By David Joel Miller.
Is there really such a thing as Marijuana Withdrawal?
Marijuana withdrawal is real and a lot more common than many people think. Among heavy marijuana smokers who enter residential treatment up to 95% experience very real symptoms of marijuana withdrawal. This set of symptoms is so significant that it was included in the new DSM-5 under the name Cannabis Withdrawal (F12.288.)
Cannabis covers a number of preparations made from the Cannabis Sativa plant including Marijuana, Hashish, and Hash Oil. There are hundreds of different chemicals in the cannabis plant, though current thinking is that the primary psychoactive chemical is THC (tetahydrocanibinoid.)
When we say withdrawal many people think of severe physical symptoms the way someone might experience withdrawal from Heroin. The symptoms of cannabis withdrawal while more subtle than that can be very problematic.
Back in the 1960’s the thinking was that there were no withdrawal symptoms from marijuana. Some people still think that. One difference then to now is that the levels of THC are higher now. There are also a much larger number of people smoking marijuana on a regular daily basis.
SAMHSA published a treatment guide titled “Brief Counseling for Marijuana Dependence” based on studies of people who voluntarily requested treatment for a Marijuana Use Disorder. One of their conclusions was that people who experience this problem smoked marijuana 28 days a month or more. In other words, daily smoking is much more likely to result in a use disorder and withdrawal disorder than the occasional one-time user.
Cannabis Withdrawal, according to the DSM-5, is only diagnosed if you have a moderate to severe cannabis use disorder. This requires smoking most days for two months or more. Symptoms customarily start 24 to 72 hours after you last smoked. Symptom peak at one week and most are gone by two weeks. Sleep problems may continue for 30 days or more.
Cannabis withdrawal can also occur when people reduce their consumption of cannabis even when they do not completely stop. Family members or others living with the heavy weed smoker may recognize the symptoms of cannabis withdrawal before the smoker does.
In Cannabis Withdrawal seven signs or symptoms have been described as significant enough that they are common features of withdrawal from Marijuana and or other forms of Cannabis. Each of these symptoms might better be called a category of symptoms. For example, emotional issues list three possible emotions and physical symptoms list seven. To get diagnosed with Cannabis withdrawal you need to have one of the signs or symptoms from 3 or more of the categories.
The seven signs or symptoms of Marijuana Withdrawal.
1. Negative, Grouchy emotions during marijuana withdrawal.
Irritability, anger or aggression are common during marijuana withdrawal.
2. High Anxiety during marijuana withdrawal.
During withdrawal from marijuana, people can become nervous, anxious or fearful. It is common for marijuana smokers to conclude that the marijuana was helping them control anxiety and return to smoking before the withdrawal is completed.
3. Messed up sleep during marijuana withdrawal.
During the initial withdrawal from marijuana, you may experience difficulty falling asleep, staying asleep or you may have bad disturbing dreams. This initial period of poor sleep might also be followed by a period of rebound sleep during which you will experience an increased need for sleep.
4. You may lose your appetite during marijuana withdrawal.
Early in the withdrawal from marijuana you may lose your appetite or even lose some weight. This period of poor appetite may be followed by a rebound of hunger.
5. Restlessness accompanies withdrawal from cannabis.
6. Depressed mood is common during marijuana withdrawals.
This is one of the more common symptoms of giving up almost all drugs. Regular users get close to their drug of choice. Most miss the drug and the related rituals when they stop. Many become depressed or grieve for the loss of the drugs companionship.
7. Physical symptoms can accompany Marijuana withdrawal.
Symptoms commonly reported during marijuana withdrawal include: Abdominal pain, shakiness, tremors, sweating, fever, chills, and headache.
These signs or symptoms need to happen during the first 3 weeks of abstinence otherwise we begin to look for other possible cases. Many marijuana smokers are using other drugs which obscure the signs of the cannabis withdrawal.
Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs, AOD professionals and the terms and descriptions used in the DSM.
FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
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