Let us simplify what may otherwise seem complicated.


Cannabis Use/Abuse

In the United States, cannabis is the most commonly used “illicit” drug; with approximately 12% of the population ages 12 and older reporting use of cannabis within the past year (Volkow et al., 2014). Some people may believe that cannabis in a non-harmful substance with no adverse effects, and while cannabis may have some beneficial qualities, the idea that there are no negative outcomes couldn’t be farther from the truth. Use of cannabis has proven to show both negative short and long-term effects with stronger effects associated with earlier use in adolescence. Short-term effects include impaired short term memory, impaired ability to learn and retain information, poor motor coordination, altered judgment and potential paranoia and psychosis if taken in larger doses. Long-term or heavy use is associated with addiction, altered brain development, poor educational outcome, cognitive impairment and lower IQ levels, diminished life satisfaction and achievement, chronic bronchitis and increased risk for psychotic disorders such as schizophrenia (Volkow et al., 2014). Compared to non-users, adults who have smoked cannabis since adolescence show brain abnormalities including reduced functional connectivity in the frontal and subcortical networks and impaired connectivity and reduced volume in the hippocampus. The frontal networks are associated with executive functions, inhibitory control while the hippocampus is critical for learning and memory. Cannabis use disorder as defined by the DSM-V refers to a span of criteria including the use of cannabis for at least one year accompanied by impairment or distress, difficulty stopping the use of cannabis, repeated failed effort to discontinue use, excessive time spent acquiring, using or recovering from cannabis, cravings or urges to use cannabis, continued use despite adverse consequences such as criminal charges or relationship problems, less involvement in occupational, social or school activities due to use, continued use despite dangerous situations such as driving, continued use despite knowing it exacerbates a medical or psychological problem, developed tolerance requiring larger amounts to receive desired effect, and withdrawal symptoms. Cannabis abuse is also associated with increased risk for other mental health problems such as depression, anxiety, bipolar disorder, or additional substance use disorders (Blanco et al., 2016).

Despite the legalization and popularity of cannabis use for certain medical conditions, the evidence does support detrimental effects of use.  Just like any medication or drug, there are effects and side effects and it is important to evaluate the possible positive outcomes from use vs. the negative.  Dr. Serin can detect chronic cannabis users from an EEG alone without any historical information because of the effects on brain activity. Frontal alpha rhythm slowing is a common problem with chronic users, and although some maintain cannabis is not addictive, the scientific evidence supports the idea that it is an addictive substance.  Some of the confusion might arise from the fact that the molecule THC is fat soluble and therefore will stay in a person’s system for a few months after last use.  So the active drug mechanism may be producing a mild effect for a significant amount of time after use and therefore withdrawal from cannabis may not occur immediately after stopping the drug.  Chronic users may report the first few months of no use was “easy” but then they started feeling symptoms, cravings, and having difficulties abstaining from using cannabis about 2-3 months after stopping.  This supports the idea of delayed withdrawal but it may be withdrawal nonetheless.  Serin Center specialists can integrate care to help with cannabis use and abuse.

Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. B. (2014). Adverse Health Effects of Marijuana Use. The New England Journal of Medicine, 370(23), 2219–2227.

Blanco C, Hasin DS, Wall MM, Florez-Salamanca, L., Hoertel., N., Wang, S., Kerridge, B. T., & Olfsen, M. (2016). Cannabis use and risk of psychiatric disorders: Prospective evidence from a US national longitudinal study. JAMA Psychiatry, 73(4):388–395. doi:10.1001/jamapsychiatry.2015.3229


What We Don’t Treat



Source: National Resource Center on ADHD



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