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Researchers say people who use marijuana on a regular basis can go through withdrawal symptoms. Getty Images
  • In a review of past studies, researchers say it’s apparent that people who regularly use marijuana experience withdrawal symptoms when they quit.
  • They say they hope their research will help those going through withdrawal to navigate that process better.
  • Experts note that for most people quitting marijuana, withdrawal symptoms are mild and short-lived.

As legalization makes marijuana more widely available to the general population, researchers are starting to be able to tackle long-standing questions.

Questions like, is it addictive? Is it addictive in a way that’s different from legal substances such as alcohol?

If someone stops using marijuana are there withdrawal symptoms as with other substances?

The state of knowledge around some of those questions is summed up in a new review of existing research.

Researchers say they found that withdrawal symptoms were prevalent among regular users of cannabis.

That prevalence varied depending on different factors, and the findings may apply primarily to heavy cannabis users who try to quit.

However, researchers hope their findings can lend some credibility to those who believe they’re suffering from marijuana withdrawal by “legitimizing” those symptoms as real.

The researchers reviewed 47 studies, which covered a total of more than 23,000 participants, most of whom had been in clinical settings.

Among those participants, 54 percent of outpatients and 87 percent of inpatients — those receiving treatment in a hospital or other facility — had symptoms of cannabis withdrawal syndrome.

Overall, 17 percent of people covered by the studies had symptoms.

Other factors, such as tobacco use, other drug use, or using cannabis daily, were also associated with a higher prevalence of cannabis withdrawal symptoms.

Dr. Anees Bahji, a psychiatry resident at Queen’s University in Kingston, Ontario, and the study’s lead author, said a lower prevalence doesn’t necessarily mean it’s less important for that group.

“It is quite likely that the field is still very much in development with regards to ‘what we can do’ with these findings,” Bahji told Healthline. “What does 17 percent mean? What does 84 percent mean? We are still trying to figure these things out, which suggests a role for future research.”

For example, he said, it’s difficult to say how much cannabis must be used before it’s likely to lead to abuse or withdrawal.

“In our study, we found an association between higher levels of cannabis consumption and higher prevalence of withdrawal. What that suggests is that individuals who consume more cannabis (e.g., daily cannabis use) are more likely to experience cannabis withdrawal upon cessation,” Bahji said.

Because the studies focused on heavy users of cannabis, outside experts cautioned that the findings about prevalence may not apply to most cannabis users.

“It is hardly surprising that such symptoms may be identifiable in this population. That said, these findings are likely less relevant or even irrelevant to the majority of cannabis consumers who use the substance on a more intermittent basis,” Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, told Healthline.

Cannabis withdrawal syndrome is now listed in the new edition of the Diagnostic and Statistical Manual of Mental Disorders, a document used to classify and diagnose mental disorders.

The syndrome is characterized by such symptoms as irritability, anxiety, sleep disturbance, appetite changes, depressed mood, nausea, headaches or abdominal pain within the first seven days after reducing cannabis use.

Current research suggests most people who use cannabis aren’t and won’t develop any sort of use disorder or withdrawal. But there are signs that some people can have factors that may make withdrawal more likely.

The National Institute on Drug Abuse recently released data that suggests that 30 percent of those who use marijuana may have some degree of “marijuana use disorder.”

In addition, people who use marijuana before age 18 were 4 to 7 times more likely to develop this use disorder than adults.

When it comes to withdrawal, Armentano said research has found symptoms to be mild and short-lived.

“Like with most matters specific to cannabis,” he said, the new findings “need to be placed in appropriate context.”

He compared cannabis withdrawal to withdrawal symptoms when someone stops using tobacco or alcohol.

“The profound physical withdrawal effects associated with tobacco are so severe that many subjects who strongly desire to quit end up reinitiating their use. In the case of alcohol, the abrupt ceasing of use in heavy users can be so severe that it can lead to death,” Armentano said.

“Simply withdrawing from caffeine can lead to a number of adverse side effects, like rebound headaches,” he added. “But we do not arrest 600,000 Americans annually for their use of caffeine.”

For those who have used cannabis heavily in the past and do find it more difficult than they thought to quit, Bahji hopes research like his study can comfort and support them.

“Ideally, the study will help to legitimize the experience of [withdrawal symptoms] among those who use cannabis,” he said. “Hopefully, this article will encourage discourse and dialogue between people who use cannabis with physicians, friends, and family. Perhaps also, it will serve to increase awareness of [withdrawal symptoms] among users of cannabis.”

In some ways, a greater understanding of how widespread withdrawal symptoms may be and who is most likely to have them can also bring increasingly legal marijuana more in line with other legal substances.

“We also hope that the article will reduce stigma around [withdrawal symptoms] and cannabis use, and increase the likelihood that people who have problematic use of cannabis will reach out for support,” Bahji said.

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