“I use marijuana for medical reasons.”

And other rationalizations we hear every day.

In The Carlat Guide to Addiction Treatment, Michael Weaver, MD, offers a smart and usable framework for these conversations—grounded in motivational interviewing, not confrontation.

Here are 4 common rationalizations patients offer—and how we might respond:

1. “I use it for medical reasons.”

How to respond:
You're not wrong—THC can help in specific cases. But the science is narrow:

• FDA approval = chemo nausea and AIDS-related weight loss
• Most dispensary products? Unregulated, unpredictable potency
• And for psychiatric conditions: the evidence just isn’t there

2. “Lots of successful people use marijuana.”

How to respond:
Absolutely—presidents, CEOs, actors. But here’s the reality:

• Fame ≠ protection. Celebrities have cash, lawyers, and PR teams
• Most patients don’t. When consequences hit, they hit harder
• Try: “Let’s bring it back to your life. What have you gained—and what have you lost—from your use?”

3. “I’m not addicted—it’s recreational.”

How to respond:
Great—so let’s explore that:

• “What’s good about cannabis for you?”
• “What’s not so good?”
• Then: “Where do you see yourself in 5 years? Still using?”

This isn’t persuasion—it’s evoking insight. That’s where change starts.

4. “It helps me think better.”

How to respond:
I get that—and for many, cannabis feels clarifying. But here’s the rub:

• Often it’s not boosting function—it’s numbing stress, anxiety, or boredom
• Try: “What’s cannabis helping you avoid?”

That shift reframes it from enhancement to coping—and opens up the real conversation.

Discussion Prompt

• What rationalizations do you hear most in your practice—and what’s helped you respond effectively?
• Join the conversation on the LinkedIn Post.
• Share this with clinicians who want real-world tools for addiction care.
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Related Materials

• Navigating Cannabis Withdrawal
  Expert Q&A with Alan J. Budney, PhD
• Are Higher-Potency Cannabis Products Riskier for Mental Illness?
  Research Update by Deepti Anbarasan, MD and John Wang, MD
• Currently Available Cannabis Products
  Clinical Update by Alex K. Rahimi, MD