Cannabis withdrawal is a syndrome that primarily affects heavy or long-term cannabis users and is triggered by the sudden cessation of THC consumption.
Cannabis withdrawal syndrome became a recognised disorder in 2013 when it was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Although cannabis withdrawal can be difficult, it is generally mild and usually resolves on its own.
Cannabis withdrawal may linger for several weeks and is caused by abruptly stopping your cannabis use, as the body adjusts to the absence of THC. Developing a treatment plan with your doctor and making sure you don’t exceed the recommended dose can help reduce the likelihood of experiencing symptoms associated with cannabis withdrawal.
However, there are times when cannabis withdrawal can become more of an issue. If other substances are involved or if a person is already experiencing mental health difficulties, treatment may be necessary. It’s important to understand how cannabis withdrawal works, so that you can have a plan and know what’s happening and why if you ever experience it.
The Symptoms of Cannabis Withdrawal
There are a number of symptoms associated with cannabis withdrawal, some of which are similar to withdrawal symptoms from other substances. However, cannabis withdrawal symptoms are typically less severe, especially when compared to substances such as alcohol or opioids.
According to the DSM, to be diagnosed with cannabis withdrawal syndrome you would have to be experiencing at least three of the following symptoms: irritability, anxiety, loss of sleep, changes in weight or appetite, restlessness, depression or difficulty concentrating within several days of cessation.
Physical symptoms of cannabis withdrawal might include headaches, sweating, vomiting, nausea or abdominal pain. A rebound effect where appetite and sleepiness increase may also follow initial periods of low appetite and insomnia.
How Long Can Cannabis Withdrawal Last?
There really are no firm answers when it comes to how long withdrawal from any substance might last, but there are some guidelines that can provide a general idea.
The DSM states that cannabis withdrawal symptoms will likely begin 24 to 72 hours after stopping cannabis use, peak within the first week, and last around 1 to 2 weeks. Sleep issues, however, may last more than a month according to the DSM and some studies.
A 2021 review noted that in heavy cannabis users, sleep disturbances may linger for up to 3 weeks depending on previous usage.. The review also notes that, depending on the individual, there is a lot of variation in how long cannabis withdrawals last. It suggests that THC-COOH (a substance that remains in the body after breaking down THC) levels in the body may be a way of guiding and managing withdrawal treatment, but that this should be studied further.
Another review found that in some rare cases, vivid or strange dreams continued for 45 days after stopping cannabis use, but that most symptoms usually resolve within 2 weeks.
What Causes Cannabis Withdrawal?
Cannabis withdrawal can occur when you abruptly stop using cannabis products that contain the cannabinoid tetrahydrocannabinol (THC), which is the main psychoactive component in cannabis.
Cannabidiol (CBD), the other major cannabinoid in cannabis, likely doesn’t cause withdrawal symptoms. Researchers believe that THC causes withdrawal through its interaction with the brain’s CB1 receptor, part of the body’s endocannabinoid system. CBD, on the other hand, doesn’t directly interact with this receptor. When receptors stop receiving THC, the body and brain have to adjust.
Generally, cannabis withdrawal isn’t serious and doesn’t require medical attention. When someone experiences serious withdrawal, it’s usually caused by excessive cannabis use or by using other substances alongside cannabis.
It’s unlikely that you will experience cannabis withdrawal if you stick to the dosage recommended by your doctor. All medications can pose risks when taken in higher doses, and medical cannabis is no exception.
Are Some at Higher Risk of Cannabis Withdrawal?
There are some risk factors that may place some people at a higher risk of cannabis withdrawal.
One review of studies found that people who use tobacco and other drugs are more likely to experience cannabis withdrawal syndrome. The same review concluded that heavy users of cannabis are also more likely to experience withdrawal.
Another study on mental health and cannabis withdrawal found that those experiencing depressive symptoms had more severe withdrawal symptoms, suggesting that mental health may play a role in the risk of experiencing cannabis withdrawal. It’s important to note that the participants in the study with depressive symptoms also tended to have cannabis use disorder.
Cannabis withdrawal may also be more common and severe in adults than young people. The DSM states that because adults tend to be heavier users of cannabis, and that they use more frequently and for a longer time, that they may be at higher risk of more severe withdrawal.
Preventing Cannabis Withdrawal
The DSM explains that many people who experience cannabis withdrawal find it difficult to break the cycle of using cannabis to avoid the withdrawal. When people experience withdrawal from any substance, including cannabis, they naturally try to find relief, which sometimes leads to using more of the substance.
Education around the risks and benefits of cannabis and other substances can help people avoid getting into the cycle of using cannabis to treat withdrawal. Having a solid treatment plan and asking your doctor about anything you’re unsure of when it comes to using medical cannabis can also help make sure you have a positive experience.
Medical cannabis, like any medication, may pose some risks. Sticking to your treatment plan and dosage can help minimise the risk of experiencing withdrawal if you decide to stop using cannabis.
Treating Cannabis Withdrawal
Studies have explored several treatment options for cannabis withdrawal. Some of these treatments are pharmaceutical, but sleep, nutrition and exercise may also play a role in managing cannabis withdrawal.
There have been several studies on certain medications for treating cannabis withdrawal. Some research has looked at medical cannabis itself, usually in the form of mouth sprays, and how it could be used similar to how smokers use nicotine patches to help stop smoking. While there were some positive results, the research is still in its infancy.
Other studies have suggested that certain anxiety medications or sleep aids may help with insomnia and other symptoms of cannabis withdrawal.
While there have been some positive results in these studies, there are currently no TGA-approved medications for treating cannabis withdrawal, as research is still in the early stages.
Why Is It Important to Understand Cannabis Withdrawal?
While cannabis withdrawal is usually well tolerated, it can be difficult and can become serious when combined with other issues. Understanding when and how cannabis withdrawal occurs can help you be prepared if you ever experience it.
If you work with a doctor – either your GP or with a dedicated cannabis clinic – you’re unlikely to experience cannabis withdrawal. A doctor will tailor your dosage to best suit you and to make sure you stay safe. It’s important to treat cannabis like any other medication to help you get the most out of your experience.
