Person, substance, environment
Experts describe addiction in terms of three sides that interact. None of them alone explains why someone becomes dependent.
Person, substance, environment
Persondealing with feelings and problems, self-confidence, predisposition
Substancehow strongly the substance acts, how easy it is to get
Environmentfamily, friends, school and work
Risk factors describe probabilities. They do not predict what will happen to any one person. When several come together, the risk rises markedly.
What happens in the brain
THC acts on the reward system, which otherwise responds to food, closeness or success. If this happens often, the brain adjusts: it becomes less sensitive and needs more for the same effect. Experts call this tolerance. After the high, restlessness, irritability and unease can follow. Over time, people then often use cannabis to get rid of this unease, and no longer for the high.
When use becomes a source of relief
- Pressurestress, anxiety, anger, loneliness
- Useto switch off
- Brief reliefthe pressure recedes
- Unease afterwardsrestlessness, irritability, the pressure returns
When cannabis becomes a crutch
People who use cannabis to dampen anxiety, anger or sadness have a higher risk of becoming dependent. Using can itself make the anxiety worse, and the relief turns into a cycle.
Risk factors
- frequency of use, the strongest single factor
- starting early, especially before 16
- high THC
- smoking tobacco at the same time
- psychological stress, lack of support, lack of prospects, major life events such as a break-up
- a circle of friends in which almost everyone uses
What protects
Optimism, the feeling of being able to make a difference, the ability to tackle problems, supportive relationships, a network of family and friends and a purpose in education or work. Such protective factors can offset risks.
How experts classify it
According to DSM-5, cannabis use disorder is present when at least two of eleven criteria apply within twelve months; two to three count as mild, four to five as moderate and six or more as severe. The criteria in everyday language are listed in the module Recognising warning signs. The World Health Organization lists disorders due to use of cannabis under code 6C41.
From risk to dependence, and what helps at each stage
- Occasional useInfrequent and without noticeable consequences.What helps: factual information about effects and risks
- Hazardous useThe frequency, amount or type of use markedly increases the risk. No harm has occurred yet.What helps: paying attention early, the self-test, an honest conversation
- Harmful useUse has already damaged health or led to behaviour that harms others.What helps: counselling and support, for example at an addiction counselling service
- DependenceA strong inner urge: control weakens, use becomes more important than other things and continues despite harm.What helps: treatment, meaning counselling, detoxification and therapy
The transitions are gradual, and not all hazardous use turns into dependence.
Almost one in two people who use regularly experience withdrawal symptoms: nervousness, sleep problems, poor appetite, irritability, anxiety or low mood. They begin one to two days after last use and usually subside within a week, after two at the latest.
Sources
- Bundesministerium für Gesundheit (2024): Mustercurriculum für Präventionsbeauftragte
- NIDA (2020): Drugs, Brains, and Behavior. The Science of Addiction
- drugcom.de (BIÖG): Was sind psycho-soziale Risikofaktoren für eine Cannabisabhängigkeit?
- drugcom.de (BIÖG): Entzugserscheinungen bei Cannabiskonsum
- cannabispraevention.de (BIÖG): Gesundheitliche Aspekte
- Bundesministerium für Gesundheit (2017): short report “Cannabis: Potenzial und Risiken” (CaPRis)
- Hasin et al. (2013): DSM-5 Criteria for Substance Use Disorders, American Journal of Psychiatry
- WHO (2024): ICD-11, Clinical descriptions and diagnostic requirements
- WHO: ICD-11, Hazardous use of cannabis (QE11.1) and Disorders due to use of cannabis (6C41)
- DHS: Suchtberatung