I Thought My Drug of Choice Wouldn’t Cause Me Problems. I Was So Wrong.
Ask A.J. is Slate’s advice column on addiction, recovery, and how to hate yourself less. Submit a question here. It’s anonymous!
Dear A.J.,
I live in Colorado and never used cannabis until it was legal, when I began vaping it occasionally. I am 50 years old, and I find myself now addicted to it. I had thought that cannabis wasn’t addictive, but there is really no other way to describe what I’m going through. My use got worse during the pandemic, when I was working from home all the time. I often vape cannabis all day, every day, and I do want to stop. I have tried more times than I can count to quit and cannot seem to do it on my own. I don’t know if AA would help or even what is the best way to get help. My doctor was encouraging to me and said she would support me, but when I asked what the options are, she said mainly anti-nausea meds, which I’m not convinced would help. What is the standard of treatment for cannabis use disorder? What can I do to give myself the best chance of success the next time I try to quit?
—Stoned in Colorado
Dear Stoned,
You’re right that cannabis doesn’t present the issues that many other substances do. My colleague Joe Schrank, who is a social worker, is a very vocal advocate for using cannabis as a part of harm reduction treatment for those with physical alcohol dependence. Here’s what he told me about the drug:
Alcohol kills 178,000 people a year compared to cannabis, which kills zero. An alcohol detox can be lethal if one isn’t under medical supervision. The consequences of a cannabis detox are pretty much wishing you had some weed.
I know how dismissive that sounds, but I assure you Joe’s on the good side, even though he’s a little grouchy. And to be clear, what he characterizes as “wishing you had some weed” can manifest in a slew of symptoms that, while not life-threatening, are rather unpleasant—everything from anxiety and anger to headaches and stomach pain, according to a paper titled “Clinical Management of Cannabis Withdrawal.” Still, the Centers for Disease Control and Prevention’s most urgent concerns when it comes to cannabis and death is the possibility of an adult getting high and driving, or kids getting into a stash of edibles.
So, you were not totally wrong in your initial assumption that weed isn’t the same as other drugs. But also, as you have discovered—you were a little wrong.
I have encountered many people like you, who feel that their cannabis addiction is being scoffed at as not a “real” addiction, and after speaking with my own personal therapist about this, and also looking up some very Google-able scientific facts, I’ve had to dismiss that notion myself. One in 10 adults who uses weed becomes real-deal addicted, same as you. That addiction—the cravings, the time spent using—can lead to “a dramatic decrease in quality of life,” Christina Brezing, a psychiatrist at Columbia University, told the New York Times. And unfortunately, according to that Times article, the best your doctor can do for you in terms of medication is probably just stuff to help manage the symptoms. “There is an urgent need to develop effective treatments, either behavioral or pharmacological, for cannabis use disorder,” psychiatrist Deepak Cyril D’Souza said in a Yale Medicine FAQ on cannabis use disorder, which also noted that various kinds of therapy can help in the meantime.
All this does not necessarily get you closer to a solution—nor contain enough of the empathic spirit I’m committed to for this column. So, to serve you better, I tagged in my friend “C.” (an alias, obv), who has also struggled with cannabis. “It can be really hard to quit,” she says. “ So hard that I have not done it fully successfully, but I have greatly reduced my THC intake and have ‘quit’ enough times to offer some advice if not expert advice.” She was delighted to share what she has learned with you:
You see? You’re not alone here. Maybe you knew that, but I definitely want you to feel that. As for what I can personally offer you, even though our specific experiences with substances differ: I can tell you that by far “fellowship and service” are the two most useful concepts holding me together and giving me the freedom to grow as a human and eliminate most of the bad feelings that drove me to (mis)use alcohol and drugs for half of my life. Those are kind of Alcoholics Anonymous terms; here is what I mean: Make yourself available to others who are going through what you are, if not the exact same scenario, others who are also struggling. Sometimes, all that’s required is to talk with someone in person or on the phone. Try to actually talk to them—not text. Part of what works here is letting the person recognize the vulnerability in your voice, opening up to them, and letting them open up to you.
If you want to gently dip your foot further into the world of fellowship, I encourage you to come to one of our Small Bow meetings. I promise you’ll find more of your people there. And the best part is, after regular attendance, you’ll feel steadier, more qualified, and, eventually, willing to help someone else find their way out. I’m excited to see you there!
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