Cannabis Withdrawal Syndrome Occurs in Almost Half of Regular Users
A recent systematic review and meta-analysis by researcher Anees Bahji and colleagues in the open access medical journal JAMA Network Open describes the symptoms and prevalence of cannabis withdrawal syndrome.
The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) indicates that cannabis withdrawal syndrome “requires the presence of at least 3 of the following symptoms developing within 7 days of reduced cannabis use: (1) irritability, anger, or aggression; (2) nervousness or anxiety; (3) sleep disturbance; (4) appetite or weight disturbance; (5) restlessness; (6) depressed mood; and (7) somatic symptoms, such as headaches, sweating, nausea, vomiting, or abdominal pain.”
According to Bahji and colleagues, cannabis withdrawal syndrome occurred in 47% of regular users. Higher rates of withdrawal were found among those in clinical settings, those who also used tobacco or other substances, and those who used cannabis daily.
Bahji and colleagues write that while many people believe that cannabis is relatively harmless, it actually has a variety of associated risks. Short-term risks include impaired short-term memory and motor coordination, altered judgment, paranoia, and psychosis. Long-term effects include addiction, altered brain development, poor educational outcomes, cognitive impairment, diminished quality of life, increased risk of chronic respiratory tract and psychotic disorders, injuries, motor vehicle collisions, and suicide.
The researchers warned that users of cannabis may resume cannabis use to allay the depression and anxiety symptoms that are part of the withdrawal syndrome, perpetuating the long-term withdrawal cycle.
Bahji and colleagues suggest that because of the high prevalence of the withdrawal syndrome, doctors should screen patients for cannabis withdrawal, particularly men and frequent cannabis users. They write, “Clinicians should be aware of CWS as it is associated with clinically significant symptoms, which can trigger resumption of cannabis use and serve as negative reinforcement for relapse during a quit attempt.” Doctors can offer support for those reducing their cannabis consumption.
