, we describe the prevalence of marijuana use and its disorders. Second, we clarify the nature of marijuana use in terms of its pharmacokinetics and acute intoxication features. In the third section, we describe the classification of marijuana use and its disorders using the current diagnostic nomenclature. Fourth, we describe the motivational bases for use of the drug. In the fifth section, we provide a synopsis of some problems associated with marijuana use and its disorders, including health problems, social problems, and psychological disturbances. Sixth, we provide a summary of the scientific work focused on marijuana, the reasons for its use, and users’ relative success in quitting. In the final section, we describe some practically oriented clinical issues for primary care medical practitioners to consider in terms of the recognition and treatment of marijuana use and its disorders.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Agosti V, Levin F (2007) Predictors of cannabis dependence recovery among epidemiological survey respondents in the United States. Am J Drug Alcohol Abuse, 33:81–88
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, text revision. American Psychiatric Association, Washington, DC
Anthony JC, Helzer JE (1991) Syndromes of drug abuse and dependence. In: Psychiatric disorders in America: the epidemiologic catchment area study. Free, New York
Anthony JC, Warner LA, Kessler RC (1994) Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: basic findings from the national comorbidity survey. Exp Clin Psychopharmacol 2:244–268
Ashton CH (1999) Adverse effects of cannibus and cannabinoids. Br J Anaesthesia 83:637–649
Ashton CH (2001) Pharmacology and effects of cannabis: a brief review. Br J Psychiatry 178:101–106
Bandura A (2000) Social-cognitive theory. Encyclopedia of psychology, vol 7. American Psychological Association, Washington, DC, New York, pp 329–332
Bickel WK, Vuchinich RE (2000) Reframing health behavior change with behavioral economics. Lawrence Erlbaum, Mahwah, NJ
Bloom JW, Kaltenborn WT, Paoletti P, Camilli A, Lebowitz MD (1987) Respiratory effects of non-tobacco cigarettes. Br Med J 295:1516–1518
Bonn-Miller MO, Zvolensky MJ, Bernstein A (2007) Marijuana use motives: concurrent relations to frequency of past 30-day use and anxiety sensitivity among young adult marijuana smokers. Addict Behav 32:49–62
Bowers M, Boutros N, D’Souza DC, Madonick S (2001) Substance abuse as a risk factor for schizophrenia and related disorders. Int J Mental Health 30:33–57
Boyd S, Tashkin D, Huestis M, Heishman S, Dermand J, Simmons M, et al (2005) Strategies for quitting among non-treatment-seeking marijuana smokers. Am J Addict 14:35–42
Brook JS, Rosen Z, Brook DW (2001) The effect of early marijuana use on later anxiety and depressive symptoms. NYS Psychol January:35–39
Budney AJ, Higgins ST, Radonovich KJ, Novy PL (2000) Adding voucher-based incentives to coping skills and motivational enhancement improves outcomes during treatment for marijuana dependence. J Consulting Clin Psychol 68:1051–1061
Budney AJ, Hughes JR, Moore BA, Novy PL (2001) Marijuana abstinence effects in marijuana smokers maintained in their home environment. Archiv Gen Psychiatry 58:917–924
Budney AJ, Hughes JR, Moore BA, Vandrey R (2004) Review of the validity and significance of cannabis withdrawal syndrome. Am J Psychiatry 161:1967–1977
Budney AJ, Hughes JR, Moore BA, Vandrey R (2004) Review of the validity of the significance of cannabis withdrawal syndrome. Am J Psychiatry 161:1967–1977
Budney AJ, Moore BA, Vandrey R, Hughes JR (2003) The time course and significance of cannabis withdrawal. J Abnormal Psychol 112(3):393–402
Budney AJ, Novy PL, Hughes JR (1999) Marijuana withdrawal among adults seeking treatment for marijuana dependence. Addiction 94:1311–1322
Caplan GA, Brigham BA (1989) Marijuana smoking and carcinoma of the tongue. Is there an association? Cancer 66:1005–1006
Chait LD, Zacny JP (1992) Reinforcing and subjective effects of oral Δ9-THC and smoked marijuana in humans. Psychopharmacology 107:255–262
Charbrol H, Duconge E, Casas C, Roura C, Carey KB (2005) Relations between cannabis use and dependence, motives for cannabis use and anxious, depressive and borderline symptomatology. Addict Behav 30:829–840
Chen C-Y, Wagner FA, Anthony JC (2002) Marijuana use and the risk of major depressive episode: epidemiological evidence from the United States national comorbidity survey. Soc Psychiatry Psychiatric Epidemiol 37:199–206
Chen K, Kandel DB, Davies M (1997) Relationships between frequency and quantity of marijuana use and last year proxy dependence among adolescents and adults in the United States. Drug Alcohol Depend 46:53–67
Coates RA, Farewell VT, Raboud J, Read SE, MacFadden DK, Calzavara LM, Johnson JK, Shepherd FA, Fanning MM (1990) Cofactors of progression to acquired immunodeficiency syndrome in a cohort of male sexual contacts of men with human immunodeficiency virus disease. Am J Epidemiol 132:717–722
Compton WM, Grant BF, Colliver JD, Glantz MD, Stinson FS (2004) Prevalence of marijuana use disorders in the United States: 1991–1992 and 2001–2002. J Am Med Assoc 291:2114–2121
Cooper ML (1994) Motivations for alcohol use among adolescents: development and validation of a four-factor model. Psychol Assess 6:117–128
Cooper M, Frone M, Russell M, Mudar P (1995) Drinking to regulate positive and negative emotions: a motivational model of alcohol use. J Pers Soc Psychol 69:990–1005
Copeland J, Swift W, Roffman R, Stephens R (2001) A randomized controlled trial of brief cognitive-behavioural interventions for cannabis use disorder. J Subst Abuse Treat 21:55–64
Copersino M, Boyd S, Tashkin D, Huestis M, Heishman S, Dermand J, et al (2006) Quitting among non-treatment-seeking marijuana users: reasons and changes in other substance use. Am J Addict 15:297–302
Cox W, Klinger E (1988) A motivational model of alcohol use. J Abnorm Psychol 97:168–180
Cunningham J (2000) Remissions from drug dependence: is treatment a prerequisite? Drug Alcohol Depend 59:211–213
Day NL, Wagener DK, Taylor PM (1985) Measurement of substance use during pregnancy: methodologic issues. NIDA Res Monogr 59:36–47
Degenhardt L, Hall W, Lynskey M (2001) Alcohol, cannabis, and tobacco use among Australians: a comparison of their associations with other drug use and disorders, affective and anxiety disorders, and psychosis. Addiction 96:1603–1614
Dennis M, Babor TF, Roebuck MC, Donaldson J (2002) Changing the focus: the case for recognizing and treating cannabis use disorders. Addiction 97:4–15
Devane WA, Hanus L, Breuer A, Pertwee RG, Stevenson LA, Griffin G, Gibson D, Mandelbaum A, Etinger A, Mechoulam R (1992) Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science 258:1946–1949
Diamond G, Panichelli-Mindel SM, Shera D, Dennis M, Tims F, Ungemack J (2006) Psychiatric syndromes in adolescents with marijuana abuse and dependency in outpatient treatment. J Child Adolesc Subst Abuse 15:37–54
Didcott P, Flaherty B, Muir C (1988) A profile of addicts in residential treatment in New South Wales. Directorate of the Drug Offensive, in House Report Series. New South Wales Department of Health, Sydney
D’Souza D, Abi-Saab S, Madonick K, Forselius-Bielen A, Doersch G, Braley R, Gueorguieva T, Cooper J, Krystal J (2000) Delta-9-tetrahydrocannabinol effects in schizophrenia: implications for cognition, psychosis, and addiction. Biol Psychiatry 57:594–608
Everest JT, Tunbridge RJ, Widdop B (1989) The incidence of drugs in road accident fatalities. Department of Transport and Road Research Laboratory Research Report 202. Department of Transport Publications, London
Fligiel SE, Roth MD, Kleerup EC, Barsky SH, Simmons MS, Tashkin DP (1997) Tracheobronchial histopathology in habitual smokers of cocaine, marijuana, and/or tobacco. Chest 112:319–326
Gerstein DR, Johnson RA (2000) Nonresponse and selection bias in treatment follow-up studies. Subst Use Misuse 35:971–1014
Gjerde H, Kinn G (1991) Impairment in drivers due to cannabis. Forensic Sci Int 50:57–60
Godley M, Kahn J, Dennis M, Godley S, Funk R (2005) The stability and impact of environmental factors on substance use and problems after adolescent outpatient treatment for cannabis abuse or dependence. Psychol Addict Behav 19:62–70
Goodstadt M, Sheppard M, Chan G (1984) Non-use and cessation of cannabis use: neglected foci of drug education. Addict Behav 9:21–31
Green BE, Ritter C (2000) Marijuana use and depression. J Health Soc Behav 41:40–49
Green B, Young R, Kavanagh D (2005) Cannabis use and misuse prevalence among people with psychosis. Br J Psychiatry 187:306–313
Hall W, Degenhardt L (2004) Is there a specific ’cannabis psychosis’? In: Marijuana and madness: psychiatry and neurobiology. Cambridge University Press, New York
Hall W, Johnston L, Donnelly N (1999) The epidemiology of cannabis use and its consequences. In: The health effects of cannabis. Centre for Addiction and Mental Health, Canada
Hall W, Solowij N (1998) Adverse effects of cannabis. Lancet 352:1611–1616
Hall W, Solowij N, Lemon J (1994) The health and psychological consequences of cannabis use. National Drug Strategy Mongraph Series, 25, http://www.druglibrary.org/schaffer/hemp/medical/HOME.HTM
Hambrecht M, Hafner H (2000) Cannabis, vulnerability, and the onset of schizophrenia: an epidemiological perspective. Aust N Z J Psychiatry 34:468–475
Haney M, Ward AS, Comer SD, Foltin RW, Fischman MW (1999) Abstinence symptoms following smoked marijuana in humans. Psychopharmacology 141:395–404
Harrison P, Asche S (2001) Adolescent treatment for substance use disorders: outcomes and outcome predictors. J Child Adolesc Subst Abuse 11:1–18
Hathaway AD (2003) Cannabis effects and dependency concerns in long-term frequent users: a missing piece of the public health puzzle. Addict Res Theory 11:441–458
Herkenham M, Lynn A, Little MD, Johnson MR, Melvin LS, de Costa BR, Rice KC (1990) Cannabinoid receptor localization in the brain. Proc Natl Acad Sci USA 87:1932–1936
Hollister LE (1986) Health aspects of cannabis. Pharmacol Rev 38:1–20
Hollister LE (1992) Marijuana and immunity. J Psychoactive Drugs 24:159–164
Hubbard R, Collins J, Rachal J, Cavanaugh E (1988) The criminal justice client in drug abuse treatment. Compulsory treatment of drug abuse: research and clinical practice. National Institute on Drug Abuse, Rockville, MD, pp 57–80
Hughes J (1996) The future of smoking cessation therapy in the United States. Addiction 91:1797–1802
Hunt CA, Jones RT, Herning RI, Bachman J (1981) Evidence that cannabidiol does not significantly alter the pharmacokinetics of tetrahydrocannabinol in man. J Pharmacokinetics Biopharmaceutics 9:245–60
Ikard FF, Green DE, Horn D (1969) A scale to differentiate between types of smoking as related to the management of affect. Int J Addictions 4:649–659
Johns A (2001) Psychiatric effects of cannabis. Br J Psychiatry 178:116–122
Johnston LD, O’Malley PM, Bachman JG (1995) National survey results on drug use from the monitoring the future study, 1975–1994. National Institute on Drug Abuse, Rockville, MD
Johnston LD, O’Malley PM, Bachman JG (2003) Monitoring the future: national survey results on drug use, 1975–2002. National Institute of Drug Abuse, Bethesda, MD
Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE (2004) Monitoring the future: national survey results on drug use, 1975–2003. University of Michigan, Institute for Social Research
Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE (2005) Monitoring the future: national results on adolescent drug use. National Institutes of Health. US Department of Health and Human Services, Bethesda, MD
Kalant H, Corrigall W, Hall W, Smart R (1999) The health effects of cannabis. Centre for Addiction and Mental Health, Canada
Kandel D, Chen K, Warner LA, Kessler RC, Grant B (1997) Prevalence and demographic correlates of symptoms of last year dependence on alcohol, nicotine, marijuana, and cocaine in the U.S. population. Drug Alcohol Depend 44:11–29
Kaplan HB (1996) Perspectives on psychosocial stress. In: Psychosocial stress: perspectives on structure, theory, life-course, and methods. Academic, San Diego, CA
Kaslow RA, Blackwelder WC, Ostrow DG, Yerg D, Palenick J, Coulson AH, Valdiserri RO (1989) No evidence for a role of alcohol or other psychoactive drugs in accelerating immunodeficiency in HIV-1-positive individuals: a report from the Multicenter AIDS Cohort Study. J Am Med Assoc 261:3424–3429
Katerndahl D, Realini J (1993) Lifetime prevalence of panic states. Am J Psychiatry 150:246–249
Latimer W, Winters K, Stinchfield R, Traver R (2000) Demographic, individual, and interpersonal predictors of adolescent alcohol and marijuana use following treatment. Psychol Addict Behav 14:162–173
Lehman WEK, Simpson DD (1992) Employee substance use and on-the-job behaviors. J Appl Psychol 77:309–321
Leirer VO, Yesavage JA, Morrow DG (1991) Marijuana carry-over effects on aircraft pilot performance. Aviation Space Environ Med 62:221–227
Litt MD, Kadden RM, Stephens RS (2005) Coping and self-efficacy in marijuana treatment: results from the marijuana treatment project. J Consult Clin Psychol 73:1015–1025
Loeber RT, Yurgelun-Todd DA (1999) Human neuroimaging of acute and chronic marijuana use: implications for frontocerebellar dysfunction. Human Psychopharmacol Clin Exp 14:291–304
Lynskey M, Hall W (2000) The effects of adolescent cannabis use on educational attainment: a review. Addiction 95:1621–1630
Martin CE, Duncan DF, Zunich EM (1983) Students’ motives for discontinuing illicit drug-taking. Health Values 7:8–11
Mathers DC, Ghodse AH (1992) Cannabis and psychotic illness. Br J Psychiatry 161:648–653
McDonald J, Schleifer L, Richards JB, de Wit H (2003) Effects of delta9-tetrahydrocannabinol on behavioral measures of impulsivity in humans. Neuropsychopharmacology 28:1356–1365
McRae AL, Budney AJ, Brady KT (2003) Treatment of marijuana dependence: a review of the literature. J Subst Abuse Treat 24:369–376
Mitchell H, Zvolensky MJ, Marshall EC, Bonn-Miller MO, Vujanovic AA (2007) Incremental validity of coping-oriented marijuana use motives in the prediction of affect-based psychological vulnerability. J Psychopathol Behav Assess 29:277–288
Moore B, Budney A (2003) Relapse in outpatient treatment for marijuana dependence. J Subst Abuse Treat 25:85–89
Newcombe MD, Bentler P (1988) Consequences of adolescent drug use: impact on the lives of young adults. Sage, Newbury Park, CA
O’Dea PJ, Murphy B, Balzer C (1997) Traffic and illegal production of drugs in rural America. In: Robertson EB, Sloboda Z, Boyd GM, Beatty L, Kozel NJ (eds) Rural substance abuse: state of knowledge and issues. NIDA Res Monogr 168:79–89
Ohlsson A, Lindgren JE, Wahlen A, Agurell S, Hollister LE, Gillespie HK (1980) Plasma delta-9 tetrahydrocannabinol concentrations and clinical effects after oral and intravenous administration and smoking. Clin Pharmacol Therapeutics 28:409–416
Piper ME, Piasecki TM, Federman EB, Bolt DM, Smith SS, Fiore MC Baker TB (2004) Amultiple motives approach to tobacco dependence: the Wisconsin inventory of smoking dependence motives (WISDM-68). J Consult Clin Psychol 72:139–154
Reilly D, Didcott R, Swift W, Hall W (1998) Long-term cannabis use: characteristics of users in an Australian rural area. Addiction 93:837–846
Russell MAH, Peto J, Patel UA (1974) The classification of smoking by factorial structure of motives. J Royal Stat Soc 137:313–329
Schuckit MA (1989) Drug and alcohol abuse: a clinical guide to diagnosis and treatment, 3rd edn. In: Critical issues in psychiatry: an educational series for residents and clinicians. Plenum Medical Book Co/Plenum, New York, NY, England
Sells SB (1974) The effectiveness of drug abuse treatment: I & II. Ballinger, Oxford, England
Semple DM, McIntosh AM, Lawrie SM (2005) Cannabis as a risk factor for psychosis: systematic review. J Psychopharmacol 19:187–194
Sherrill DL, Krzyzanowski M, Bloom JW, Lebowitz MD (1991) Respiratory effects of non-tobacco cigarettes: a longitudinal study in general population. Int J Epidemiol 20:132–137
Simpson DD, Savage LJ, Lloyd MR, Sells SB (1978) Evaluation of drug abuse treatments based on first year follow-up (NIDA Services Research Monograph Series, DHEW No. ADM 78–701). U.S. Government Printing Office, Washington, DC
Simons J, Correia CJ, Carey KB (2000) A comparison of motives for marijuana and alcohol use among experienced users. Addict Behav 25:153–160
Simons J, Correia CJ, Carey KB, Borsari BE (1998) Validating a five-factor marijuana motives measure: relations with use, problems, and alcohol motives. J Counseling Psychol 3:265–273
Solowij N (1998) Cannabis and cognitive functioning. University Press, Cambridge
Sridhar KS, Raub WA, Weatherby NL Jr, Metsch LR, Surratt HL, Inciardi JA, Duncan RC, Anwyl RS, McCoy CB (1994) Possible role of marijuana smoking as a carcinogen in the development of lung cancer at a young age. J Psychoactive Drugs 26:285–288
Stephens RS (1999) Effects of brief and extended treatment on marijuana use and related problems. In: Babor T (Chair) Treatment of marijuana dependence. Symposium conducted at the meeting of the American Public Health Association, Chicago
Stephens RS, Babor TF, Kadden R, Miller M, the Marijuana Treatment Project Group. (2002) The marijuana treatment project: rationale, design, and participant characteristics. Addiction 97:109–124
Stephens RS, Roffman RA, Curtin L (2000) Comparison of extended versus brief treatments for marijuana use. J Consult Clin Psychol 68:898–908
Stephens RS, Roffman RA, Simpson EE (1993) Adult marijuana users seeking treatment. J Consult Clin Psychol 61:1100–1104
Stephens RS, Roffman RA, Simpson EE (1994) Treating adult marijuana dependence: a test of the relapse prevention model. J Consult Clin Psychol 62:92–99
Stephens R, Wertz J, Roffman R (1995) Self-efficacy and marijuana cessation: a construct validity analysis. J Consult Clin Psychol 63:1022–1031
Stewart SH, Zeitlin SB, Samoluk SB (1996) Examination of a three-dimensional drinking motives questionnaire in a young adult university student sample. Behav Res Therapy 34:61–71
Stewart SH, Zvolensky MJ, Eifert GH (2001) Negative-reinforcement drinking motives mediate the relation between anxiety sensitivity and increased drinking behavior. Pers Individual Differences 31:157–171
Substance Abuse and Mental Health Services Administration (1998) Services research outcome study. Department of Health and Human Services Publication No. SMA 98–3177. Author, Rockville, MD
Sussman S, Stacy A, Dent C, Simon T (1996) Marijuana use: current issues and new research directions. J Drug Issues 26:695–733
Tanda G, Goldberg SR (2003) Cannabinoids: reward, dependence, and underlying neurochemical mechanisms – a review of recent preclinical data. Psychopharmacology 169:115–134
Tashkin DP (1993) Is frequent marijuana smoking harmful to health? Western J Med 158:635–637
Tashkin DP, Simmons MS, Sherrill DL, Coulson AH (1997) Heavy habitual marijuana smoking does not cause an accelerated decline in FEV1 with age. Am J Respir Critical Care Med 155:141–148
Thomas H (1996) A community survey of adverse effects of cannabis use. Drug Alcohol Depend 42:201–207
Thorndike AN, Rigotti NA, Stafford RS, Singer DE (1998) National patterns in the treatment of smokers by physicians. JAMA: J Am Med Assoc 279:604–608
Tunving K (1985) Psychiatric effects of cannabis use. Acta Psychiatrica Scandinavica 72:209–217
Weiner M, Sussman S, McCuller W, Lichtman K (1999) Factors in marijuana cessation among high-risk youth. J Drug Education 29:337–357
Young ME, Rintala DH, Rossi CD, Hart KA, Fuhrer MJ (1995) Alcohol and marijuana use in a community-based sample of persons with spinal cord injury. Archiv Phys Med Rehab 76:525–532
Zvolensky M, Bernstein A, Sachs-Ericsson N, Schmidt N, Buckner J, Bonn-Miller MO (2006) Lifetime associations between cannabis, use, abuse, and dependence and panic attacks in a representative sample. J Psychiatr Res 40(6):477–486
Zvolensky MJ, Bonn-Miller MO, Bernstein A, McLeish. AC, Feldner MT, Leen-Feldner EW (2006) Anxiety sensitivity interacts with marijuana use in the prediction of anxiety symptoms and panic-related catastrophic thinking among daily tobacco users. Behav Res Ther 44:907–924
Zvolensky MJ, Feldner MT, Leen-Feldner E, Bonn-Miller MO, McLeish AC, Gregor K (2004) Evaluating the role of anxiety sensitivity in smoking outcome expectancies among regular smokers. Cogn Ther Res 28:473–486
Zvolensky MJ, Lewinsohn P, Bernstein A, Schmidt NB, Buckner JD, Seeley J, Bonn-Miller MO (2008) Prospective associations between cannabis use, abuse, and dependence and panic attacks and disorder. J Psychiatr Res 42:1017–1023
Zvolensky MJ, Vujanovic AA, Bernstein A, Bonn-Miller MO, Marshall EC, Leyro T (2007) Marijuana use motives: a confirmatory test and evaluation among young adult marijuana users. Addict Behav 32:3122–3130
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Zvolensky, M.J., Bonn-Miller, M.O., Leyro, T.M., Johnson, K.A., Bernstein, A. (2010). Marijuana: An Overview of the Empirical Literature. In: Johnson, B. (eds) Addiction Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0338-9_20
Download citation
DOI: https://doi.org/10.1007/978-1-4419-0338-9_20
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4419-0337-2
Online ISBN: 978-1-4419-0338-9
eBook Packages: MedicineMedicine (R0)