How do you recognise cannabis dependence?

Cannabis dependence shows itself in patterns that persist over time, not in a single event. Typically, use takes up more space, can no longer be reduced easily and continues despite negative consequences. The Bundesinstitut für Öffentliche Gesundheit (BIÖG) states that roughly one in eight people who use cannabis become dependent. This article describes the warning signs in daily life and shows where to find support.

What dependence actually means

Dependence describes a situation in which someone can no longer control their use, even though they have resolved to do so. Quantity alone does not determine it. Even those who use little can fall into a pattern that is hard to break. Drugcom points out that long-term use can lead to psychological dependence.

According to drugcom, psychological dependence means that those affected feel they can no longer manage without cannabis. According to the BIÖG, psychological dependence can become very strong, and the desire to use then becomes overwhelming.

Warning signs in daily life

Drugcom describes eleven diagnostic criteria under DSM-5. If at least two of them apply within twelve months, a substance use disorder is considered to be present. The points below paraphrase some of the criteria and include one sign from the BIÖG text:

• You use more often or more than you had intended.
• You have tried several times to stop, without success.
• Use becomes more important than school, work or friendships.
• You often think about the next use or plan your day around it.
• You keep using even though you notice it is harming you.
• You conceal your use or do not like talking about it.

Individual points do not necessarily indicate dependence. If several signs come together over a longer period, however, a closer look is worthwhile.

Physical and psychological signals

During a break, withdrawal symptoms such as nervousness, restlessness, sleep problems or aggression can occur. According to drugcom, not all people with cannabis dependence experience physical withdrawal symptoms. Mood swings and withdrawal from usual activities can also be signs. These signs are not unambiguous, and they can have other causes. That is why they are above all a reason for a conversation.

It is important not to play these signals down. Anyone who observes them over weeks should classify them together with a specialist.

How many users are affected

According to the BIÖG, roughly one in eight people who use cannabis become dependent. This means that the large majority of users do not develop dependence. The risk should nevertheless not be underestimated, particularly for young people whose development is still under way.

The figure also explains why it makes sense to look closely early. Anyone who does not want to wait until a problem is large can seek help at the first signs.

Self-test: questions that help

An honest look helps with classification. Drugcom asks, among other things: do you use more often, in larger amounts or for longer than planned? Have there been unsuccessful attempts to stop or reduce use? Have you failed to fulfil important obligations at work, at school or at home because of cannabis use?

A self-test does not replace a diagnosis. It can, however, show whether a conversation with specialists makes sense. More on this is in the article on the dependence self-test.

Why resolutions often fail

Repeated unsuccessful attempts to reduce or stop use are named by drugcom as one of the criteria. This is a reason to seek support. Anyone who starts again after several attempts should seek a conversation with a counselling service. The article on attempts that repeatedly fail describes this point in more detail.

Why surroundings and habits matter

According to drugcom, for some people cannabis use increasingly takes on the function of coping with feelings such as boredom, anxiety or difficulty sleeping. Those affected then tend to use alone more often and to withdraw. According to drugcom, psychological problems such as depression or anxiety symptoms increase the risk of dependence.

It is therefore worthwhile to consider, alongside the use itself, the situations and feelings in which it happens.

How people around can help

Relatives often feel helpless when they notice that someone can no longer control their use. They can calmly raise what they see, without judging. A clear offer to seek help together is a possible next step.

Relatives need support too. Counselling services offer conversations for families and show how to set limits without breaking off contact.

When medical help makes sense

A medical check-up makes sense if complaints such as sleep disorders, anxiety or strong mood swings persist. Doctors can classify causes and discuss further steps. It helps to name the cannabis use openly, so that the assessment is complete.

After a relapse

A relapse after an attempt to stop is a reason to look at the difficult situations and to involve support.

A counselling service can help plan the next attempt.

What you can do

• For one to two weeks, note when and why you use. This makes patterns visible.
• Speak to a trusted person who knows you well and gives honest feedback.
• Arrange an appointment with a doctor if physical or emotional complaints are added.
• Use anonymous services if you do not yet want to tell anyone in your circle.

Where to find support

Counselling services offer conversations, some of them anonymously. According to the BIÖG, the drugcom chat accepts anonymous questions (Monday to Friday, 15:00 to 17:00), and the BIÖG information phone gives anonymous advice on 0221 89 20 31. Counselling services near you are listed in the DHS addiction help directory, and there is also the section Help and counselling, which explains how to reach an addiction counselling service in your region.

Prevention: looking early

Anyone who notices early that use is becoming a pattern can counter it before it becomes hard. This applies to yourself and to people around you. An honest conversation with open questions is a good start.

It is also important that relatives do not remain alone. Anyone who is worried can seek support and advice themselves.