Cannabis is a unique substance with an excellent safety profile. Many believe that discontinuation after regular cannabis use doesn’t incur a risk of withdrawal symptoms. However, that’s not necessarily true. While cannabis does not cause physical withdrawal symptoms like opiates or alcohol, the idea that cannabis cannot be inherently addictive and that withdrawing from it is a simple process is somewhat incorrect. Now, anecdotal stories of daily cannabis users for years or even decades suggest quitting without any issue is the norm. But, several pieces of research suggest cannabis withdrawal can lead to psychological and sometimes psychical withdrawal symptoms, including:
- Spontaneous changes in mood, including aggression, irritability, anxiety, depression, restlessness, and anger.
- Physical discomfort such as headaches, vomiting, nausea, abdominal pain.
- Feelings of insomnia and intense fatigue
What research says on cannabis withdrawal
While research has painted a partial picture of withdrawal rates associated with cannabis and the dependence one can develop through the use of cannabinoids, some big questions remain largely unanswered. One of the most prominent meta-analysis studies on cannabis withdrawal, completed by Anees Bahji, MD, Callum Stephenson, and Richard Tyo, BsocSc for the JAMA Network journal, found in 23,518 participants in observational studies, 47 percent demonstrated marked withdrawal symptoms from cannabis. The majority of those who experienced withdrawal also had many other clinical factors related to their cannabis use. These factors include using concurrently with tobacco, using other substances such as LSD or alcohol, or daily use of cannabis.
Based on the data from similar studies where nearly half of participants show signs of withdrawal, cannabis withdrawal symptoms are perhaps not as rare as commonly believed — particularly among those who may struggle with concurrent substance use disorders. However, there are also some issues with the JAMA study, which we will now explore.
Understanding the meta-analysis
While showing a clear correlation between heavy cannabis use and withdrawal symptoms, the JAMA study may not be totally accurate for a specific reason. Being, it’s missing a meta-analysis. A meta-analysis is a study where many previous studies meeting specific criteria get paired together to increase the likelihood of particular outcomes or statistics. In a way, one could argue that completing a meta-analytic study is similar to cherry-picking and ignoring other results. That said, using the JAMA study as a baseline for whether or not cannabis can cause withdrawal symptoms might not be accurate. It’s also important to note that much of the JAMA study related not to the medicinal use of cannabis, but the recreational use. There is no way for the reader to distinguish between medical cannabis use and recreational. This distinction is key, as many licensed medical dispensaries focus primarily on legally regulated, sometimes low-dose THC and high CBD strains for use in medical treatment. Recreational cannabis, however, is more likely to contain high THC and significantly lower CBD, which increases the psychoactive effects and may lead to an increase in the risk of dependence and subsequent withdrawal.
The reality of withdrawal
Even with somewhat sketchy evidence to go by, it’s clear in some sections of the cannabis-using population that withdrawal symptoms are a reality. Even if we are unaware of the quality of cannabis used in the JAMA study, we still don’t know how many members of the study who consumed cannabis experienced withdrawal symptoms. And, we’ve yet to see the extent of these withdrawal symptoms, what specific factors increase their likelihood, and if they are more prevalent in either a medical or recreational setting.
Remember, help is available if you feel your cannabis use has become problematic in your own life or if you’ve discontinued your use of cannabis and are experiencing withdrawal symptoms. Consider consulting a medical professional for short-term assistance with withdrawing from cannabis. If you feel your cannabis dependence is too difficult to handle alone, you might consider speaking to an addiction professional or entering in-person treatment for substance use. Regardless of where you are in your cannabis use journey, always remember that there is no harm in cutting back or taking the occasional tolerance break.