National Survey Found 44% of Frequent Cannabis Users Experienced Withdrawal Symptoms | Research

The takeaway

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.

Read this if you use cannabis frequently and want to understand what to expect if you stop or cut back.

44% of frequent cannabis users experienced withdrawal symptoms (confirmed in cannabis-only users)

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

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.

When this study was published

Published in 2008. Cannabis withdrawal was subsequently added to DSM-5 in 2013, partly based on evidence from this and similar studies.

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.

Questions still open

How long do cannabis withdrawal symptoms last? Do the two symptom factors respond to different treatments? Does withdrawal severity predict relapse risk?

Common 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.

Read the original research

Cannabis withdrawal in the United States: results from NESARC.

The Journal of clinical psychiatry, 69(9), 1354-63

View on PubMed ↗

Citation

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.