Welcome to AXIS MENTAL HEALTH | Marijuana: Cannabis Use Disorder, Risks and Treatment

Cannabis is legal for adults in California, and legal does not mean risk-free — alcohol makes that obvious enough. Cannabis use disorder is a recognized diagnosis, cannabis withdrawal is a recognized syndrome, and the potency of modern products bears little resemblance to what was available a generation ago.

This page is not an argument about legalization. It is for people who have noticed that they cannot stop, or that their teenager’s use has stopped looking casual.

Talk to Axis Mental Health

Axis Mental Health provides outpatient substance use and mental health treatment from Desert Hot Springs, California, serving the Coachella Valley, Riverside County and the wider Southern California region. Our care includes individual and group therapy, psychiatric medication management, dual-diagnosis treatment for co-occurring mental health conditions, and telehealth appointments anywhere in California.

We are an outpatient provider. We do not operate a medical detox or residential unit. If your assessment shows you need that level of care first, we will help you find a licensed program and pick your treatment up again the moment you step down.

Call (855) 405-2733 for a free, confidential consultation, or send us a message.

Potency changed the equation

Cannabis flower in the 1990s typically contained under 5% THC. Dispensary flower today commonly runs 15–25%, and concentrates — wax, shatter, live resin, distillate for vape carts — can exceed 80–90% THC.

At the same time, CBD content in high-THC cultivars has fallen. CBD appears to buffer some of the anxiety- and psychosis-promoting effects of THC, so modern products deliver more of the risky compound with less of the moderating one. Dependence, cannabis-induced psychosis, hyperemesis and severe withdrawal are all more commonly seen now, and high-potency concentrates are the main reason.

Cannabis use disorder

Estimates suggest roughly 3 in 10 people who use cannabis develop some degree of cannabis use disorder, with risk substantially higher for those who start in adolescence and those who use daily or use concentrates. The criteria are the same eleven used for any substance:

Using more or longer than intended
Repeated failed attempts to cut down or stop
Craving
Significant time spent using or recovering
Failing obligations at work, school or home
Continuing despite relationship conflict about it
Giving up other activities
Using in physically hazardous situations — driving in particular
Continuing despite a physical or psychological problem it worsens
Tolerance
Withdrawal

Practical tells: waking and using; needing it to sleep, eat or relax at all; concentrate use throughout the day; anxiety when supply runs low; spending well beyond budget; and a distinctive flattening of ambition where things you cared about quietly stop mattering.

Cannabis withdrawal is real

It is not dangerous, and it is uncomfortable enough to keep daily users using. Onset is usually within 24–72 hours, peaking around days two to six, and mostly resolving over one to three weeks. Sleep can stay disrupted for longer.

Irritability, anger, aggression
Anxiety and restlessness
Insomnia and unusually vivid, unpleasant dreams
Decreased appetite and weight loss
Depressed mood
Physical symptoms: headache, sweating, chills, stomach pain, tremor
Craving

Because THC is stored in fat and released slowly, withdrawal from heavy use has a longer tail than most people expect.

Mental health risks worth taking seriously

Psychosis. There is a dose-response relationship between cannabis use — especially high-potency products and daily use — and risk of psychotic disorders, with the greatest risk in adolescents and people with a family history. Cannabis-induced psychosis can also occur acutely, particularly with concentrates or with edibles taken in large amounts.
Anxiety and panic. Common with high-THC products, and paradoxical for people using cannabis specifically to manage anxiety.
Depression and motivation. Heavy use is associated with depressed mood and reduced motivation. Untangling cause from effect is difficult; abstinence trials usually show improvement.
Adolescent brain development. Regular use before the mid-twenties is associated with impaired learning and memory and lower educational attainment, and earlier onset predicts worse outcomes. This is the strongest reason to be strict about age.
Bipolar disorder. Cannabis can trigger manic episodes and worsen the course of the illness.

Physical risks

Cannabinoid hyperemesis syndrome (CHS): cycles of severe vomiting and abdominal pain in long-term heavy users, characteristically relieved temporarily by hot showers. Frequently misdiagnosed for years and often leading to repeat ER visits. The only reliable treatment is stopping cannabis; symptoms typically resolve over weeks.
Respiratory: chronic bronchitis, cough and phlegm from smoking. Vaping is not established as safe, and illicit vape cartridges cut with vitamin E acetate caused the EVALI outbreak.
Cardiovascular: acute increase in heart rate and, in the hour after use, elevated heart attack risk — relevant for anyone with existing cardiac disease.
Driving: cannabis measurably impairs reaction time, tracking and divided attention, and roughly doubles crash risk. Combined with alcohol the impairment is far worse.
Edibles: delayed onset of one to two hours leads to overconsumption, which is behind a large share of cannabis ER visits — including in children who find them.
Pregnancy and breastfeeding: THC crosses the placenta and enters breast milk, and is associated with low birth weight and developmental concerns. Not recommended, including for morning sickness.

Treatment

No medication is FDA-approved for cannabis use disorder. What has evidence:

Cognitive behavioral therapy plus motivational enhancement therapy, the best-studied combination.
Contingency management, incentives for verified abstinence, which adds meaningfully to CBT.
Adolescent-specific approaches: Multidimensional Family Therapy, the Adolescent Community Reinforcement Approach, and family-based treatment generally — family involvement matters more with teenagers than almost anything else.
Symptomatic support during withdrawal: sleep interventions (CBT-I rather than a hypnotic where possible), exercise, and short-term help with anxiety.
Treating what the cannabis is doing a job for. Most heavy users we see are managing anxiety, insomnia, PTSD, ADHD or pain with it. Remove the cannabis and leave the underlying condition untreated and the return is close to inevitable. This is straightforward dual-diagnosis work.
Medications under investigation: N-acetylcysteine (with better evidence in adolescents than adults), gabapentin, and dronabinol for withdrawal symptoms. Worth discussing with a clinician; none is standard care.

Axis Mental Health treats cannabis use disorder on an outpatient basis alongside the anxiety, depression, insomnia or trauma underneath it, in Desert Hot Springs and by telehealth across California.

Frequently asked questions

Is marijuana actually addictive?

Yes. Cannabis use disorder is in the DSM-5-TR, cannabis withdrawal is a recognized syndrome, and roughly 3 in 10 users develop some degree of the disorder. It does not carry the overdose risk of opioids or the withdrawal danger of alcohol, and it can absolutely become compulsive and life-narrowing.

Why do I get sick every few weeks and only hot showers help?

That pattern strongly suggests cannabinoid hyperemesis syndrome. It is caused by long-term heavy cannabis use and does not improve with anti-nausea medication. Stopping cannabis resolves it, usually over a few weeks. See a doctor to rule out other causes, and mention CHS specifically — it is frequently missed.

Is medical marijuana different?

Same compounds and same risks. There is reasonable evidence for cannabis in a handful of conditions — chemotherapy-induced nausea, certain seizure disorders using CBD formulations, some chronic pain and spasticity. A recommendation from a dispensary physician does not change the dependence or psychosis risk.

How long does cannabis stay in your system?

Longer than most drugs, because THC stores in fat. Occasional use: roughly three to seven days in urine. Daily heavy use: commonly three to six weeks. This is why testing is a poor measure of current impairment.

My teenager says it is natural and safe. What do I say?

That the risk is not about natural versus synthetic, it is about a developing brain and a much stronger product. Regular use before the mid-twenties is linked to lasting learning and memory effects and to significantly higher psychosis risk, and modern concentrates are many times stronger than what previous generations used. Family-based treatment has the best evidence for adolescents, which means involving you is part of what works.

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If this is an emergency, call 911. If you are in crisis or having thoughts of suicide, call or text 988 to reach the Suicide & Crisis Lifeline. For free, confidential treatment referrals 24 hours a day, call SAMHSA’s National Helpline at 1-800-662-4357.

This page is general health education, not medical advice, a diagnosis, or a treatment plan. Never stop or change a prescribed medication without speaking to a clinician first. Withdrawal from alcohol, benzodiazepines and barbiturates can cause seizures and can be fatal without medical supervision.

Marijuana: Cannabis Use Disorder, Risks and Treatment