Cannabis Withdrawal

The symptoms of cannabis withdrawal can vary from person to person. They can range from mild to severe, depending on several factors, such as the duration and frequency of cannabis use, individual biology, and other contextual factors. Typically, symptoms begin within a week after cessation and may last up to a few weeks. Below are some of the common cannabis withdrawal symptoms:

Physical symptoms:

• Headaches
• Shakiness or tremors
• Sweating
• Reduced appetite and weight loss
• Fever and chills

Psychological symptoms:

• Irritability or aggression
• Anxiety
• Depression
• Restlessness
• Disturbed sleep, including insomnia and vivid or unpleasant dreams

In many cases, these symptoms are more uncomfortable than they are dangerous. However, the psychological effects can be particularly challenging and may lead to relapse if not properly managed.

Cannabis withdrawal symptoms can have varying degrees of intensity. Mild withdrawal might involve minor physical discomfort and some mood changes. In contrast, severe withdrawal could lead to significant physical discomfort, strong cravings for cannabis, and substantial changes in mood or behavior.

While these symptoms can be difficult to manage, they are typically temporary. The severity of the symptoms generally decreases over time as the body adjusts to the absence of cannabis. However, if symptoms are severe or lead to significant distress, seeking medical help or support from a mental health professional may be beneficial. They can often provide strategies to cope with the symptoms and, if necessary, may suggest medication to help manage severe symptoms or cravings.

The cessation of long-term, heavy use of cannabis primarily causes cannabis withdrawal. The body can become accustomed to THC (tetrahydrocannabinol), the psychoactive component in cannabis. When its intake suddenly stops, the body typically needs time to adjust, which can lead to withdrawal symptoms.

There are several potential risk factors associated with cannabis withdrawal:

• Frequency and duration of use: Regular and prolonged use of cannabis can lead to a higher likelihood of experiencing withdrawal symptoms. The body typically becomes more dependent on the substance over time, making the withdrawal process potentially more challenging.
• Potency of cannabis used: Typically, the higher the concentration of THC in the cannabis used, the greater the risk of developing withdrawal symptoms upon cessation.
• Personal biological factors: Individual factors such as genetics and overall physical health can also influence the likelihood and severity of cannabis withdrawal.
• Co-occurring mental health disorders: Individuals with certain mental health disorders, such as anxiety or depression, may be at higher risk for more severe withdrawal symptoms.
• Age of first use: Early cannabis use may increase the risk of developing withdrawal symptoms later.

Understanding these risk factors can be useful in identifying individuals who may be at higher risk for cannabis withdrawal. However, each person's experience with withdrawal is unique and can be influenced by a combination of many factors. It's always recommended to seek professional help when considering quitting cannabis, especially for heavy or long-term users.

Treatment for cannabis withdrawal often involves a comprehensive approach that addresses physical and psychological symptoms. The primary goals of treatment are to help individuals manage withdrawal symptoms, prevent relapse, and promote long-term abstinence from cannabis use.

Medication

While no specific medication is approved by the FDA for treating cannabis withdrawal, some medications may be used to help manage particular symptoms. The following are some examples:

• Sleep aids: Over-the-counter or prescription sleep aids might help manage insomnia related to cannabis withdrawal.
• Anxiolytics: In some cases, short-term use of these drugs may help with the anxiety symptoms that sometimes occur during cannabis withdrawal.
• Antiemetics: Anti-nausea medications may not only improve nausea symptoms but also improve appetite in cannabis withdrawal.

Any medication should be used under the supervision of a healthcare provider, and individuals should discuss potential risks and benefits with their doctor. Do not start, stop, or change a medication without consulting with a healthcare professional.

Other treatment options

Some people may benefit from complementary strategies, such as:

• Exercising regularly: Regular physical activity may help reduce anxiety and improve mood, which can be beneficial during withdrawal.
• Practicing mindfulness and relaxation techniques: Yoga, meditation, and progressive muscle relaxation can help manage stress and anxiety.
• Seeking nutritional counseling: Since withdrawal can affect appetite, guidance on maintaining a balanced diet may be helpful.
• Maintaining a regular sleep schedule: Maintaining a consistent sleep schedule can be beneficial as sleep can be disrupted during withdrawal.
• Engaging in relaxing activities: Reading, bathing, or listening to calming music may help reduce stress and anxiety.

The combination of treatments may vary depending on the individual's symptoms, overall health, and personal circumstances. A healthcare professional can typically guide you in choosing the most appropriate treatment strategy for managing cannabis withdrawal.

One key resource for managing cannabis withdrawal is therapy. Those who don’t feel comfortable discussing cannabis withdrawal in an office setting might benefit from an online therapy service like BetterHelp. With online therapy, you can communicate with a counselor in a way that’s most comfortable for you, whether by audio, video, or live chat. 

Additional resources are also available:

• SAMHSA's National Helpline: The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a free 24/7 helpline (1-800-662-HELP [4357]) for individuals facing mental health or substance use disorders.³
• National Institute on Drug Abuse (NIDA): NIDA's website provides a wealth of information on drug use and addiction, including resources specific to cannabis.
• Marijuana Anonymous: Marijuana Anonymous offers a 12-step program with online and in-person meetings.
• Government websites: MedlinePlus and the Centers for Disease Control and Prevention (CDC) provide reliable information on cannabis withdrawal and other substance use disorders.

While online resources can be useful, they should not replace professional medical advice. Always contact a healthcare provider for personal medical advice and treatment options.

Emerging research on cannabis withdrawal continues to shed light on potential new treatments and a deeper understanding of its underlying causes.

A study published in Psychological Medicine found that cannabis withdrawal symptoms are moderately heritable. The study found that approximately “50% of between-individual variation in withdrawal could be attributed to additive genetic variation.” This may help clinicians to advance research on who may be more susceptible to withdrawal symptoms. 

In another study published in Nature Medicine, Columbia University Irving Medical Center and French biopharmaceutical company Aelis Farma conducted a Phase 2a clinical trial on a new drug, AEFO117, which “significantly reduced the effects of cannabis in daily cannabis smokers.” A Phase 2b is being planned to test three dosages to assist individuals living with cannabis addiction. 

While these studies show promising leads in understanding and treating cannabis withdrawal, more research is needed to validate these findings and develop effective, evidence-based treatment strategies.

47% of cannabis users experience withdrawal in their lifetime

A study in JAMA Network Open found that 47% of regular cannabis users will experience cannabis withdrawal in their lifetime.¹

¹JAMA Network Open

Here are more key statistics on cannabis withdrawal:

• An estimated 47% of regular cannabis users will experience symptoms of cannabis withdrawal in their lifetime.
• According to the 2012-2013 National Epidemiologic Survey, about 2.5% of adults in the U.S. experienced cannabis withdrawal syndrome.
• Among adolescents seeking treatment for cannabis use disorder, approximately 40% to 75% experienced cannabis withdrawal syndrome. 
• Cognitive behavioral therapy, contingency management, and motivational enhancement treatment have been shown to reduce cannabis use.
• A study published in Advances in Preventive Medicine found that among “individuals with a history of cannabis dependence, 72% were in remission in the year preceding the survey.”

These statistics underline the prevalence of cannabis withdrawal and highlight the importance and efficacy of therapeutic intervention⁴ in managing this condition. Always consult a healthcare professional if you or someone you know is experiencing cannabis withdrawal.