Dependence on Cannabis—An Ever Lasting Issue

Abstract

In this paper the dependence syndrome on cannabis as it is defined in International Classification Systems (e.g., DSM-IV) will be examined from a theoretical and a technical point of view. Therefore, both the conceptualization and the operationalization of the dependence syndrome are the focus of interest. It is shown that dependence on cannabis should deal with only psychic dependence. Analyzing criteria of psychic dependence via DSM-IV points to the need of conceptual reformulation. Deficiencies concerning variable validity and measurement conditions are pointed out. It is suggested, that the dependence syndrome on cannabis via international classification systems (e.g. DSM-IV) should be revised.

Keywords:

• cannabis
• dependence
• diagnostic systems

Notes

¹Whether the term dependence can be value free in a society, which puts strong emphasis and value on independence remains questionable.

²In addition to these two aspects, the legal and health-related issues in evaluating the effects of cannabis use should also be analyzed and discussed separately (Hall, 1999).

³In an Expert Report on Cannabis on the initiative of the Ministers of Health of five European states the conclusion was drawn, that “there is not enough evidence for an amotivational syndrome in relation to cannabis use as suggested in early field studies” (Cannabis 2002 Report, 2002, p. 73).

⁴Nevertheless, frequency of use has been shown to be uncorrelated with dependence measured by the DSM-III-R in some studies (Soellner, 2000). This could have been an effect of the homogenous sample of only high-frequency users, which yielded minor variables variance and, thus, minor correlations.

⁵Considering psychic dependence separately only five criteria remain, resulting in different probabilities (base rates) to reach the diagnosis.

⁶Research based on hypotheses that are insensitive to empirical observations because they imply a priori true or false meanings is called pseudoempirical.

Additional information

Notes on contributors

Renate Soellner

Renate Soellner, Ph.D., (Germany), psychologist, is an Assistant Professor at the Freie Universität Berlin and head of the department of evaluation, quality assurance, and quality management in education and psychology.After finishing her studies in psychology in 1992, she worked as a research assistant in applied research fields predominantly concerning drugs and AIDS like “drug- mortality,” “HIV and drug use,” and “determinants of different cannabis use patterns.” In her Ph.D. thesis she analyzed the construct validity of the dependence syndrome via DSM-IV for the substance of cannabis. Her major research interests are evaluation of prevention programs in the field of public health and social science research methods. She is lecturer in evaluation research, statistics, methodology, and health psychology. The results of her studies concerning cannabis have been published in two books: Dependent on cannabis?, and, together with Dieter Kleiber, The Use of Cannabis: Development Trends, Use Patterns and Risks of Use.