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Marijuana, which has been legalized in some states across America mainly for medical purposes, is often categorized as a non-addictive substance. In a new study, researchers questioned whether or not this is true. The team from Massachusetts General Hospital (MGH) found that many adolescents who were being treated for outpatient substance use disorder had signs of cannabis withdrawal.

"Our results are timely given the changing attitudes and perceptions of risk related to cannabis use in the U.S.," stated senior author, John Kelly, PhD, of the Center for Addiction Medicine in the MGH Department of Psychiatry. "As more people are able to obtain and consume cannabis legally for medical and, in some states, recreational use, people are less likely to perceive it as addictive or harmful. But research shows that cannabis use can have significant consequences, and we know that among adolescents it is second only to alcohol in rates of misuse."

In this study, the researchers recruited 127 participants between the ages of 14 and 19. The teens were being treated as outpatients for substance use disorder. 90 of them reported using cannabis the most frequently. The researchers monitored the teens' drug use, withdrawal symptoms, psychiatric symptoms and consequences at the beginning of the study as well as at three, six and 12 months later by conducting interviews/surveys. The participants were then separated into two groups based on who had cannabis withdrawal symptoms and who did not.

Overall, out of the 90 cannabis users, 76 of them, or 84 percent, exhibited signs of cannabis dependence. These signs included increased tolerance, increased use, inability to reduce or stop using, and continued use regardless of medical or psychological issues caused by cannabis. Out of the entire group, 36 of them, or 40 percent, reported suffering from withdrawal symptoms.

The team added that at the start of the study, substance use and consequences from it were greater in the teens that admitted experiencing withdrawal symptoms. These teens also reported a higher incidence of mood disorders. Consequences from substance use included missing schoolwork, poor job performance, financial issues and relationship complications.

Despite the presence of having withdrawal symptoms, the teens did not use cannabis less frequently at 12-months. The researchers found that people who believed that they had a problem made a small improvement in substance use. People who did not think that they a problem but suffered from withdrawal symptoms had an initial increase in abstinence. However, cannabis use increased after three months.

"We hypothesize that participants who experience withdrawal symptoms but do not recognize having a substance use problem may not attribute those symptoms to cannabis withdrawal," explained Claire Greene, MPH, corresponding author of the report according to the press release. "Those who do acknowledge a substance-use problem may correctly attribute those symptoms to cannabis withdrawal, giving them even more motivation to change their substance use behavior."

The study, "The Prevalence of Cannabis Withdrawal and Its Influence on Adolescents' Treatment Response and Outcomes: A 12-Month Prospective Investigation," was published in the Journal of Addiction Medicine.