As a trauma and substance use therapist, I’m often asked by clients who are seeing me for issues related to trauma or depression if their use of marijuana is problematic. For me, it’s a loaded question; My answer is going to be different from other therapists working in the substance abuse realm. As a former “pothead” millennial, weed was very much a part of my cultural upbringing and more normalized than those older than me. In my substance abuse work with clients, I take a harm reductionist approach in therapy and want to share this approach to help others examine and contemplate their personal use.
1. “What’s making you ask?”
My first question is going to be what is making you question your use. Did something recently happen where your use was confronted? Are you becoming more mindful of your use and noticing you’re using more than you ever wanted to (tolerance is too high)? Did you go a few days without smoking and find it hard to cope or relax? Maybe you’re asking because there’s a lot of negative stigma around substance use and you’re unsure about what’s considered appropriate.
Knowing the issues coming up that are making you question your substance use are important in determining if cannabis is causing disruption in your life. Some of my clients are simply very self-reflective and evaluate many areas of their life. Some of my clients find themselves questioning their use because shit is hitting the fan. Be honest with yourself (and your therapist if you’re working with one).
2. “What role does pot play in your life?”
What do you use weed for? Is it for connecting with others, relaxing on the weekends, or handling emotions that seem too overwhelming when you’re sober? Or is it hard to tell what you use it for at this point because you’re using it consistently throughout the day? Is being high the only way you can get through the day? Maybe you never asked yourself these questions.
How you answer this question is going to provide YOU with a lot of insight. When I was at the peak of my use, I found myself smoking a bowl when I was lonely because I had come to associate the high feeling with group hang outs and community events, but then I found myself smoking when I was alone and not reaching out to others to make a connection.
If you’re using weed to escape powerful feelings or emotions you are uncomfortable with, a negative feedback loop is going to be created in which your tolerance for any discomfort is decreased due to never being exposed long enough to those emotions to learn to cope with them. This leads to needing weed more and more to regulate yourself because you aren’t using any other tool or method to feel and move through the emotions. This is how we find ourselves feeling anxious, uncomfortable in our bodies, depressed, and out of sorts when we don’t have any weed for a time period longer than we are used to. (Cue the panicked texts to the weed man after your stash and roaches are deplenished.)
Often people turn to cannabis when trying to quit another addiction, like alcohol. Usually this is an innocent attempt to take the edge off while coming down from being addicted to another substance, but can easily turn into a cross addiction before we’re even aware. If you have other addictions, be honest with yourself about what you are really doing with weed. If you’re trying to fill the hole left by another vice, cannabis isn’t going to be the filler you’re looking for.
3. “When do you smoke?”
Are you smoking at night before bed? Do you smoke in the morning, on the way to work, on break, when you get home, and continuously from that point? Is it when you’re around certain people? Is it just to handle being around certain people? Maybe it’s just a weekend thing.
When we’re using it consistently, we may stop noticing the triggering events that lead us to light a joint. Things start feeling automatic and thoughtless. The timing of our use can key us into the people, events, and feelings that we are trying to avoid and not experience. For example: If you're high every time you're with your partner is there something about true intimacy and vulnerability that scares you? Are you afraid you won’t enjoy each other’s company without a boost? Do you like being with this person?
4. “Are other people concerned about your use?”
What are the people who love you saying about your use? Is your partner concerned and tired of never catching you sober? Are your friends telling you that you’re absent-minded, numb, or not as enjoyable to be around? Are your kids constantly asking you what’s wrong when you’re high on the couch? Maybe your family is concerned about the amount of money, time and risk-taking associated with your use. When people voice concern about our use, they’re not attempting to hurt you or judge you. They’re expressing concern about your wellbeing. As hard as it can be to hear, remember these are people you picked to be in your life- for a reason.
5. “Can you take it or leave it?”
Bottom line, most important question: Could you do without? If you’re using to the point that you’re having consequences such as loss of relationships, restricted job opportunities, financial problems, legal issues, or negative impacts on your emotional wellbeing, and you know it’s related to your use, and you still think you cannot go without marijuana, then yes, I would feel comfortable telling you your smoking has become a problem.
Here’s the thing though... It doesn’t matter what I think. It’s about what you think and what you’re willing to do. If you’re committed to smoking 5 blunts a day for the rest of your life, then there’s not much I can do for you about your use until you want something different. If you’re coming into my office and asking about your use, then I believe there’s a part of you that wants to do something different -- and we can just talk about those feelings for as long as we need to. I don’t believe in forcing people to do work they’re not willing to do -- it’s ineffective long-term. Therapy is about what you want it to be about. So if you’re at peace with your use of smoking on the weekends, then we’re going to talk about something you actually want to work on, but depending on your level of usage, there may be a ceiling to progress that can be achieved in other areas of your life -- and I’m not going to bullshit you about it.
Authored By: Tori Emerick, APC