Marijuana Addiction Treatment – An Overview of Effective Programs, Therapies, Medications and Supplements

How about a quote from comedian Steve Martin to start things off ...

"I used to smoke marijuana. But I'll tell you something: I would only smoke it in the late evening. Oh, occasionally the early evening, but usually the late evening - or the mid-evening. Just the early evening, mid-evening and late evening. Occasionally, early afternoon, early mid-afternoon, or perhaps the late-mid-afternoon. Oh, sometimes the early-mid-late-early morning. . . . But never at dusk." - Steve Martin¹⁶

Sound familiar!?!???

Marijuana is the world’s most widely used and abused illicit drug. A lot of people use it recreationally and never have much difficulty with it, but about 10% of people that smoke marijuana develop an addiction at some point.

Of those people that become marijuana dependent:

1. Some manage to quit on their own
2. Some seek help and manage to quit
3. Some never quit

If you smoke marijuana and you don’t want to quit…you probably won’t find much of interest here.

If you smoke marijuana and you want to quit or cut down, but you’ve never tried on your own – that’s probably something you need to do first before you consider getting professional help (check out this free online CBT based marijuana treatment program).

If you smoke marijuana, you want to quit or cut down, and you’ve tried on your own without success…then read on, pay attention and learn more about:

• Different types of marijuana treatment programs
• How to know what kind of treatment you need
• Evidence based marijuana addiction therapies
• Over the counter (OTC) marijuana addiction treatment medications
• Experimental marijuana addiction treatment medications

Should You Get Marijuana Addiction Treatment?

It's up to you. We’re not here to debate the evils/merits of pot. If you’ve smoked enough to be contemplating treatment you likely know for yourself what the drug gives…and what it takes.

People commonly seek treatment when:

1. They are unable to stop for significant lengths of time, even when motivated
2. And when the negative consequences significantly outweigh any benefits

 Examples of negative consequences include:

• Health complaints
• Thinking or memory problems
• Poor work or school performance
• Legal issues
• Financial problems
• Anxiety or paranoia
• Problems with motivation/inability to achieve goals
• Pressure from friends/family/employer

Where to Get Marijuana Addiction Treatment

If marijuana’s a problem for you, and if you can’t stop on your own, it is entirely reasonable to seek outside treatment help.

1. You probably have more treatment options than you realize
2. Treatment doesn’t always mean rehab and in a lot of situations it needn’t be costly or intensive

Some basic treatment options include:

• Getting individual substance abuse counseling
• Getting family or relationship counseling with an emphasis on changing substance use patterns
• Joining an intensive outpatient program (usually, evenings and weekends)
• Joining a day treatment program (an all day, more intensive version of an intensive outpatient program)
• Going to a residential rehab
• Going to a psychiatric hospital
• Joining a community support/self-help organization, like NA
• Moving into a sober living environment, like a halfway or three-quarter house

So you have a number of options, but which is right for you? To find out, it makes a lot of sense to meet with a professional for a substance abuse assessment and for treatment recommendations.

The Benefits of a Professional Assessment

You can save a lot of wasted time and effort (and heartache) by getting into an appropriate level of treatment right from the start.

You have a better chance of starting with an appropriate level of treatment after getting an assessment from a professional substance abuse counselor.

During an assessment, a professional will:1

• Define the specific nature of the problem you’re looking to solve
• Evaluate your readiness/motivation to change
• Evaluate your addiction severity              
• Identify barriers to treatment and recovery
• Identify secondary conditions/disabilities that may influence the treatment process
• Identify client strengths that can enhance the recovery process
• Gather information on your living arrangements and socioeconomic status to determine options and eligibility for various programs

Then, based on the results of the assessment, your resources and what’s available locally, the counselor can give you specific recommendations on what you need and where you can get it.

It doesn’t take long, it doesn’t cost much (comparatively) and it decreases the likelihood of wasted time and effort…all in all, it’s a good idea.

Marijuana Addiction Therapies

Whether you get individual therapy or get involved with a more structured treatment program, you’ll probably receive a variety of different types of therapies and interventions, such as skills training (anger management, refusal skills etc.) relapse prevention training, an introduction to community self-help groups, and many others.

So you can expect a variety of interventions, but you may want to make sure that any program (or counselor) you choose also makes use of evidence based therapies - therapies that have been proven effective for people addicted to marijuana.

Three therapies that are research proven effective, specifically for people with marijuana issues, are:

1. Cognitive Behavioral Therapy
2. Motivation Enhancement Therapy
3. Contingency Management

Cognitive Behavioral Therapy (CBT)

In a CBT for marijuana addiction program you learn skills that help you maintain abstinence. Examples of these skills include: marijuana refusal skills, coping techniques for cravings, learning to minimize your exposure to dangerous situations, general problem solving skills and many others.

Research tested marijuana addiction CBT programs are generally about an hour in length, once a week, for between 6 and 14 weeks. Marijuana CBT can be delivered through individual or group therapy sessions.

Motivational Enhancement Therapy (MET)

People often have at least some ambivalence about serious life changes (although a big part of you wants to quit using…there’s another part of you that still likes getting high or finds smoking after a hard day relaxing).

Ambivalence can derail treatment efforts, so transforming ambivalence into resolve greatly improves your chances…but how do you do this?

In MET, you explore your current behaviors and also your personal values and your short, middle and long term goals, and then you evaluate your behaviors to see where they mesh and where they clash with your values and your hopes and dreams for the future. In doing so you generate your own personally relevant reasons to seek change and you become more committed to taking the steps needed to realize this change.

MET typically occurs over 1 to 4, 45 minute sessions.

Contingency Management (CM)

It may seem like a strange idea…to win a prize for doing what you’re supposed to do – but research shows that it can help a lot to keep you on the right track.

Programs that offer contingency management motivational incentives give voucher ‘prizes’ to clients who meet treatment goals, like perfect attendance or progressive clean urine tests. Research shows that having this reward incentive as a bonus for staying clean and sober increases a person’s odds of achieving lasting recovery.

Which one works best?

All three types of treatments are proven to work, but MET and CBT works better than MET alone, and MET, CBT and CM all together seem to work best of all.²

Marijuana Addiction Treatment for Teens

Adults are more likely to initiate treatment of their own accord – teens are more likely forced into the process.

And unfortunately, though you can force an adolescent into a treatment program, you can’t make anyone want to change – that has to come from within.

For this reason, Motivational Enhancement Therapy (MET) or similar, is often a core component of marijuana addiction treatment for teens.³

OTC Marijuana Addiction Medications

Marijuana treatment medications that you can buy without needing a doctor's prescription.

N-acetylcysteine (NAC)

NAC is a cheap and safe FDA approved antioxidant supplement that greatly increases the amount of the amino acid L-cysteine that gets to the brain. People have been using NAC for a long time to treat kidney and liver diseases, among a number of other conditions. More recently, researchers have found NAC helpful in the treatment of psychiatric conditions like impulse control disorders, bipolar, OCD and addiction – even marijuana addiction.

In one study, teens given 8 weeks of NAC as a part of a marijuana addiction treatment program were almost twice as likely to give clean urine samples as teens given a placebo medication.⁴

Valerian Root

Valerian root can help with insomnia during the initial withdrawal phase.

Valerian root has been used as a sleeping aid for hundreds of years and it is endorsed by the American Academy of Family Physicians and recognized by the FDA as ‘Generally Safe’.⁵

As an adjunct to any OTC, prescription or herbal sleeping aid, you should also take steps to improve your sleep hygiene (avoiding stimulation before sleep, maintaining a regular sleep schedule, keeping your sleeping area clean and inviting, shutting off extra lights, avoiding caffeine etc.)

Experimental Marijuana Addiction Medications

The FDA has yet to approve any marijuana addiction treatment medications. However, it always makes sense to talk to your doctor about your medication options. Research continues and as the knowledge base increases, prescribing practices may change. As of April 2013, medications that show some promise as treatments include:

Oral THC

Taking small doses of synthetic THC, in a pill form, may help to reduce the severity of marijuana withdrawal symptoms. In laboratory and outpatient experiments, people given oral THC reported fewer/less severe withdrawal symptoms and no adverse effects. At higher doses, oral THC eliminated all withdrawal symptoms.⁶

Oral THC is currently available as dronabinol (Marinol), which is FDA approved for the treatment of AIDS related anorexia and weight loss and for chemotherapy related nausea and vomiting.⁷

The Canadian Society for Addiction Medicine recommends the short term use of dronabinol to help with withdrawal symptoms in early recovery.⁸

Buspirone

Buspirone is an anxiolytic (anti-anxiety) medication, similar to medications like benzodiazepines (valium, Xanax etc.).

Initial studies on buspirone show that people given buspirone as a part of a marijuana addiction treatment program experience fewer drug cravings and marijuana withdrawal symptoms.

When researchers compared buspirone to a placebo, they found that marijuana dependent subjects given buspirone had fewer failed urine tests and achieved a first cannabis-negative urine sample sooner than marijuana dependent subjects given a placebo medication.⁹

Buspirone is normally prescribed as a medication for anxiety. Though many anxiolytics, like benzodiazepines, have a high potential for abuse, there is no evidence that buspirone has any abuse potential.¹⁰

Lithium

There is some limited evidence that the bipolar mood stabilizer, Lithium, may work well to reduce the severity of marijuana withdrawal symptoms, without causing significant adverse reactions.¹¹

Zolpidem (Ambien)

People often have insomnia during the marijuana withdrawal phase. A study done on marijuana withdrawal insomnia revealed that people given zolpidem got more sleep and better REM sleep than subjects given a placebo medication. The subjects given zolpidem did not suffer next day cognitive impairments or other significant side effects.¹²

The Canadian Society for Addiction Medicine recommends that doctors prescribe zolpidem to patients looking to manage marijuana withdrawal insomnia.

Marijuana Addiction Treatment Facts and Stats

So, is it weird to get treatment for an addiction to marijuana?

Although some still argue against marijuana’s addictiveness, the volume of people seeking treatment for marijuana addiction argues strongly against this supposition.

• As of 2008, people seeking help for marijuana as a primary addiction accounted for 17% of admissions to publicly funded treatment programs. This is third only to alcohol at 40% and opiates at 20%¹³
• The average marijuana dependent treatment seeker used marijuana on a daily basis for more than 10 years.
• The average treatment seeker tries to quit marijuana without assistance 6 times before seeking professional help.
• People seeking marijuana addiction treatment are more likely than the general population to also have a co-occurring psychiatric disorder. In fact, people who smoke marijuana weekly or more are 7 times more likely than people from the general population to have a mental illness¹⁴
• Most people seeking marijuana addiction treatment also abuse other drugs or alcohol¹⁵