Cannabis withdrawal

Cannabis withdrawal is a form of withdrawal associated with the substance cannabis. It is included in the proposed revision of DSM-5.

At one time cannabis was considered a drug that had no withdrawal symptoms because users did not display symptoms similar to those withdrawing from alcohol or opiates. Contrary to this, experimental research supports reports of users who relate evidence of heavy cannabis use producing comparatively mild psychological withdrawal symptoms.

Kouri and Pope examined withdrawal symptoms over 28 days abstinence from cannabis, while Budney et al. looked at a time period of abstinence of 45 days. Their study assessed withdrawal symptoms among chronic cannabis users who were assessed daily on various symptoms while on a hospital ward for 28 days. They rated mood, anxiety, depression and irritability and compared them to those of two control groups of abstinent former heavy cannabis users and non-users of cannabis. Chronic cannabis users showed decreases in mood and appetite and increases in irritability and anxiety and their scores on the Hamilton Rating Scale for Depression scale increased. Both studies used urinalysis to ensure abstinence, and showed that withdrawal symptoms began within 1–3 days of abstinence and lasted for 10–14 days. According to Budney et al., the withdrawal syndrome associated with cannabis use is similar to that for tobacco but of lesser magnitude than withdrawal from other drugs like opiates or alcohol.

Significantly, evidence indicates that withdrawal symptoms are alleviated when cannabis users resume using cannabis after a period of abstinence and recent laboratory research has focused on the role of brain chemistry in cannabis dependence. As with other drugs, cannabis increases the amount of dopamine in the synapses. Dopamine is a neurotransmitter associated with rewarding feelings. Budney et al. argue that the upkeep of this neurotransmitter may motivate people to use cannabis in an addictive way.