Addiction vs Dependence

I have come to realize when you are discussing medical cannabis with someone who has never consumed the plant before that next to intoxication, addiction is the biggest concern. Even when you discuss this with someone who works at a dispensary, or even a substance abuse counselor you find that the answers are inconsistent and often based from bias or, that one article everyone has been talking about for YEARS now, that said about 9% of cannabis consumers would show dependence, and everyone FREAKED out! Let’s talk about this for a minute, and hopefully give dispensary workers, patients and advocates another tool in their tool box when advocating for themselves and others.

Addiction – Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. (American Psychiatric Association) Green Flower Media, a leader in cannabis education and training, defines addiction as a neurobiological disease that can cause impulsive cravings and use of a substance or activity even if you know it causes harm.

Many of those in the substance abuse community seem to be the last to agree that cannabis has a myriad of beneficial medical applications, including being used to transition people off of truly addictive substances. However, the evidence, both anecdotal and in the very small amount of research that has been conducted so far, points to the fact cannabis very likely causes dependence in some people, but not addiction. So since we defined addiction, let’s do the same for dependence and see why cannabis falls under this category and not under addiction.

Dependence – “the situation in which you need something or someone all the time, especially in order to continue existing or operating” (Cambridge Dictionary), or as Green Flower presents in it’s classes, “the likelihood of experiencing withdrawal after stopping something abruptly that does NOT cause physical damage to the body.” (Green Flower Media). For many, both of these definitions are vague and make people question the difference between addiction, and truly this lies in the mind of each individual.
With a background in mental health and substance abuse, I can tell you that treatment is never successful unless you address the underlying reasons for WHY someone became an addict in the first place. The research over the centuries into substance abuse, addiction and mental health have proven the link and this is why people go through counseling outside of drug counseling when seeking treatment, because if you don’t address the underlying issue, the process of addiction will continue. Let’s take me for example, since using someone else would be kind of icky… I was an addict because of my pain. Not because of any other deep seated psychological issue, but because of the amount of pain I was in on a daily basis and I had not been shown any other options. I spent my days in a haze and missed years of my life because of opioids, all prescribed by a doctor, and I never took more than I was prescribed, and yet, I was an addict. When I found my way to cannabis and began to ween myself off the medications, it became clear they had control of my life. When I wasn’t in pain, I still had to take doses of medication to keep the sweats, shakes, and nausea at bay, not to mention the mood swings. It was emotionally painful for me to KNOW that the oxy had more control over my life than I did, that was addiction in a clear cut, straightforward form that in the end, was a pretty rough battle. After two years of adding cannabis to my life I spent seventy-two hours without opioids, only CBD and THC, and I have never looked back. Breaking the chains of addiction was one of the best things I ever did for myself, and one of the hardest, but convincing people I didn’t just swap one addiction for another has been an even harder battle!

I depend on cannabis most definitely like a daily coffee drinker depends on their caffeine. Have you ever SEEN a coffee person when they are forced to go without their caffeine, or daily cuppa? They get irritated easily, their sleep can get disturbed, they can actually experience anxiety when they go to the cabinet and find it empty of their favorite brew! Are you sending them to rehab? Nope. The same can be said for cigarette smokers. They get moody, and their eating and sleeping patterns become disturbed and they can even get anxiety when the pack is almost empty and the bank account is too. And yet, no one would ever say they are addicts, or need to go to rehab, so why do we say people are addicted to cannabis and not dependent?

I know the veteran who fought for this country who has experienced debilitating nightmares for the last ten years, who has now been nightmare free for two years will experience severe anxiety, fear, depression and probably anger if someone told him those nightmares were going to return, wouldn’t you? I know the former executive with Parkinson’s who is getting to play golf, drive and LIVE again would get pretty upset, maybe even aggressive and hostile if his twice a day dose of RSO was suddenly taken away. Are you starting to get the picture? Dependence has been put into a negative light, and since 2013 there isn’t even a distinction in the DSM between dependence and addiction. For those who are using cannabis to get off opioids, or to help with the withdrawal symptoms from alcohol there needs to be a recognition of their efforts in harm reduction and a turning away from addiction, even if it is to something they may become dependent upon, especially if it is only HELPING their body!

When you are advocating for yourself, others or just the plant in general, don’t be afraid to address the dependence issue. Talk about it. Find real life examples of people you know, or use the ones I have and show people the difference and help remove the stigma! It is the responsibility of those who use the plant to enhance their lives to share with the world WHY and to remove the negative vibes that still surround it!

The conversation about addiction and dependence requires you to understand the difference and to not be afraid to talk about your cannabis use in an open forum. It is no secret that may day is regulated around medicating and keeping myself functioning. Even as the landscape of my illness(es) change, staying functional and LIVING is my main priority, because I spent years doing nothing but feeling sorry for myself, lying prone in a bed so drugged I couldn’t move. So now I wake and bake for at least an hour every morning before I do pretty much anything, and then every few hours throughout the day from there, with doses of RSO in the morning and again at night, spaced out with my medications so I can make sure I am not interfering with how my pharmaceuticals work by overloading my liver. Medicating with cannabis is not simple. It has been filled with trials and errors, but in the end, this routine means I can be a meaningful partner, a present parent, and now, an educator, advocate and cannabis wellness coach, helping others find their bliss!

Have a wonderfully wickedly elevated rest of your day!

Nicole

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