National Survey Found 44% of Frequent Cannabis Users Experienced Withdrawal Symptoms
In a nationally representative sample, 44% of frequent cannabis users experienced two or more withdrawal symptoms that caused significant distress, supporting the addition of cannabis withdrawal to diagnostic criteria.
Quick Facts
What This Study Found
Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), researchers examined cannabis withdrawal among 2,613 frequent users (three or more times per week) and a subset of 1,119 "cannabis-only" users who didn't binge drink or use other drugs frequently.
Withdrawal was common: 44.3% of the full sample and 44.2% of the cannabis-only subset experienced two or more symptoms. About 34% experienced three or more symptoms. The nearly identical rates in the cannabis-only subset confirmed these symptoms were specific to cannabis, not other substances.
The symptoms clustered into two distinct factors: (1) a "weakness" factor including weakness, excessive sleep, and psychomotor retardation, and (2) an "anxiety" factor including anxiety, restlessness, depression, and insomnia.
Both symptom types were associated with significant distress or impairment. Psychiatric disorders predicted anxiety-type withdrawal, family drug problems predicted weakness-type withdrawal, and depression was associated with both types.
Key Numbers
2,613 frequent users examined. 44.3% experienced 2+ withdrawal symptoms. 34.4% experienced 3+ symptoms. Cannabis-only subset (n=1,119) showed 44.2% and 34.1% respectively. Two symptom factors identified: weakness/hypersomnia and anxiety/insomnia.
How They Did This
Analysis of NESARC data (2001-2002), a nationally representative survey. 2,613 frequent cannabis users and 1,119 cannabis-only subset assessed via structured in-person interviews covering substance history, DSM-IV disorders, and withdrawal symptoms after cessation.
Why This Research Matters
This study provided some of the strongest evidence that cannabis withdrawal is a real, clinically significant phenomenon. The identical rates in the cannabis-only subset eliminated the argument that withdrawal symptoms were caused by other substances. These findings influenced the addition of cannabis withdrawal to DSM-5.
The Bigger Picture
This study was instrumental in the eventual recognition of cannabis withdrawal as a formal diagnosis in DSM-5 (2013). Prior to studies like this, cannabis withdrawal was not officially recognized, and many believed cannabis did not produce physical dependence.
What This Study Doesn't Tell Us
Cross-sectional survey data relies on retrospective self-report. The definition of "frequent use" (3+ times/week) may include a wide range of use patterns. Withdrawal symptoms were assessed through structured interview rather than clinical observation.
Questions This Raises
- ?How long do cannabis withdrawal symptoms last?
- ?Do the two symptom factors respond to different treatments?
- ?Does withdrawal severity predict relapse risk?
Trust & Context
- Key Stat:
- 44% of frequent cannabis users experienced withdrawal symptoms (confirmed in cannabis-only users)
- Evidence Grade:
- This is a large, nationally representative study with a cannabis-only subset that confirms symptom specificity, providing strong evidence for the clinical significance of cannabis withdrawal.
- Study Age:
- Published in 2008. Cannabis withdrawal was subsequently added to DSM-5 in 2013, partly based on evidence from this and similar studies.
- Original Title:
- Cannabis withdrawal in the United States: results from NESARC.
- Published In:
- The Journal of clinical psychiatry, 69(9), 1354-63 (2008)
- Authors:
- Hasin, Deborah S(31), Keyes, Katherine M(11), Alderson, Donald, Wang, Shuang, Aharonovich, Efrat, Grant, Bridget F
- Database ID:
- RTHC-00312
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
What are cannabis withdrawal symptoms?
This study identified two clusters: (1) weakness, excessive sleepiness, and slowed movement, and (2) anxiety, restlessness, depression, and insomnia. Both caused significant distress or functional impairment.
Is cannabis withdrawal dangerous?
Cannabis withdrawal is generally not medically dangerous (unlike alcohol or benzodiazepine withdrawal), but it causes significant discomfort and distress that can make quitting difficult. The symptoms typically resolve within 1-2 weeks.
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Cite This Study
https://rethinkthc.com/research/RTHC-00312APA
Hasin, Deborah S; Keyes, Katherine M; Alderson, Donald; Wang, Shuang; Aharonovich, Efrat; Grant, Bridget F. (2008). Cannabis withdrawal in the United States: results from NESARC.. The Journal of clinical psychiatry, 69(9), 1354-63.
MLA
Hasin, Deborah S, et al. "Cannabis withdrawal in the United States: results from NESARC.." The Journal of clinical psychiatry, 2008.
RethinkTHC
RethinkTHC Research Database. "Cannabis withdrawal in the United States: results from NESAR..." RTHC-00312. Retrieved from https://rethinkthc.com/research/hasin-2008-cannabis-withdrawal-in-the
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.