title: Marijuana abstinence effects in marijuana smokers maintained in their home environment.
abstract: BACKGROUND
  Although withdrawal symptoms are commonly reported by persons seeking treatment for marijuana dependence, the validity and clinical significance of a marijuana withdrawal syndrome has not been established. This controlled outpatient study examined the reliability and specificity of the abstinence effects that occur when daily marijuana users abruptly stop smoking marijuana.
  
  
  METHODS
  Twelve daily marijuana smokers were assessed on 16 consecutive days during which they smoked marijuana as usual (days 1-5), abstained from smoking marijuana (days 6-8), returned to smoking marijuana (days 9-13), and again abstained from smoking marijuana (days 14-16).
  
  
  RESULTS
  An overall measure of withdrawal discomfort increased significantly during the abstinence phases and returned to baseline when marijuana smoking resumed. Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other. Collateral observers confirmed participant reports of these symptoms.
  
  
  CONCLUSIONS
  This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant. These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal.
authors.affiliation: Department of Psychiatry, The University of Vermont, 54 W Twin Oaks Terr, Suite 9, S Burlington, VT 05403, USA. abudney@zoo.uvm.edu
authors.forename: A J
authors.initials: AJ
authors.lastname: Budney
authors.forename: J R
authors.initials: JR
authors.lastname: Hughes
authors.forename: B A
authors.initials: BA
authors.lastname: Moore
authors.forename: P L
authors.initials: PL
authors.lastname: Novy
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000139:chemically induced / Q000175:diagnosis; D000374:Aggression / Q000523:psychology; D000553:Ambulatory Care; D016739:Behavior, Addictive / Q000139:chemically induced / Q000175:diagnosis; D003404:Creatinine / Q000652:urine; D013759:Dronabinol / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000378:metabolism / Q000652:urine; D001068:Feeding and Eating Disorders / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000150:complications* / Q000175:diagnosis / Q000652:urine; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011595:Psychomotor Agitation / Q000209:etiology / Q000523:psychology; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000139:chemically induced / Q000175:diagnosis; D015813:Substance Abuse Detection / Q000706:statistics & numerical data; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000652:urine; D015431:Weight Loss
chemical_list: C016780:11-nor-delta(9)-tetrahydrocannabinol-9-carboxylic acid; D013759:Dronabinol; D003404:Creatinine