New Cannabis Withdrawal Scale developed: nightmares were most diagnostic, angry outbursts caused the most distress

The Cannabis Withdrawal Scale was developed with excellent reliability (Cronbach's alpha = 0.91), finding nightmares as the most diagnostic symptom and angry outbursts as the most distressing.

Allsop, David J et al.·Drug and alcohol dependence·2011·Moderate EvidenceProspective Cohort
RTHC-00467Prospective CohortModerate Evidence2011RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Prospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Researchers developed and validated the Cannabis Withdrawal Scale using 49 dependent cannabis users who provided daily symptom scores during one baseline week and two weeks of abstinence.

The scale demonstrated excellent psychometric properties: internal reliability (Cronbach's alpha = 0.91) and test-retest stability (average intra-class correlation = 0.95).

Nightmares and strange dreams were the most statistically valid withdrawal indicator (Wald chi-squared = 105.6) but caused relatively little distress. Angry outbursts were both intense (Wald chi-squared = 73.69) and highly distressing (Wald chi-squared = 45.54). Difficulty falling asleep was also intense (Wald chi-squared = 42.31) and distressing (Wald chi-squared = 47.76).

Scores on the Severity of Dependence Scale predicted the severity of cannabis withdrawal symptoms.

Key Numbers

49 dependent cannabis users. Cronbach's alpha = 0.91. Intra-class correlation = 0.95. Nightmares: Wald chi-squared = 105.6. Angry outbursts: Wald chi-squared = 73.69. Sleep onset difficulty: Wald chi-squared = 42.31.

How They Did This

Prospective validation study with 49 dependent cannabis users providing daily Cannabis Withdrawal Scale scores during 1 week of baseline use and 2 weeks of monitored abstinence. Psychometric analysis included internal reliability, test-retest stability, content validity, and predictor analysis.

Why This Research Matters

Having a validated withdrawal measure was essential for clinical trials of cannabis dependence treatments and for establishing cannabis withdrawal as a clinically recognized condition.

The Bigger Picture

This scale became an important tool for cannabis dependence research and clinical practice, contributing to the eventual inclusion of cannabis withdrawal as a diagnosis in the DSM-5.

What This Study Doesn't Tell Us

Volunteer sample of 49 participants may not represent all cannabis-dependent populations. Two weeks of abstinence may not capture the full withdrawal timeline. Self-reported symptoms.

Questions This Raises

  • ?How does the Cannabis Withdrawal Scale perform in clinical treatment settings?
  • ?Do withdrawal severity scores predict treatment outcomes?

Trust & Context

Key Stat:
Nightmares: most diagnostic. Angry outbursts: most distressing.
Evidence Grade:
Well-designed psychometric validation study with excellent reliability statistics, though with a moderate sample size.
Study Age:
Published in 2011. The Cannabis Withdrawal Scale has been widely used in subsequent research.
Original Title:
The Cannabis Withdrawal Scale development: patterns and predictors of cannabis withdrawal and distress.
Published In:
Drug and alcohol dependence, 119(1-2), 123-9 (2011)
Database ID:
RTHC-00467

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Enrolls participants and follows them forward in time.

What do these levels mean? →

Frequently Asked Questions

What is the worst cannabis withdrawal symptom?

While nightmares/strange dreams were the most diagnostically useful symptom, angry outbursts and sleep onset difficulty caused the most distress. Different symptoms peaked in intensity versus causing the most suffering.

Is cannabis withdrawal a real medical condition?

This study provided validated measurement tools for cannabis withdrawal. The syndrome was subsequently included as a diagnosis in the DSM-5. Symptoms include nightmares, angry outbursts, sleep difficulties, and irritability.

Read More on RethinkTHC

Cite This Study

RTHC-00467·https://rethinkthc.com/research/RTHC-00467

APA

Allsop, David J; Norberg, Melissa M; Copeland, Jan; Fu, Shanlin; Budney, Alan J. (2011). The Cannabis Withdrawal Scale development: patterns and predictors of cannabis withdrawal and distress.. Drug and alcohol dependence, 119(1-2), 123-9. https://doi.org/10.1016/j.drugalcdep.2011.06.003

MLA

Allsop, David J, et al. "The Cannabis Withdrawal Scale development: patterns and predictors of cannabis withdrawal and distress.." Drug and alcohol dependence, 2011. https://doi.org/10.1016/j.drugalcdep.2011.06.003

RethinkTHC

RethinkTHC Research Database. "The Cannabis Withdrawal Scale development: patterns and pred..." RTHC-00467. Retrieved from https://rethinkthc.com/research/allsop-2011-the-cannabis-withdrawal-scale

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.