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Smoking Pot: the Hidden Addiction : Health: Marijuana is the No. 2 recreational drug after alcohol. But there's only one federally funded program to help compulsive users.


SEATTLE — When Tom started smoking pot in the mid-1960s, the marijuana leaf motif was emblazoned on belt buckles, T-shirts and tattoos, and the feeling in the air was that--sooner or later--Everybody Must Get Stoned.

Twenty-five years later, Tom says, he realized that his pot use was hurting his family and interfering with his life: "When I didn't have (marijuana), I became a Doberman pinscher."

Tom is one of a substantial number of people who started using marijuana during the '60s and '70s and were unable to quit, says University of Washington Professor Roger Roffman, principal investigator for the only federally funded program that examines ways to help habitual marijuana users stop smoking. His project is underwritten by a $1-million grant from the National Institute on Drug Abuse.

Although only alcohol surpasses marijuana in use as a recreational drug, few people are studying pot dependency and its effects.

"Marijuana dependence may not hit the headlines because of the absence of violence, death and overdose associated with its use," Roffman says. "But quietly and insidiously, it is adversely affecting up to 2 million people." (The estimated number of marijuana-dependent adults nationally.)

Compulsive pot use "has certainly been understudied," agrees Dr. Jack Blaine, treatment research chief at the National Institute on Drug Abuse.

It's easy to discount the problems caused by marijuana because so many people experimented with the drug in the '60s and walked away from it non-addicted and unscathed, Roffman says. The prevailing attitude seems to be: Who could get hooked on a quaint, feel-good high like pot?

Another barrier to study: Marijuana users don't hit bottom as dramatically as alcoholics or crack or heroin addicts, so their dependence may inspire less of a sense of urgency among researchers, says Roffman, an associate professor in the university's school of social work.

To get a grant to study chronic pot smoking, Roffman had to overcome initial resistance from NIDA. Agency officials believed that chronic use existed only in conjunction with other drugs, Roffman says.

To disprove that theory, Roffman put out the word in the Seattle area that he wanted to talk anonymously with people who were troubled by their pot use. Within two weeks, his staff fielded 225 calls; almost 75% indicated that marijuana was their only problem drug.

In the project's first phase, from 1986 to 1989, Roffman's researchers worked with 212 chronic pot users and studied two group counseling approaches. Only one in five people in either group achieved long-term abstinence, a figure consistent with other studies of addiction, Roffman says.

That rate suggests, however, that marijuana is harder to kick than some might suspect.

In the current four-year phase of Roffman's study--which winds up in 1993--he is comparing group with individualized counseling. Therapists use such techniques as "quit contracts" (people commit to a written agreement to stop using pot), "urge surfing" (people are encouraged to focus on the physical sensations of the urge to smoke pot until the urge subsides) and "quit ceremonies" (people dump their drug paraphernalia in the garbage).

Although project participants have included teen-agers and senior citizens, the typical participant is a man in his mid-30s who began smoking marijuana 15 to 25 years ago. (Two hundred people are enrolled. Roffman hopes to eventually include 360.)

Roffman, 49, himself first experimented with marijuana in the late '60s while he was an Army social worker with the 9th Infantry Division in Vietnam, studying pot use among enlisted men. (About one-third had tried marijuana, he found.)

Later, while a doctoral student at UC Berkeley, Roffman smoked pot more regularly. He eventually became an outspoken advocate for decriminalization, working as Washington state coordinator for the National Organization for the Reform of Marijuana Laws.

In 1977, however, he began to feel "like pot was getting in my way," causing him to be less productive at work and straining his marriage.

"I managed to stop (using pot)," he says, "but along the way I saw that it was a struggle."

Researchers debate whether the struggle to stay clean is partly a result of marijuana's addictive powers. Roffman--and others--believe that marijuana is mildly physiologically addictive because withdrawal can induce night sweats, headaches, nightmares and irritability. But, Roffman says, withdrawal symptoms occur much less predictably with marijuana than with other drugs.

In addition to a possible physiological component, he says, there are psychological reasons people stay hooked. Many project participants said they reached for a joint whenever they were bored, lonely, anxious or depressed.

Others have a hard time quitting because pot use tends to be social. Giving up grass may mean giving up friends who get together primarily to indulge.

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