03/18/2010

Dear Patti,
My husband Jack smokes marijuana almost every night after dinner. He functions fine socially and never misses work, but at times he’s very lazy and I can’t help but wonder if marijuana interferes with his motivation. He doesn’t believe it does, but I’m not convinced.
—Molly

Dear Molly,
Whether or not your husband’s smoking habit is interfering with or contributing to the quality of his life — or if he might have a marijuana addiction — is beyond the scope of this article, but it may be worthwhile exploring these concerns with a professional psychotherapist who specializes in the subject. 
 
A therapist might delve into whether or not he’s using marijuana just for enjoyment or to quell negative feelings such as tension, anxiety or a low mood. Is he depressed or anxious even though he seems to be functioning OK? If so, he may be self-medicating to avoid symptoms caused by suppressed feelings. Unfortunately, running away from these feelings instead of facing them is a short-term solution. Unless they’re confronted, those core feelings won’t go away.
 
If he’s not self-medicating, why isn’t he motivated? Why is he lazy? Is he unhappy? Is he denying himself participation in things he really loves to do? Or could it be that laziness is your interpretation of his behavior and not his? You mentioned he functions well at work, so is he just unmotivated at home? 
 
It might be beneficial in therapy for the two of you to explore relationship issues as well as your husband individually taking a look at how his marijuana usage is impacting his individual growth and health. 
 
There has been controversy as to whether or not long-term marijuana use causes “amotivational syndrome.” While some studies embrace the conclusion that there’s a definite relationship between marijuana and amotivation, others cite that there’s no connection at all. This disparity suggests faulty research on both sides. In some cases, for instance, the presence of the syndrome derived from the observation of subjects who were in a low socioeconomic position and/or unemployed. Conversely, studies showing no correlation between drug use and amotivation kept inadequate dosage records and failed to establish whether high doses versus low or moderate doses were more likely to induce amotivation.
 
Theories have recently emerged that the incidence of amotivation may be more dependent on certain personality types or predispositions and that, in these cases, marijuana is being used in order to try to cope with problems like depression, anxiety and even relationship issues. This advances the possibility that these negative effects are the cause of the amotivation and that marijuana is an exacerbation of a preexisting condition, rather than a primary cause. In general, the effects of cannabis are extremely subjective and can vary broadly due to factors such as the dosage, the environment, the reason for which it’s used, a preexisting mood, predisposition to mood disorders, personality disorders and/or psychotic disorders, a combination with other drugs, etc.
 
There is no one identifiable behavior or symptom. While heavy cannabis use can have many negative effects on some people, there are those who maintain an adequate level of occupational and social functioning. At this time, research is unclear concerning long-term cannabis use. However, long-term effects on healthy individuals may differ noticeably from those with a coexisting mental illness or cognitive deficit. 
 
Insofar as the concerns you’ve expressed about your husband’s near-daily smoking, it’s in his best interest to clarify for himself his reasons for drug use and gain a deeper understanding of his overall mental health.