Comprehensive review describes cannabis withdrawal occurring in half of regular users, with no approved medications for treatment | Research

The takeaway

Cannabis withdrawal occurs in about half of regular users, typically starting 24-48 hours after cessation with symptoms peaking at days 2-6, and while supportive counseling is first-line treatment, no medications are specifically approved for it.

Clinicians treating cannabis dependence, people trying to quit cannabis, and addiction researchers.

~50% of regular users experience withdrawal; no approved medications

What the researchers found

Cannabis withdrawal occurs in approximately 50% of regular/dependent users. Symptoms begin 24-48 hours after cessation, peak at days 2-6, with some lasting 3+ weeks. Most common symptoms: anxiety, irritability, anger/aggression, sleep disturbance, depressed mood, appetite loss. No approved medications exist. Supportive counseling and psychoeducation are first-line. Promising pharmacological agents have been studied but findings are not replicated.

Why it matters

Cannabis withdrawal is clinically significant because symptoms often precipitate relapse. Understanding its course and management options is essential for anyone attempting to quit.

The numbers in context

Occurs in ~50% of regular users. Onset: 24-48 hours. Peak: days 2-6. Duration: up to 3+ weeks in heavy users. No approved medications.

How the study worked

Narrative review of the literature covering diagnosis, prevalence, course, and clinical management of cannabis withdrawal.

What this study cannot tell us

Narrative review, not systematic. Pharmacological trial evidence is limited and underpowered. Cannabis agonist use is off-label. Withdrawal severity likely varies by product potency and duration of use.

How to read the evidence

Comprehensive narrative review of a well-characterized phenomenon, though pharmacotherapy evidence is limited.

When this study was published

Published in 2022.

The bigger picture

As cannabis potency increases and more people become regular users, withdrawal is becoming a more common clinical challenge. The lack of approved pharmacotherapy represents a significant gap in addiction medicine.

Questions still open

Would gradual tapering of THC products reduce withdrawal severity? Are higher-potency products associated with worse withdrawal? Could CBD mitigate withdrawal symptoms?

Common questions

What does cannabis withdrawal feel like?

The most common symptoms are anxiety, irritability, anger or aggression, sleep problems (including vivid dreams), depressed mood, and loss of appetite. Less common physical symptoms include chills, headaches, sweating, and stomach pain.

How long does cannabis withdrawal last?

Symptoms typically start within 24-48 hours of quitting, peak between days 2-6, and most resolve within 2-3 weeks. However, some symptoms can persist longer in heavy users.

Read the original research

Clinical management of cannabis withdrawal.

Addiction (Abingdon, England), 117(7), 2075-2095

View on PubMed ↗Publisher’s paper ↗

Citation

Connor, Jason P; Stjepanović, Daniel; Budney, Alan J; Le Foll, Bernard; Hall, Wayne D. (2022). Clinical management of cannabis withdrawal.. Addiction (Abingdon, England), 117(7), 2075-2095. https://doi.org/10.1111/add.15743