Marijuana, also known as cannabis, is often considered to be quite safe relative to other illicit drugs. However, long-term marijuana use can lead to physical dependence on the drug. Although the rates of development of marijuana dependence tend to be lower than other illicit drugs (around 15% for cocaine and 24% for heroin), around 9% of all individuals who try marijuana develop a dependence on the drug.
Individuals attempting to abstain from marijuana use often experience difficult withdrawal symptoms such as depression and anxiety, which may lead to relapse. Although there has been skepticism about dependence on marijuana use and withdrawal symptoms, separate studies have consistently shown reproducible withdrawal symptoms arising due to abstaining from marijuana use. Cannabis detox treatment in an inpatient or an outpatient clinic can help deal with these symptoms under professional supervision and is the first step towards treating marijuana dependence and addiction.
What Causes Withdrawal?
Long-term marijuana use can lead to physical dependency. As people become dependent, they develop a tolerance for the drug and need to consume greater quantities of the drug to achieve the desired effects.
For someone who is dependent, lowering or stopping use can result in withdrawal symptoms as the brain and body react to the removal of the drug.
Diagnosing Marijuana Withdrawal
Abstinence from marijuana use after intake over a long period of time can lead to withdrawal symptoms. Individuals with drug dependence or addiction are often defensive about their drug use or try to rationalize their substance use.
For the accurate diagnosis and treatment of marijuana addiction and its withdrawal symptoms, it is essential for the individual to be honest with the doctor about their history of drug use as well as about instances of drug relapse while undergoing detoxification.
According to the Diagnostic and Statistical Manual of Mental Disorders ( DSM 5th edition), to be diagnosed with cannabis withdrawal requires the presence of at least three of the following symptoms within one week of stopping use:
- anger or aggression
- nervousness or anxiety
- sleep difficulties including insomnia and unpleasant dreams
- decreased appetite
- depressed mood
To be diagnosed as withdrawal symptoms, patients must have symptoms that cause significant distress and result in impaired functioning in their social or occupational lives. Furthermore, these symptoms should not be a consequence of another primary condition such as a mood disorder or due to withdrawal symptoms from a different substance.
Marijuana Withdrawal Symptoms
The withdrawal symptoms associated with marijuana may differ from one individual to another in their duration and intensity. Withdrawal symptoms due to dependence on weed generally involve irritability, anxiety, depressed mood, cravings for cannabis and physical pain.
Physical Symptoms of Withdrawal
Physical symptoms of marijuana withdrawal include:
- Weakness or tiredness
- Decreased appetite and weight loss
- Abdominal pains
- Fever or chills
Psychological Symptoms of Withdrawal
The psychological symptoms of cannabis withdrawal include:
- Depressed mood
- Disturbances in sleep patterns including insomnia
- Anxiety and nervousness
- Unpleasant dreams
- Drug cravings
Marijuana Withdrawal Timeline
Abstinence from marijuana use generally results in withdrawal symptoms that last for about 2–3 weeks. The onset of symptoms generally occurs within 1–3 days after abstinence and the symptoms reach their peak during days 2–6. After a week of abstinence from cannabis use, most of the withdrawal symptoms start to subside. Some symptoms like difficulty sleeping may show a fluctuating pattern whereas unpleasant dreams tend to occur throughout the withdrawal period. Other symptoms like cravings and depression may also persist for several weeks after the onset of abstinence.
Factors Affecting Withdrawal Duration
Various factors affect the duration and severity of cannabis withdrawal symptoms, including the duration of marijuana use, the doses used, the use of other substances, current life stressors and personality traits. The levels of cannabinoids in marijuana and the method of intake may also influence withdrawal duration. For example, it has become more popular to consume resins from the cannabis plant that have high concentrations of THC. Also, newer marijuana strains with higher levels of the psychoactive compound, tetrahydrocannabinol (THC) and lower levels of cannabidiol are associated with a higher likelihood of developing drug dependence and tolerance, leading to more withdrawal symptoms.
Marijuana use is also associated with a high likelihood of using other substances such as alcohol and tobacco, and using these substances during withdrawal may interfere with the detoxification process. Furthermore, co-occurring substance use disorder and mood disorders can also increase the duration and severity of withdrawal symptoms.
Marijuana Detox and Withdrawal Treatment
Withdrawal symptoms due to stopping marijuana use can cause significant distress and may lead to relapse. Detoxification is the process of eliminating the drug from the body and is the first step in treatment. Cannabis detoxification at an inpatient medical detox or outpatient detox generally involves behavioral therapy, support groups and medications. There are currently no approved medications for the treatment of withdrawal symptoms due to the discontinuation of marijuana use, but medications can help with withdrawal symptoms. Following marijuana detox, enrolling in an inpatient or outpatient rehabilitation clinic is recommended.
A medical detox is the most effective method of detoxification, especially for cases of severe marijuana addiction or in cases involving co-occurring mood or substance use disorders. Medical detox involves 24-hour care provided by doctors and nurses and helps the individual to cope with the withdrawal symptoms using behavioral therapy and pharmacotherapy.
Outpatient cannabis detox involves visiting a detox clinic for treatment but allows individuals to carry on with daily life activities such as school or work. Outpatient detox tends to be less expensive than inpatient detox.
Detoxing at Home
Symptoms of marijuana withdrawal can cause significant distress and often lead to relapse. Although it is possible to detox at home, this is not advised.
Although there are many detox kits available online, they are not approved by the FDA and may be unsafe, especially due to the presence of adulterants. Home remedies for marijuana detox and natural therapies for cannabis detox are also not advised as there is no medical supervision and there are no studies to back up their effectiveness.
Healthy nutrition may be helpful to counteract the changes in appetite induced by marijuana withdrawal, while exercise and other physical activities are useful in alleviating stress-related symptoms. Engaging in hobbies and other activities may provide a useful distraction from the withdrawal symptoms.
Finding a Detox Center
Finding the best detox center for marijuana dependence can be challenging. When selecting a detox center for cannabis abuse, it is essential to find a clinic that involves evidence-based, individualized treatment provided by trained and accredited staff.
- Inpatient vs. Outpatient: An inpatient detox center provides constant care and more intensive treatment in a safe, drug-free environment. Inpatient treatment may also be necessary when marijuana addiction co-occurs with other psychiatric conditions or substance use disorders that may exacerbate the withdrawal symptoms. Outpatient treatment is less expensive but may result in exposure to triggers that lead to relapse.
- Treatment Effectiveness: Treatment for withdrawal symptoms may involve various forms of behavioral therapy including group therapy, individual therapy, support groups as well as various activities. This may also include medications to relieve withdrawal symptoms. The effectiveness of any particular treatment approach may vary from person-to-person, depending on their drug use history, and their genetic and environmental factors.
- Length of Program: The length of a detox program may vary depending on the type of treatment provided and the withdrawal symptoms.
How Detox Helps
Both inpatient and outpatient detox involve various behavioral approaches, including group therapy, individual therapy sessions and support groups. These behavioral approaches can help the individual deal with the psychological symptoms of marijuana withdrawal. These approaches also involve a social component and provide the individual with the necessary support to cope with the withdrawal symptoms.
Doctors at the detox center can also prescribe medications that can alleviate the withdrawal symptoms and make them more manageable. Furthermore, an inpatient detox can provide a drug-free environment and the necessary intensive care to deal with the withdrawal symptoms. Treatment at a detox should be followed by enrollment in rehab for long-term recovery and to reduce the chances of relapse.
Key Points: Understanding Marijuana Withdrawal and Detox
Marijuana dependence is relatively common and can lead to withdrawal symptoms. Some of the key points relevant to marijuana withdrawal and detox include:
- Marijuana withdrawal can lead to physical symptoms like fever, chills and insomnia, and psychological symptoms like depression, anxiety and drug cravings
- These withdrawal symptoms can lead to relapse and treatment at a detox clinic may help cope with these symptoms
- Withdrawal symptoms may last 2–3 weeks, with most symptoms at their highest during the first week and then receding over subsequent weeks
- Duration and severity of withdrawal symptoms may vary depending on how long the patient used cannabis, dosage, and any other comorbid disorders
- Treatment at an inpatient or outpatient marijuana detox can provide the support and medical care needed to cope with the withdrawal symptoms
- Treatment at an inpatient detox provides a safe, drug-free environment as the individual copes with the withdrawal symptoms
- Cannabis detox at home is not advisable and may result in relapse due to exposure to triggers
The Recovery Village at Palm Beach specializes in the treatment of substance abuse disorders and co-occurring mental disorders. Treatment for substance abuse disorders is tailored to the needs of each individual and is provided by clinical and medical staff with expertise in the treatment of such conditions. If you or someone you know suffers from marijuana addiction, contact The Recovery Village at Palm Beach to begin your path to recovery.
Oleson, Erik B., and Joseph F. Cheer. “A brain on cannabinoids: the role of dopamine release in reward seeking.” Cold Spring Harbor Perspectives In medicine. August 2012. Accessed July 18, 2019.
Cooper, Ziva D., and Margaret Haney. “Cannabis reinforcement and dependence: role of the cannabinoid CB1 receptors.” Addiction Biology. June 2008. Accessed July 18, 2019.
Gorelick, David A., Kenneth H. Levin, Marc L. Copersino, Stephen J. Heishman, Fang Liu, Douglas L. Boggs, and Deanna L. Kelly. “Diagnostic criteria for cannabis withdrawal syndrome.” Drug and Alcohol Dependence. June 2012. Accessed July 18, 2019. Accessed July 18, 2019.
Budney, Alan J., Brent A. Moore, Ryan G. Vandrey, and John R. Hughes. “The time course and significance of cannabis withdrawal.” Journal of Abnormal Psychology. August 2003. Accessed July 18, 2019.
Bonnet, Udo, and Ulrich W. Preuss. “The cannabis withdrawal syndrome: current insights.” Substance Abuse and Rehabilitation. 2017. Accessed July 18, 2019