In many countries, cannabis use is not viewed as a serious problem. It may be perceived as a form of entertainment, relaxation, or even as a form of medicine. Popular culture often seems to downplay the risks associated with cannabis use. However, it is impossible to ignore the fact that cannabis, being a psychoactive substance, affects the brain’s reward system. Experts agree that cannabis dependence is not merely a bad habit - it is a serious threat to both physical and mental well-being.

The Difference Between Cannabis and Synthetic Cannabinoids

Cannabis is a plant that contains over 100 different cannabinoids, the most important being tetrahydrocannabinol (THC) and cannabidiol (CBD). THC produces psychoactive effects such as euphoria, altered perception, and relaxation. CBD, on the other hand, has antioxidant and anti-inflammatory properties.

Synthetic cannabis refers to a group of chemical substances designed to mimic the effects of THC, but their structure and impact on the body can be significantly different from natural cannabis. Synthetic cannabinoids are composed of psychoactive compounds that often bind more strongly to cannabinoid receptors, leading to more intense effects. While they imitate natural cannabis, they also cause severe adverse effects such as respiratory difficulties, hypertension, tachycardia, chest pain, muscle spasms, acute kidney failure, anxiety, agitation, psychosis, and suicidal thoughts. Chronic use of synthetic cannabinoids has been associated with serious psychiatric and medical conditions, and even death.

What is Cannabis Use Disorder?

Cannabis use disorder develops when a person starts using the substance in larger amounts or over a longer period than originally intended. For example, someone may plan to smoke cannabis once a week, but ends up using it daily and in larger quantities. Over time, they may want to reduce or control their use but find it difficult to do so. Another symptom involves spending significant time obtaining, using, or recovering from cannabis. Strong cravings may develop, and important work, family, or social responsibilities may be neglected.

A key sign is continued use despite clear negative consequences. Cannabis use disorder can range in severity - from mild dependence (with 2–3 symptoms) to severe dependence (with 6 or more symptoms). About 4% of the adult population worldwide has used cannabis at some point in their lives.

Development and Stages of Dependence

Dependence develops gradually and progresses through several stages. Initially, a person may use cannabis to relax, improve mood, or relieve stress. Over time, use may become regular, and doses may increase to achieve the same effects. At this stage, the person may begin losing control over their use and engage in it even in risky or socially inappropriate situations.

The next phase involves both psychological and physical dependence. The person may feel a strong urge to use cannabis despite negative effects on health, work, or personal relationships. Attempts to quit may result in withdrawal symptoms.

In the final stage, the person loses control over their life. Cannabis - or synthetic cannabis - becomes the center of their existence, replacing vital aspects of life such as work, family, and hobbies. The addiction leads to a decline in physical and mental health, social isolation, and overall quality of life.

Impact on Life

Dependence on cannabis or synthetic cannabis can have serious health consequences. Chronic use impairs cognitive function, learning ability, memory, and concentration. It may also increase the risk of developing mental health disorders such as depression, anxiety disorders, and schizophrenia, especially in individuals with a predisposition.

The risks of synthetic cannabis are greater. It can trigger acute psychosis, severe cardiovascular and respiratory complications, and neurological impairments. These effects can be long-lasting and, in some cases, irreversible.

People dependent on cannabis or synthetic cannabinoids often feel hopeless and ashamed. They may recognize the destructive consequences of their behavior but feel powerless to stop. Addiction disrupts social connections, often results in job loss, financial difficulties, and a generally diminished quality of life.

Treatment

Treatment goals for cannabis and synthetic cannabinoid use disorder may include abstinence, reduced use, or harm reduction. Most treatment takes place in outpatient settings, though more complex cases may require inpatient care.

Psychotherapy is the first-line treatment, with behavioral approaches being the most effective. Cognitive Behavioral Therapy (CBT) and Motivational Enhancement Therapy (MET) have shown benefit in treating cannabis use disorder. Other approaches - such as counseling, family therapy, mindfulness-based therapy, and relapse prevention - may also be helpful, although their effectiveness is less well established. Mutual aid groups can be valuable resources for some individuals but should be used in addition to evidence-based methods.

Pharmacological treatment may involve medications that ease withdrawal symptoms or treat co-occurring mental health conditions, thereby supporting therapy adherence and success. It’s important to note that successful treatment takes time and patience, and relapses are often part of the recovery process.

The prognosis depends on many factors, including the severity of dependence, the presence of support, motivation for treatment, and co-occurring mental health disorders. With appropriate treatment and support, many people are able to stop using cannabis and synthetic cannabinoids altogether and rebuild their lives.