Cannabis dependence has become a significant presetation at addiction rehab treatment centres in Ireland. A common presentation is a dual diagnosis of cannabis and alcohol dependence.

Cannabis dependence is also complicated in recent years by the emergence of synthetic forms of cannabis (cannabinoids). Cannabinoids lack cannabidiol which natural forms of cannabis contain. Cannabidiol is antipsychotic in nature. It is theorised that synthetic forms of cannabis are more inclined to lead to psychosis due to the absence of cannabidiol.

Hydroponic growth mechanisms have allowed the growth of super-strength cannabis with THC contents of 15% or higher. Police in the U.K. have noted increasing strength cannabis available on the streets of the U.K. with THC contents approaching 20%.

All this data suggest that cannabis is becoming a more potent drug. Presentations to addiction treatment rehabilitation centres also suggest that cannabis dependence is an increasing concern.

Cannabis dependence may present with compulsivity, apathy, amotivation, depression, anxiety and anger. Detoxification may take several weeks in the inpatient setting. Detox may also occur in the outpatient setting but is limited by the availability of cannabis to the detoxing patient.

Rehab for cannabis dependence will seek to address the faulty cognitions attached to chronic cannabis use and increase awarness of contructive relapse prevention strategies.

Relapse prevention strategies often focus on the need to make cannabis users aware of the effects of smoking tobacco rather than the cannabis itself. Of course cannabis itself causes toxic effects to the lungs but users often neglect the reality of tobacco damage.

Cigarette smoke contains over 2000 chemicals, some of which are seriously toxic and carcinogenic. As tobacco smoke first hits the oral cavity and then the lungs, chronic cannabis smokers are prone to cancers of the lips, tongue, oral cavity and lungs.

Fitness in younger cannabis smokers is an area of focus for positive relapse prevention strategies. Both cannabis and tobacco smoke are a major hinderance to optimal cardiopulmonary performance - an issue which helps with motivation in some cannabis users.

Many cannabis users will report paranioa and some will suffer significant paranoia leading to a psychotic state. Drug-induced psychoses can have very serious consequences for the cannabis user.