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Cannabis withdrawal is real and likely to lead to relapse

Many cannabis users and clinicians cling to the myth that cannabis withdrawal is not an issue. Now a team from the National Cannabis Prevention Information Centre at NDARC has shown that withdrawal from cannabis is not only significant enough to cause relapse, but also interferes with daily living.

Dr David Allsop and colleagues studied 49 non-treatment seeking dependent users over a two week period of abstinence. Dependent cannabis users who abstained from the drug for two weeks experienced withdrawal symptoms significant enough to interfere with daily life including sleep problems, anxiety, depression mood swings, physical tension and loss of appetite. Symptoms such as physical tension and sleep problems were more associated with relapse than other symptoms such as general fatigue and loss of appetite. Heavy users were most likely to experience more severe symptoms and most likely to relapse.

Allsop says that the findings now need to be tested in a larger treatment seeking sample. But these findings would suggest that targeting education and counseling to help quitters understand and manage their withdrawal symptoms, particularly those associated with the risk of relapse, is likely to improve treatment outcomes.

The findings have resonated with leading clinicians around the world.

Scott Lukas, a professor of psychiatry and pharmacology at Harvard Medical School, who was not involved with the study, told America’s ABC that contrary to common opinion cannabis was similar to other drugs of abuse when people want to quit.

"There is a common belief among the public that marijuana is not very addictive and so it is not a big problem," he said. "It is not enough to simply say, 'I want to quit,' but, instead, the person must be able to withstand the turmoil of going through withdrawal."

Harley Street therapist Michael Garnham told the UK’s Daily Mail: “In my experience of working with hundreds of drug users, withdrawal from cannabis can be one of the worst in terms of feelings of anger, anxiety and extreme mood swings. People also find it very hard to remain focussed both mentally and physically.”

Allsop DJ, Copeland J, Norberg MM, Fu S, Molnar A, et al. (2012) Quantifying the Clinical Significance of Cannabis Withdrawal. PLoS ONE 7(9): e44864. doi:10.1371/journal.pone.0044864