How to Manage Cannabis Withdrawal Symptoms

Some researchers and consumers claim that cannabis is not addictive and it would be easy to stop at any given time, on the other side, other researchers describe a list of withdrawal symptoms related to halting cannabis use. Smoking marijuana a handful of times may not be enough to cause symptoms when you no longer use it. For people who smoke marijuana regularly, it may be a different story. If it turns out that cannabis withdrawal syndrome is your experience, knowing how to manage the withdrawal is important.

Common Symptoms of Cannabis Withdrawal

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Marijuana withdrawal symptoms may not be as severe as withdrawal symptoms from other substances. Opioids, alcohol, cocaine, and heroin can produce severe, even dangerous, withdrawal issues. Still, many people who stop using marijuana do experience physical and psychological symptoms such as:

  • irritability
  • difficulty sleeping
  • decreased appetite
  • restlessness
  • cravings for marijuana
  • nausea
  • abdominal pain

The individual must exhibit three or more of the listed symptoms and one must be of a physical nature. Research that has investigated the course of the symptoms for marijuana/cannabis withdrawal has indicated that there is a withdrawal timeline to be expected:

  • The symptoms begin within a week after discontinuation.
  • The symptoms peak within 10 days after an individual has discontinued marijuana use.
  • Following the peak of the symptoms, they begin a steady decline in severity over a period of 10-20 days.
  • The symptoms can be very quickly resolved if the individual begins smoking marijuana again.
  • The actual length and severity of symptoms are related to the amount and frequency of marijuana use in the individual.
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For some individuals, there is always the possibility that they will continue to experience symptoms of lethargy, mild depression, mood swings, issues with motivation, and intermittent cravings for marijuana for weeks, months, and maybe even years after they have stopped using the drug. In addition, there are relatively high relapse rates associated with any substance use disorder. Individuals who begin smoking marijuana after even lengthy periods of abstinence run the risk of reestablishing their old habits rather quickly and in many cases significantly more quickly than their cannabis use disorder took to develop the first time.

How do you know if your cannabis use is a problem?

The standard definition of cannabis use disorder is based on having at least two of 11 criteria, such as: taking more than was intended, spending a lot of time using it, craving it, having problems because of it, using it in high-risk situations, getting into trouble because of it, and having tolerance or withdrawal from discontinuation. As cannabis becomes legalized and more widely accepted, and as we understand that you can be tolerant and have physical or psychological withdrawal from many medicines without necessarily being addicted to them (such as opiates, benzodiazepines, and some antidepressants), I think this definition seems obsolete and overly inclusive. For example, if one substituted “coffee” for “cannabis,” many of the 160 million Americans who guzzle coffee on a daily basis would have “caffeine use disorder,” as evidenced by the heartburn and insomnia that I see every day as a primary care doctor. Many of the patients that psychiatrists label as having cannabis use disorder believe that they are fruitfully using cannabis to treat their medical conditions — without problems — and recoil at being labeled as having a disorder in the first place. This is perhaps a good indication that the definition doesn’t fit the disease.

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Managing Withdrawal Symptoms

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If you smoked regularly and often, tapering off and slowly reducing your marijuana use may help you ease into a marijuana-free life. If you only smoked occasionally, you may be able to stop entirely without any step-down.

When you’re ready to quit, take these self-help steps to make the initial withdrawal period of 24 to 72 hours easier.

  • Stay hydrated. Drink lots of water and avoid sugary, caffeinated beverages like soda.
  • Eat healthy foods. Fuel your body with a generous supply of fresh fruit, vegetables, and lean protein. Avoid junk food, which can make you feel sluggish and irritable.
  • Exercise every day. Squeeze in at least 30 minutes of exercise each day. This provides a natural mood boost, and it can help remove toxins as you sweat.
  • Take up some yoga. Whenever you feel anxious and even before bed, do some yoga and breathing exercises. Yoga has a variety of mental and physical benefits and can help you sleep, relax, and feel physically and emotionally better.
  • Tell someone you trust about what you are doing and going through. This can help keep you accountable and provides you with the necessary support.
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Medications to Assist with Cannabis Withdrawal

There are no currently approved medications specifically designed to assist in withdrawal from cannabis. However, a number of medications can be used to address the specific symptoms associated with cannabis withdrawal. There also several medications that have shown promise in the treatment of cannabis withdrawal.

These include:

  • Ambien (zolpidem) has demonstrated some promise for helping individuals with sleep difficulties during marijuana/cannabis withdrawal.
  • BuSpar (buspirone) appears to have some utility for addressing many of the issues with irritability and anxiety that individuals may experience during withdrawal period.
  • Neurontin (gabapentin) may also address sleep issues.
  • A class of drugs known as fatty acid amide hydrolase inhibitors or FAAH inhibitors may have some promise in breaking down the ingredients of cannabis in the system; however, clinical trials for other uses for these drugs indicate some potential serious side effects.
  • Drugs that are allosteric modulators for cannabis may be useful in reducing cravings during withdrawal.

Again, it is important to understand that the medications used to assist with withdrawal from cannabis are typically forms of symptom management and used based on the specific symptoms that are giving the individual trouble at any period in time. Currently, there is no approved overall medication to assist with withdrawal from cannabis.

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It should be understood that cannabis is one of, if not the most, safest and beneficial herbal substances available, even among man-made ones. People who smoke cannabis can become addicted. You may experience symptoms like trouble sleeping, mood swings, and irritability when you quit. Symptoms are rarely dangerous, and most of them will stop within 72 hours after your last use of marijuana. In the long term, finding guidance and accountability with a therapist or support group is encouraged.

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