Cannabis addiction

What is cannabis addiction?

Cannabis comes from the hemp plant. In India it is mainly used in three forms: ganja (dried flowers and leaves, usually smoked), charas or hashish (the resin, often smoked mixed with tobacco) and bhang (a paste made from the leaves, taken in thandai, lassi or as golis). The chemical mainly responsible for the “high” is called THC.

Cannabis addiction, known medically as cannabis use disorder or cannabis dependence, is when use becomes hard to control even though it is causing problems. It usually builds slowly. Someone who started smoking with friends at weekends may, over months or years, find they need a joint to sleep, relax, eat or simply get through the day.

This is not a sign of laziness or bad character. Regular cannabis use changes the brain’s reward and stress systems, so the person needs more to feel the same effect and feels unsettled without it. That is why “just stop” rarely works on its own, and why treatment helps.

Cannabis use is common in India. A national survey led by AIIMS found that about 3.1 crore people aged 10–75 had used a cannabis product in the past year: about 2.2 crore used bhang and about 1.3 crore used ganja or charas. Around 72 lakh people need help for problems related to their cannabis use.

Bhang, festivals and when use becomes a problem

Bhang has a long cultural place in India, especially around Holi and Mahashivratri, and many people have it occasionally without developing an addiction. There is no need for shame or judgement about that tradition. Bhang is legally sold in many states, while ganja and charas are illegal under the NDPS Act, 1985.

Two points are still worth knowing. First, bhang taken in food or drink acts slowly, so people often take more while waiting to “feel something”, and the effects can last for many hours. Second, the national survey found that dependence was proportionately more common among people using ganja or charas (about one in seven) than among those using bhang (about one in sixteen). Use becomes a concern when it moves from an occasional festival to a regular routine, or when it is hard to cut down.

Stronger cannabis today

Cannabis is not the same product it was a generation ago. Higher-potency forms, such as strong imported strains, hash oil, concentrates, vape cartridges and cannabis edibles, contain much more THC. A large European study defined high-potency cannabis as more than 10% THC and found it carried a clearly higher risk of psychosis than lower-potency types. Stronger products also make dependence, anxiety and panic more likely.

Signs to look out for

You or someone close to you may have a problem with cannabis if you notice several of these:

• Using more often, or in larger amounts, than intended
• Wanting to cut down, or trying to, without success
• Strong cravings, or thinking about the next smoke much of the day
• Needing more to get the same effect
• Feeling irritable, restless or unable to sleep or eat without it
• Spending a lot of time and money getting cannabis or recovering from it
• Falling behind in studies, work or family responsibilities
• Continuing despite arguments at home, low mood, anxiety or suspicious thoughts
• Losing interest in hobbies, sport or friends who don’t use
• Using before driving or other risky situations
• Hiding use, lying about it, or borrowing money without explanation

A psychiatrist assesses how many of these apply and how much cannabis is affecting health and daily life.

Cannabis withdrawal

When someone who uses cannabis regularly cuts down or stops, withdrawal is common. A large review found that nearly half of people with regular or dependent use experience it. Symptoms usually begin within a week of stopping and include:

• Irritability, anger or restlessness
• Anxiety or nervousness
• Poor sleep and vivid, disturbing dreams
• Low appetite or weight loss
• Low mood
• Strong cravings
• Physical discomfort such as headache, sweating or stomach upset

Cannabis withdrawal is not usually medically dangerous, but it is very uncomfortable, and it is a common reason people start using again within days. Support during this period makes a real difference.

How cannabis affects memory, motivation and studies

THC acts on parts of the brain involved in memory, attention and learning. While someone is high, and for some time after, it becomes harder to take in and recall new information. With regular use, people often notice:

• Poor concentration and forgetfulness
• Slower thinking and reaction times
• Reduced motivation and a feeling of “not caring” about goals
• Falling grades, missed classes or poor work performance
• Disturbed sleep routines

The World Health Organization notes that cannabis impairs learning, and that prolonged heavy use may lead to greater impairment that does not always fully recover after stopping. The encouraging news is that many people find their focus and energy return once they stop and their sleep and mood settle.

Smoking cannabis, often mixed with tobacco, also irritates the lungs and can cause a long-term cough and bronchitis.

Cannabis and psychosis

Psychosis is a condition in which a person loses touch with reality. They may hear voices, feel watched or followed, or hold strong beliefs that others cannot share. It is important to be clear and careful about what the research shows:

• A large study across 11 sites in Europe and Brazil found that people who used cannabis daily were about three times as likely to have developed psychosis as people who had never used it. For daily use of high-potency cannabis, the odds were nearly five times higher.
• The researchers concluded that differences in daily and high-potency use contributed to the large differences in how common psychosis was between cities.
• The risk appears greater when use starts at a young age and is heavy and frequent.
• In people who already have schizophrenia, cannabis can worsen symptoms.

Most people who use cannabis will not develop psychosis. But the risk is real, and it can be reduced. If a person who uses cannabis becomes unusually suspicious, withdrawn, fearful or confused, stopping cannabis and getting an early assessment is the most important step.

Cannabis, anxiety and depression

Many people use cannabis to calm anxiety, lift low mood or sleep. In the short term it can seem to help, but regular use often makes anxiety, panic attacks and low mood worse, and withdrawal adds to the distress. Some people also experience thoughts of self-harm. If this happens, it is important to reach out for help straight away. Anxiety and depression respond well to treatment, and treating them alongside cannabis use improves recovery.

Young people and parents

The teenage brain is still developing into the mid-twenties, which makes it more sensitive to cannabis. In India’s national survey, about 0.9% of children aged 10–17 had used cannabis in the past year. Early, heavy use is linked with a higher risk of addiction, problems with memory and studies, and psychosis.

Parents may notice:

• Red eyes, a sweet smoky smell, or rolling papers, small pipes or unusual packets
• Sleeping at odd hours, missing school, coaching or college
• A new friend group and secretive phone use
• Irritability, mood swings or loss of interest in family life
• Money or valuables going missing

These signs can have other causes, so avoid jumping to conclusions. A calm conversation and an early assessment work far better than punishment. Under-18s are seen together with a parent or guardian.

When to see a psychiatrist

Consider speaking to an addiction psychiatrist if:

• You have tried to cut down or stop and haven’t managed to
• You feel irritable, anxious or can’t sleep without cannabis
• Cannabis is affecting your studies, work, finances or relationships
• You use cannabis to cope with stress, anxiety, sadness or sleeplessness
• You have had unusual experiences, such as intense suspicion or hearing things
• Family or friends are worried about your use

Early help is simpler and more effective than waiting for things to get worse.

How cannabis addiction is diagnosed

The first consultation is a conversation, not a judgement. The psychiatrist will ask about how and when you use cannabis, which forms you use, past attempts to stop, withdrawal symptoms, mood, anxiety, sleep, any unusual experiences, other substances such as alcohol or tobacco, and what you would like to change. With your permission, a family member can join part of the discussion.

A urine drug test may sometimes be suggested, usually to support your progress rather than to “catch” you. The diagnosis follows international criteria (ICD-11), and the plan is built around your goals.

Treatment

There is currently no medicine proven to treat cannabis addiction itself, so talking therapies are at the heart of treatment. They are practical, focused and effective.

1. Motivational counselling

Many people feel mixed about stopping. Motivational counselling helps you explore, without pressure, what cannabis gives you and what it is costing you, and builds your own reasons and confidence to change. Research reviews find it is most effective when combined with cognitive behavioural therapy.

2. Cognitive behavioural therapy (CBT) and relapse prevention

CBT helps you recognise the thoughts, feelings, people and places that trigger use. You learn practical ways to handle cravings, manage stress and boredom, sleep better, refuse offers and plan for high-risk situations, such as parties or exam pressure.

3. Family approaches and rewarding progress

For young people especially, involving the family can make treatment much more effective. Family sessions improve communication, set clear and fair expectations, and help parents support recovery without constant conflict. Some programmes also build in agreed rewards for progress, such as small incentives for cannabis-free urine tests. This approach, called contingency management, has good research support.

4. Treating anxiety, depression and psychosis

Anxiety, depression, ADHD, sleep problems and psychosis often occur alongside cannabis use. Treating both together, called dual diagnosis care, improves recovery and lowers the chance of relapse. Medicines such as antidepressants or antipsychotics may be used for these conditions when needed. They must only be started, changed or stopped with your doctor.

Outpatient, online or inpatient care?

• Outpatient care suits most people, with regular sessions while continuing studies or work.
• Online consultations are convenient for follow-up, counselling and family guidance.
• Inpatient or residential rehabilitation may be advised for psychosis, severe depression or self-harm risk, heavy use of several substances, or when outpatient treatment has not worked.

Dr. Tarwani sees patients at Sukoon Health in Gurugram and South Delhi, where inpatient rehabilitation is also available, and online.

Recovery and relapse

Recovery takes time. The first few weeks, when withdrawal and cravings are strongest, and the months that follow, when old friends and routines pull people back, are when support matters most.

A slip does not mean treatment has failed. It is a chance to learn what triggered it and adjust the plan. Many people who stop cannabis find their sleep, concentration, mood and relationships improve steadily.

For families

Watching a loved one lose interest in studies, work or life can be frightening and frustrating. A few things help:

• Talk when they are not high, calmly and without labels or blame
• Focus on specific concerns (“You have missed college three times this week”) rather than character
• Avoid threats, locking them in or public shaming, which usually backfire
• Agree clear, consistent rules at home and follow through on them
• Notice and praise positive steps, however small
• Look after your own health and seek support for yourself

You are welcome to consult Dr. Tarwani first, on your own, to plan the next steps.

Common myths

• “Ganja is natural, so it’s harmless.” Natural does not mean safe. Cannabis can cause dependence and affect memory and mental health.
• “Nobody gets addicted to cannabis.” Cannabis dependence is a recognised condition, and withdrawal symptoms are common in regular users.
• “Bhang is part of our culture, so it can’t cause problems.” Occasional festival use is different from regular use, which can lead to problems.
• “It helps me sleep and calms my anxiety.” Any relief is often short-lived; regular use tends to worsen sleep and anxiety over time.
• “He just needs to be sent away somewhere strict.” Counselling, family support and treating underlying conditions work far better than punishment.