Does Marijuana Withdrawal Syndrome Exist?
Does Marijuana Withdrawal Syndrome Exist?
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Update: "Marijuana Withdrawal Syndrome": Should Cannabis Withdrawal Disorder Be Included in DSM-5? Marijuana Use, Withdrawal, and Craving in Adolescents |
The question of whether a clinically significant marijuana (cannabis) withdrawal syndrome exists remains controversial. In spite of the mounting clinical and preclinical evidence suggesting that such a syndrome exists (Beardsley et al., 1986; Budney et al., 2001; Holson et al., 1989; Huestis et al., 2001), the DSM-IV does not include marijuana withdrawal as a diagnostic category. The clinical syndrome has been characterized by restlessness, anorexia, irritability and insomnia that begin less than 24 hours after discontinuation of marijuana, peak in intensity on days 2 to 4, and last for seven to 10 days (Budney et al., 1999; Haney et al., 1999; Mendelson et al., 1984).
The question of whether this syndrome is clinically significant is important, not only because marijuana is the most commonly used illicit drug in the United States (Johnston et al., 2001), but also because marijuana has been shown to produce dependence at rates comparable to other drugs of abuse (Kandel et al., 1997; Kessler et al., 1994) and because relapse rates among individuals seeking treatment for marijuana dependence are similar to those with other drugs of abuse (Budney et al., 1998; Stephens et al., 1993). Furthermore, many violent crimes are committed by individuals undergoing withdrawal from drugs of abuse, including marijuana (Kouri et al., 1997; Peters and Kearns, 1992). If a clinically significant marijuana withdrawal syndrome does exist, the omission of this syndrome from the DSM-IV might contribute to the perception that behavioral or pharmacological treatment regimens for marijuana dependence are not necessary.
We conducted two studies in our laboratory to determine whether abstinence from marijuana after long-term use results in withdrawal symptoms, to identify those symptoms and to quantify their severity (Kouri and Pope, 2000; Kouri et al., 1999). The first study focused specifically on whether abrupt discontinuation of marijuana following chronic use results in changes in aggressive behavior (Kouri et al., 1999). To measure aggressive behavior, we used the Point Subtraction Aggression Paradigm (PSAP). This computer test has been used to detect changes in aggressive responses following acute administration of a number of drugs, and its external validity has been demonstrated in a number of studies of male and female parolees with histories of violent behavior (Cherek and Lane, 1999; Cherek et al., 1996).
Subjects in our study were long-term heavy users of marijuana who reported a history of at least 5,000 separate episodes of marijuana use in their lifetime (the equivalent to smoking once per day for 13.7 years), were smoking at least once daily at the time of recruitment and met DSM-IV criteria for marijuana dependence without meeting criteria for a current Axis I disorder. Subjects were excluded if they reported that they had used another class of drugs more than 100 times in their lifetimes or had consumed more than five alcoholic drinks per day continuously for one month or more in their lifetimes.
The controls were composed of two groups: 1) individuals who had not smoked marijuana more than 50 times in their lives and had not smoked more than once per month in the last year and 2) individuals who had formerly smoked marijuana on a daily basis but who had not smoked more than once per week during the last three months. The rationale for using infrequent or former smokers rather than marijuana-naive subjects as controls was to minimize possible confounding variables that might differentiate individuals who had never tried marijuana from those who had. We based this decision on data from our laboratory demonstrating that heavy marijuana users do not differ from occasional users in a wide range of demographic and psychiatric measures (Kouri et al., 1995).
During the study, subjects were required to abstain from smoking marijuana and using any other drugs for 28 consecutive days. To verify abstinence, subjects had to come to the laboratory every day to provide supervised urine samples that we analyzed quantitatively for tetrahydrocannabinol (THC) metabolites. We measured aggressive responses with the PSAP on study days 0 (before abstinence), 1 (after 24 hours of abstinence), 3, 7 and 28.
Subjects were told they would be playing a computer game against an anonymous same-sex subject from the study. In fact, however, this second subject was actually a computer. During the course of each 20-minute computer session, subjects had the option of pressing one of two buttons on the PSAP response panel (labeled "A" or "B"). Pressing button A resulted in the accumulation of points that were exchanged for money at the end of the study. Pressing this button was defined as a non-aggressive response. By pressing button B, subjects could subtract points from the fictitious opponent. Points taken from the opponent, however, were not added to the subject's counter, and pressing button B was defined as an aggressive response. Aggressive responding was provoked by random subtractions of the subject's points, which were attributed to the fictitious opponent.
I am a marijuana smoker for over 17 years. In the beginning i thought nothing of it untill about 5 years ago i realized it was ruining my life both financially and health wise. I tried quitting many times in the past either cold turkey or thru rehab never was i successful. I attribute my relapse to the withdrawals I encountered and the sickness that came upon me while trying. I never made it past 7 days without relapse until i tried taking Maritox. I was able to get thru the quitting proccess without cravings or withdrawals and can proudly say I am clean for over a year now. I agree it is both physical and mental so you need the support of friends and family as well as Maritox to get thru it. The pill is natural not pharma so i had no desire to take it once i was done. others should check it out its great!
I am not a smoker but I know someone who has smoked Marijuana and later Skunk as they call it for about 15years now. And it has truely taken over their life, they live for their next fix and is suffering sleep deprivation from getting up so many times at night to smoke. they have tried severally to quit but the severe withdrawal symptom they experience has always led them back smoking. The struggle continues as they truely want to quit.
I am an occassional marijuana smoker. In my teens and twenties I smoked probably approx. 2-3 times a week. In my 30's. probably, once every month or so. I am now 46. I gotta tell you, It's not the same. I don't know why my mind desires to smoke. It makes me think real hard about my job and God. It does not relax me, usually; yet I still want to smoke the shit..
From the experiences and readings of a friend I can report:
1) For an occasional smoker - several days after the event there may me a cortisol surge (think hair-trigger on the fight or flight response) due to event related depletion of a chemical that typically mediates cortisol in the H-P-A axis. Check hedweb for details. This can be destabilizing to the depressive especially if he/she minors in an anxiety disorder.
2) If care is taken to moderate events, the above can be avoided using a. low doses, b. oral administration (moderating the onset allows greater psychological integration with the altered state) c. exercise and d. anxiolytic bump-up during the vulnerable recovery period.
3) Why bother? Events may effectively counter blunting (sexual and otherwise) or anhedonia that SSRIs (for example) may, respectively, be causing or not be effectively treating in the underlying depression.
NET- positive or negative effects may result largely depending on if the same care is applied to dosage as any other drug you are taking / prescribing. Kind of obvious eh?
I am a marijuana smoker for over 17 years. In the beginning i thought nothing of it untill about 5 years ago i realized it was ruining my life both financially and health wise. I tried quitting many times in the past either cold turkey or thru rehab never was i successful. I attribute my relapse to the withdrawals I encountered and the sickness that came upon me while trying. I never made it past 7 days without relapse until i tried taking Maritox. I was able to get thru the quitting proccess without cravings or withdrawals and can proudly say I am clean for over a year now. I agree it is both physical and mental so you need the support of friends and family as well as Maritox to get thru it. The pill is natural not pharma so i had no desire to take it once i was done. others should check it out its great!
I am
I am not a smoker but I know someone who has smoked Marijuana and later Skunk as they call it for about 15years now. And it has truely taken over their life, they live for their next fix and is suffering sleep deprivation from getting up so many times at night to smoke. they have tried severally to quit but the severe withdrawal symptom they experience has always led them back smoking. The struggle continues as they truely want to quit.
I began smoking Marijuana regularly at age 30 after a brief addiction to amphetamines. My father had just died suddenly in a car accident where he was intoxicated with a blood alcohol level of .16 and had driven head-on into a brick wall at 60MPH. I just wanted to drop out, but I didn't ever ask myself, "but for how long?"
I stopped smoking 3 years ago. I am 48 and I have emphysema, DVT and Gingivitis that is so severe I recently had to have gum replacement surgery all due to smoking.
Also, Let me just say that Marijuana is the most intensely mind-altering drug that I have experienced in my many years of my long history of addiction and my vocation as a scholar and physician specializing in Dual Diagnosis Addiction/Mood Disorders department at a major research center in California.
Perhaps it is the most life-depleting of them too. It is a depressant that similar to the anti-psychotic class of drugs that are prescribed more and more often to patients who have been diagnosed with Borderline Personality/ Bi-polar Disorder II with co-morbid Avoidant Personality Disorder yet there has been no clinical significance that has been linked to treatment with the drugs. 70% of new inpatient admits at rehabilitation centers are for Marijuana Addiction. This is a serious substance not to be questioned as a political point, but from a self-harming behavioral pattern needing treatment.
From the experiences and readings of a friend I can report:
1) For an occasional smoker - several days after the event there may me a cortisol surge (think hair-trigger on the fight or flight response) due to event related depletion of a chemical that typically mediates cortisol in the H-P-A axis. Check hedweb for details. This can be destabilizing to the depressive especially if he/she minors in an anxiety disorder.
2) If care is taken to moderate events, the above can be avoided using a. low doses, b. oral administration (moderating the onset allows greater psychological integration with the altered state) c. exercise and d. anxiolytic bump-up during the vulnerable recovery period.
3) Why bother? Events may effectively counter blunting (sexual and otherwise) or anhedonia that SSRIs (for example) may, respectively, be causing or not be effectively treating in the underlying depression.
NET- positive or negative effects may result largely depending on if the same care is applied to dosage as any other drug you are taking / prescribing. Kind of obvious eh?
Reading through these testimonials has made me sick. I have been smoking for 5 years now, taken a plethura of other substances, and never once have I had trouble quitting smoking when needed. There are absolutely no withdrawl symptoms other than the users will. If the user is not strong enough to abstain from several days/weeks of smoking, than the user should not use any substance period. Also, I highly dislike people refering to marijuana as a drug. It is an herb and Gods plant, use it responsibly and God Bless.
I am
Every time i quite smoking I would within 3 days become depressed, agitated, easily frustrated, hostile. Me thinks there is withdrawal. some jamaican farm workers in canda have said when they come here yearly they have trouble eating and sleeping. In the 70s they would but our weak pot just to feel somewhat normal but not high on it.
I began smoking Marijuana regularly at age 30 after a brief addiction to amphetamines. My father had just died suddenly in a car accident where he was intoxicated with a blood alcohol level of .16 and had driven head-on into a brick wall at 60MPH. I just wanted to drop out, but I didn't ever ask myself, "but for how long?"
I stopped smoking 3 years ago. I am 48 and I have emphysema, DVT and Gingivitis that is so severe I recently had to have gum replacement surgery all due to smoking.
Also, Let me just say that Marijuana is the most intensely mind-altering drug that I have experienced in my many years of my long history of addiction and my vocation as a scholar and physician specializing in Dual Diagnosis Addiction/Mood Disorders department at a major research center in California.
Perhaps it is the most life-depleting of them too. It is a depressant that similar to the anti-psychotic class of drugs that are prescribed more and more often to patients who have been diagnosed with Borderline Personality/ Bi-polar Disorder II with co-morbid Avoidant Personality Disorder yet there has been no clinical significance that has been linked to treatment with the drugs. 70% of new inpatient admits at rehabilitation centers are for Marijuana Addiction. This is a serious substance not to be questioned as a political point, but from a self-harming behavioral pattern needing treatment.
If this is such a concern, why are we still depending upon studies that we done 10 to 27 years ago?
Reading through these testimonials has made me sick. I have been smoking for 5 years now, taken a plethura of other substances, and never once have I had trouble quitting smoking when needed. There are absolutely no withdrawl symptoms other than the users will. If the user is not strong enough to abstain from several days/weeks of smoking, than the user should not use any substance period. Also, I highly dislike people refering to marijuana as a drug. It is an herb and Gods plant, use it responsibly and God Bless.
Not only does withdrawal exist, but it can be extremely debilitating with headaches, fatigues, nausea, irritability, poor focus concentration and memory
Every time i quite smoking I would within 3 days become depressed, agitated, easily frustrated, hostile. Me thinks there is withdrawal. some jamaican farm workers in canda have said when they come here yearly they have trouble eating and sleeping. In the 70s they would but our weak pot just to feel somewhat normal but not high on it.
If this is such a concern, why are we still depending upon studies that we done 10 to 27 years ago?
Not only does withdrawal exist, but it can be extremely debilitating with headaches, fatigues, nausea, irritability, poor focus concentration and memory
I am an occassional marijuana smoker. In my teens and twenties I smoked probably approx. 2-3 times a week. In my 30's. probably, once every month or so. I am now 46. I gotta tell you, It's not the same. I don't know why my mind desires to smoke. It makes me think real hard about my job and God. It does not relax me, usually; yet I still want to smoke the shit..