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High, Functioning Weed Users

Editorial Oversight by Brian Canfield, Ed.D.

High-functioning marijuana users are those who are capable of maintaining a balanced, competent outward appearance. Yet, physical dependence on marijuana means they also routinely use.

If you are a high-functioning user, you may successfully evade the harmful “stoner” stereotype that is often portrayed in American media. Yet, while high-functioning users may escape much of the societal stigma associated with marijuana use, you are still at risk. Your marijuana use poses a significant risk to your ability to keep afloat. Therefore, no matter how much marijuana you use, be aware of the classic signs of high-functioning marijuana users before you may blow off your marijuana habit as no big deal.

Using Alone

While using marijuana outside of the company of friends can be a way to escape from the stresses of daily life, one sign of a brewing problem is using alone more frequently.

One recent study found that people who reported solitary use of marijuana had higher rates of symptomatic marijuana dependency, needing to use marijuana to cope, and overall use versus people who used marijuana around other people (Spinella et al, Drug Alcohol Rev, 2019). So, the next time you consider using marijuana, ask yourself: do I want to get high to enjoy the company of my friends, or because I don’t want to be alone with my thoughts while sober? If the latter is your answer, it may be time to reconsider your marijuana habits, despite how well-adapted you are in other areas of your life.

Coping via Marijuana

Even for those of us who appear to have it together, all of the time, negative emotions such as stress, frustration, grief, and anxiety are an inescapable part of the human experience.

People may choose to deal with these emotions in a variety of ways, but for some, using marijuana is a means of helping you to relax and escape your mind for a period, however brief. Over time, this can become a regular and irresistible temptation. If you find yourself reaching for a blunt after a hard day at work, after worrying about money, or after an argument with a loved one, this may be a sign that you’re using marijuana to cope with negative emotions. This is often a tell-tale sign of being a high-functioning marijuana user, and a sign that it may be a good time to seek help with your potentially harmful marijuana habit.

Difficulty Controlling Intake

If you find yourself using marijuana at every possible opportunity, this may be the biggest clue of all that your marijuana habit is at risk of overtaking your ability to function.

You’re not alone in this. Most people start out with rational reasons for using marijuana–perhaps your friend is hosting a party when someone starts passing around a blunt, and you want to fit in; perhaps you’ve never tried marijuana before, and you’re curious to discover what all the hype is about. Eventually, though, your initial justifications may fade, and you start to use marijuana “just because”.

Ultimately, your specific reasons for using marijuana don’t matter. If you’re using more and more as an attempt to escape from the external pressures of life, take pause. Is it because you are greater stress in your life, or is it because you’re developing a new problem? If you’re feeling the urge to use, and no longer able to articulate why, consider if your habit has bridged into this harmful territory.

Use in Risky Situations (e.g., before or during work)

For high-functioning users, it can be easy to get lulled into a false sense of security when it comes to repercussions of their marijuana use. Over time, it can become tempting to think that there’s no harm in using marijuana in risky situations, like using before work or even while you’re on the job.

Don’t let yourself be fooled! Studies have shown that using even small amounts of marijuana can impair your judgment (Volkow, N Engl J Med, 2014). When you’re under the influence, it’s especially hard to appreciate when you aren’t thinking at top speed. Using while driving or operating machinery fall under the umbrella of risky situations. Yet, the risks of slipping up on the job because you’re high come with equally high costs, whether that’s causing potential for physical injury, missing work deadlines, or even losing your job.

Bottom line–if you find yourself even tempted to use marijuana in a risky scenario such as work, it might be time to examine your habits with a wary eye. The life consequences of your marijuana use may be far more damaging to you than the physical effects of the marijuana itself.

Professional Performance

As with all balancing acts, the incredible pressures of concealing regular marijuana use will inevitably create problems. As hard as you may try, cracks will start to appear in the façade of your outwardly perfect life. Perhaps they already have.

Marijuana attacks your professional performance from all angles, and it often does so in ways you don’t notice at first. You start showing up to work late by a few minutes a couple times a week. Maybe you find yourself struggling to concentrate on tasks at work that used to be a breeze. Even worse, maybe you find yourself caught with a surprise drug test from HR, and your paranoia impacts your ability to focus on the job at hand.

Whatever the case is, the underlying theme is the same–it’s challenging to completely suppress the pervasive effects of marijuana, and to avoid the potential consequences that it poses to your professional life. Reflect on your own work performance ever since you began using marijuana. Have you noticed any differences, or received any negative feedback from your boss or colleagues? If so, it may be time to take another look at your marijuana habit and ask yourself–is this worth it?

Complications of Chronic Marijuana Use

Over the past several decades, marijuana has undergone dramatic shifts in its medico-legal status. As federal and state legislations have changed, marijuana use has grown in prevalence. Still, many questions remain regarding whether chronic marijuana use has a negative impact on long term health and cognition. If you’re reading this, chances are you have many of these questions yourself: will smoking daily permanently change my brain function? Am I increased risk for acquiring diseases later on in life? While there are still more questions than answers, we’re here to dispel many of the mysteries surrounding complications of marijuana use. At the same time, we’re going to offer some hard-to-face truths. Being able to confront these realities, as you begin to contemplate or plan your journey to recovery, is a huge step.

Neuropsychological Functions

You may be wondering whether long term marijuana use has long-term or permanent effects on your brain. Many studies have attempted to measure the durations and kinds of cognitive impairment that affect marijuana users. In analyses of multiple studies of young adults and adolescents, scientists found that while frequent marijuana use does affect multiple brain functions (including learning, processing speed, memory, and executive functions) in the short term, most of these impairments are barely detectable after 72 hours of abstinence (Scott, JAMA Psychiatry, 2018). In adulthood, however, cumulative lifetime exposure to marijuana is associated with poorer performance in some aspects of cognition compared to others, especially if you’ve still actively using (Schulte, Clin Psychol Rev, 2014; Auer, JAMA Intern Med, 2016). So, if you’re still wondering if chronic marijuana use changes your brain, the best answer we have right now is yes, but that these changes are largely reversible. The caveat which remains to be answered is for how long, and by how much.

Psychiatric Complications

There is very mixed scientific evidence to support that marijuana use, especially during adolescence, is associated with later development of psychiatric disorders. These include increased risk of mood disorders like depression and bipolar disorder, anxiety disorders, and even psychotic disorders, like schizophrenia or marijuana-induced psychosis (Lev-Ran, Psychol Med, 2014; Bally, J Affect Disord, 2014; Gobbi, JAMA Psychiatry, 2019). Much of the increased risk that is found in these studies may reflect a genetic predisposition to this psychiatric illness, which become potentiated or unmasked by marijuana use or marijuana withdrawal. Similarly, the psychosocial factors which lead to increased risk of anxiety and depression may be the same ones that make people more likely to use marijuana. Very large population studies have found no link at all between cannabis use and later psychiatric illness (Blanco, JAMA Psychiatry, 2016), although this still needs to be confirmed by more studies. In summary, scientific opinion on this remains conflicting, and controversial. If you’re confused, suffice it to say that the experts are too!

Other Physical Complications

Of all the postulated long-term complications of chronic marijuana use, this category is probably the weakest in terms of scientific evidence. When you smoke marijuana, you aren’t just inhaling weed—you’re also inhaling respiratory irritants and cancer-promoting molecules, many of which are also found in tobacco smoke. Marijuana fumes therefore cause transient lung damage and airway irritation, which manifests as cough, wheezing, and chest tightness (Gates, Respirology, 2014). So far, however, there are no clear associations between chronic use and long-term impairments in lung functions or lung diseases, including obstructive lung disease, lung cancer, or asthma (Kempker, Ann Am Thorac Soc, 2015). Similarly, while acute marijuana intoxication can cause acute cardiovascular changes, and even chest pain, there does not appear to be any obvious long-term increase in risk of heart attacks or stroke (Ravi, Ann Intern Med, 2018). For a deeper dive into all of the potential complications of long-term marijuana use, go to Effects of Marijuana.

Cannabis Hyperemesis Syndrome

Cannabis hyperemesis syndrome (CHS), also known as cyclic vomiting syndrome (CVS), is a rare but serious condition. It usually develops suddenly, in people who are daily marijuana users, or who have a history of prolonged (at least 2 years), high-dose use. CHS is characterized by episodes of intractable nausea and vomiting, oftentimes to the point that you are unable to keep down food or water (Sorensen, J Med Toxicol, 2017). One of the hallmarks of CHS is relief of nausea with hot showers or baths, and many people find that this is the only way to improve their symptoms. The exact pathophysiology of CHS is unknown, but as marijuana use becomes more common, doctors and healthcare providers increasingly have this marijuana-related complication on their radar, as should you. People with CHS may require hospitalization in order to maintain hydration while their nausea and vomiting persist. While anti-emetic or anti-nausea medications would make sense as treatments for CHS, the hard reality is that they don’t really help. At the end of the day, the only proven way to treat CHS is to stop using marijuana (Richards, J Emerg Med, 2018).