Article

The cannabis withdrawal syndrome

University of Arkansas at Little Rock, Little Rock, Arkansas, United States
Current Opinion in Psychiatry (Impact Factor: 3.94). 06/2006; 19(3):233-8. DOI: 10.1097/01.yco.0000218592.00689.e5
Source: PubMed

ABSTRACT

The demand for treatment for cannabis dependence has grown dramatically. The majority of the people who enter the treatment have difficulty in achieving and maintaining abstinence from cannabis. Understanding the impact of cannabis withdrawal syndrome on quit attempts is of obvious importance. Cannabis, however, has long been considered a 'soft' drug, and many continue to question whether one can truly become dependent on cannabis. Skepticism is typically focused on whether cannabis use can result in 'physiological' dependence or withdrawal, and whether withdrawal is of clinical importance.
The neurobiological basis for cannabis withdrawal has been established via discovery of an endogenous cannabinoid system, identification of cannabinoid receptors, and demonstrations of precipitated withdrawal with cannabinoid receptor antagonists. Laboratory studies have established the reliability, validity, and time course of a cannabis withdrawal syndrome and have begun to explore the effect of various medications on such withdrawal. Reports from clinical samples indicate that the syndrome is common among treatment seekers.
A clinically important withdrawal syndrome associated with cannabis dependence has been established. Additional research must determine how cannabis withdrawal affects cessation attempts and the best way to treat its symptoms.

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    • "Symptoms of psychological discomfort are reported predominantly (Budney & Hughes, 2006). The CWS cluster of symptoms include: (1) irritability, anger or aggression, (2) nervousness or anxiety, (3) sleep difficulty (insomnia), (4) decreased appetite or weight loss, (5) restlessness, (6) depressed mood, (7) physical symptoms causing significant discomfort from at least one of the following: stomach pain, shakiness/tremors, sweating, fever, chills, headache (Budney & Hughes, 2006). A recent Dutch study by Hesse & Thylstrup (2013) was the first to publish a study examining these seven symptoms and follow their cannabis withdrawal time-course, however, there is no published work assessing the severity of withdrawal. "
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    ABSTRACT: Background: No previous studies have investigated cannabis withdrawal severity in indigenous or incarcerated populations. Aims: We sought to quantify life-time cannabis use, report cannabis withdrawal symptoms and severity, and define the holistic experience of cannabis withdrawal. Methods: Seventy consenting males (18–40 years) from an Australian correctional center were interviewed about lifetime cannabis use and experience of withdrawal upon incarceration. Results: Findings indicate that participants smoked on average 12.3 cones or joints/day (95%CI: 9.5–15.2) for 9.4 years (95%CI: 7.6–11.1). Cannabis withdrawal symptoms most frequently reported were; physical symptoms (52.9%), insomnia (52.9%) and depressed mood (47.1%). The most severe symptoms were insomnia (22.9%), nervousness/anxiety (17.1%) and aggression (14.3%). Analysis further revealed the construct of “stressing out”, defined as a highly anxious state with increased aggression. Conclusions: Insomnia and physical symptoms were the most commonly reported symptoms with insomnia and nervousness/anxiety the most severe. Psychological symptoms were also voiced by this population sample; however, they were less frequent than the combined aggregated physical symptoms of “stressing out”. Implications: The identification of severe withdrawal symptoms, especially aggression, will facilitate identification and treatment to new inmates upon incarceration. The recognition of “stressing out” will enable safety measures and treatments to be prescribed in this setting.
    Full-text · Article · Nov 2015 · Journal of Substance Use
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    • "Studies have unequivocally documented the occurrence of a cannabis dependence syndrome by demonstrating that cannabis has reinforcing properties in nonhuman primates and that abstinence from the drug causes withdrawal in humans [Tanda and Goldberg, 2003; Fattore et al. 2008]. This withdrawal syndrome can last from 1 to 3 weeks after cannabis cessation [Budney and Hughes, 2006]. The risk of relapse after a period of abstinence is significant [Perkonigg et al. 2008]. "
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    ABSTRACT: Cannabis is the most commonly used illicit drug in the world. However, only few studies have shown the efficacy of pharmacologic agents in targeting cannabis withdrawal symptoms or reducing the reinforcing effects of cannabis. Baclofen has been shown to reduce cannabis withdrawal symptoms and the subjective effects of cannabis. We think that the clinical utility of baclofen for cannabis dependence is a reasonable approach. A case report using baclofen is presented and provides preliminary support for the use of baclofen in the management of cannabis dependence.
    Full-text · Article · Feb 2014 · Therapeutic Advances in Psychopharmacology
    • "at highest risk of cannabis dependence have a history of poor academic achievement, deviant behaviour in childhood and adolescence, rebelliousness, poor parental relationships , and a parental history of drug and alcohol problems.[10]In laboratory studies, animals and humans develop tolerance to many of the effects of THC.[13]Cannabis users who seek help to quit commonly report withdrawal symptoms that include anxiety, insomnia, appetite disturbance and depression.[14]Over the past two decades, increased cannabis use among young adults has been accompanied by increasing numbers of persons seeking help in the USA, Europe, and Australia to stop using cannabis.[2,15]Some of this increase may be explained by more diversion of users into treatment by the courts but increases have also occurred in the Netherlands where cannabis use has been decriminalized.[16]The adverse health and social consequences of cannabis use reported by those who seek treatment for dependence are probably less severe than those reported by persons with comparable levels of alcohol or opioid dependence.[2,17]The "
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    ABSTRACT: This paper summarizes the most probable of the adverse health effects of regular cannabis use sustained over years, as indicated by epidemiological studies that have established an association between cannabis use and adverse outcomes; ruled out reverse causation; and controlled for plausible alternative explanations. We have also focused on adverse outcomes for which there is good evidence of biological plausibility. The focus is on those adverse health effects of greatest potential public health significance - those that are most likely to occur and to affect a substantial proportion of regular cannabis users. These most probable adverse effects of regular use include a dependence syndrome, impaired respiratory function, cardiovascular disease, adverse effects on adolescent psychosocial development and mental health, and residual cognitive impairment. Copyright © 2013 John Wiley & Sons, Ltd.
    No preview · Article · Jan 2014 · Drug Testing and Analysis
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