By Robert L. DuPont
Following the publication of “High Hopes? Or Smoke and Mirrors?”, Robert Bell asked me to share my thoughts on marijuana abuse, addiction, and addiction treatment options. I am a psychiatrist specializing in addiction medicine who served as first Director of the National Institute on Drug Abuse and second White House Drug Chief, and so I have dealt extensively in matters related to addictive substances.
Substance use disorders, as defined in the DSM-V, are the negative consequences produced by the use of specific substances such as alcohol and cocaine. When this criterion is applied to marijuana use, there is a substantial amount of dependence resulting from the use of marijuana (a.k.a., marijuana addiction). In fact, in 2013 over 60 percent of all Americans 12 and older with dependence on any drug other than alcohol were dependent on marijuana. That is more than any other drug. The wonder is not that marijuana dependence exists or that it is so prevalent; the wonder is that anyone could doubt the widespread existence of marijuana addiction. It is well known that everyone who smokes a cigarette does not become addicted to nicotine and everyone who drinks does not become dependent on alcohol. These facts are true of marijuana too. But unlike marijuana, most people wouldn’t seriously claim that cigarettes or alcohol are safe and not addictive just because not everyone who uses these drugs becomes addicted.
It is remarkable that there are so many passionate, vociferous people who deny that marijuana is addictive. For decades, the tobacco and alcohol industries tried taking this approach of active denial of addiction. Today, they would be ashamed to do that. How long will it take before marijuana falls into that same category as a universally recognized addictive drug? How long until virtually everyone accepts that marijuana is a dependence-producing drug, right along with alcohol, nicotine, and other widely used drugs?