If you use cannabis and are thinking of stopping, you might be wondering what to expect if you quit. Cannabis is a psychoactive drug containing nearly 500 chemicals, including tetrahydrocannabinol (THC), a mind-altering compound. Cannabis today contains three times the THC that it contained 25 years ago, and the higher the THC concentration, the stronger its effects on your brain. Roughly one in 10 people who use cannabis will develop cannabis use disorder (CUD). CUD is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as the continued use of cannabis despite “clinically significant impairment.” When use begins before the age of 18, the CUD rate rises to one in six. The more frequently and longer you use the drug, the more severe your withdrawal symptoms might be. Understanding this connection can help you prepare for detox, withdrawal and the treatments that will help you heal.
Detox and Cannabis Withdrawal Symptoms
Symptoms of cannabis withdrawal can begin one to seven days after you stop using the drug. They will generally peak within 10 days, then decline on their own during the following couple of weeks. Symptoms can range from mild nervousness or restlessness to ones of greater intensity. More severe symptoms can interfere with your home life, work, overall quality of life and may even become disabling. If you experience at least three of the following symptoms within a week after stopping the drug, you may have cannabis withdrawal syndrome (CWS) according to the DSM-5:
- Anxiety or nervousness
- Depression or emotional numbness
- Excessive sweating
- Fever and chills
- Headaches
- Irritability or hostility
- Loss of appetite
- Restlessness
- Shakes or tremors
- Trouble getting to sleep or staying asleep
Anxiety or nervousness, hostility, sleep disturbance and depressed mood are the most commonly reported symptoms of CWS.
Psychotherapy and Dual Diagnosis
Research has also linked cannabis use with certain psychiatric conditions, particularly in those who start using it as teenagers. Such conditions can include:
- Mood disorders (depression, bipolar)
- Anxiety disorders (social phobia, agoraphobia, panic disorder)
- Post-traumatic stress disorder (PTSD)
- Personality disorders (borderline, obsessive-compulsive)
Recent studies suggest that smoking high-potency cannabis daily can increase your chances of developing psychosis (schizophrenia) by nearly five times, compared with people who have never used the drug. Genetic vulnerability is another factor. Scientists have found that cannabis users who carry a particular form of the gene AKT1 are also at higher risk of developing schizophrenia. AKT1 affects dopamine signaling in your brain. Dopamine is a chemical produced by your body that impacts your ability to think and plan and also how you feel pleasure. Daily cannabis users with this variant are seven times more likely to have schizophrenia than those who use it less frequently or not at all.
Studies show that treating mental health disorders can reduce cannabis use, especially if the use has been heavy. Some promising behavioral therapies include:
- Cognitive-behavioral therapy (CBT): Therapy that teaches patients how to identify and correct unproductive behaviors may strengthen self-control and stop substance use.
- Contingency management: Involves frequent monitoring of a target behavior coupled with the appropriate provision or removal of tangible rewards.
- Motivational enhancement therapy: A technique designed to facilitate the person’s inner motivations and resources to effect change.
While these are currently the most effective techniques for treating CUD, they appear to be of less benefit when CUD occurs alongside schizophrenia. Antipsychotic drugs are better able to reduce cannabis craving and use, as well as psychotic symptoms, in patients with this dual diagnosis.
Medication-Assisted Treatment
While the U.S. Food and Drug Administration (FDA) has not yet approved any medications for the express treatment of cannabis use disorder, early studies suggest that several pharmacological therapies may have some benefit in managing withdrawal symptoms:
- Zolpidem / Ambien®. Zolpidem is a sedative-hypnotic drug. It’s prescribed for insomnia, to slow activity in the brain and allow sleep to occur.
- Buspirone / BuSpar®. Buspirone is an anti-anxiety medication approved for Generalized Anxiety Disorder. It is not related to barbiturates, benzodiazepines, or other sedative/ anxiolytic drugs but can still react with alcohol.
- Gabapentin / Horizant®, Neurontin®. Gabapentin is an anticonvulsant medication. Horizant and Neurontin are both anticonvulsants but have different primary uses. Horizant is commonly prescribed for restless leg syndrome in adults. Neurontin is used to treat epilepsy in people aged 12 and over and ease nerve pain from shingles.
The nutritional supplement N-acetylcysteine and other agents are also being studied for their potential to relieve symptoms of cannabis withdrawal.
Recovering from cannabis use disorder (CUD) can be challenging but learning what to expect and what your options are can make the process easier. Cannabis withdrawal symptoms (CWS) can be mild or severe. While they usually decline on their own within a few weeks, help is available for those who experience cannabis withdrawal syndrome. If your symptoms are persistent or disabling, contact Casa Palmera today. Located in Los Angeles, California, we offer an interdisciplinary therapeutic drug and alcohol rehab with the highest level of care possible. We will tailor your treatment to your needs and maintain the utmost confidentiality during your stay with us. Casa Palmera offers the advanced clinical techniques necessary for treating both substance use disorders and co-occurring conditions, emphasizing evidence-based drug and alcohol treatment methods. Even after you leave us, rest assured that you will still receive the support and aftercare you need to continue your healing journey. Contact us today.
About the author
