Cannabis withdrawal symptoms in non-treatment-seeking adult cannabis smokers.
BACKGROUND
Cannabis withdrawal is not recognized in DSM-IV because of doubts about its clinical significance.


OBJECTIVE
Assess the phenomenon of cannabis withdrawal and its relationship to relapse in non-treatment-seeking adults.


METHODS
Convenience sample of 469 adult cannabis smokers who had made a quit attempt while not in a controlled environment.


METHODS
Subjects completed a 176-item Marijuana Quit Questionnaire collecting information on sociodemographic characteristics, cannabis use history, and their "most difficult" cannabis quit attempt.


RESULTS
42.4% of subjects had experienced a lifetime withdrawal syndrome, of whom 70.4% reported using cannabis in response to withdrawal. During the index quit attempt, 95.5% of subjects reported > or =1 individual withdrawal symptom (mean [SD] 9.5 [6.1], median 9.0); 43.1% reported > or =10. Number of withdrawal symptoms was significantly associated with greater frequency and amount of cannabis use, but symptoms occurred even in those using less than weekly. Symptoms were usually of > or = moderate intensity and often prompted actions to relieve them. Alcohol (41.5%) and tobacco (48.2%) were used more often than cannabis (33.3%) for this purpose. There was little change during withdrawal in use of other legal or illegal substances.


CONCLUSIONS
Cannabis withdrawal is a common syndrome among adults not seeking treatment. The intention to relieve withdrawal symptoms can drive relapse during quit attempts, giving cannabis withdrawal clinical significance as a target of treatment.
Intramural Research Program, National Institute on Drug Abuse, Baltimore, MD 21224, USA.
Kenneth H
KH
Levin
Marc L
ML
Copersino
Stephen J
SJ
Heishman
Fang
F
Liu
Deanna L
DL
Kelly
Douglas L
DL
Boggs
David A
DA
Gorelick
D000328:Adult; D002188:Cannabis / Q000009:adverse effects*; D016009:Chi-Square Distribution; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D012008:Recurrence; D012720:Severity of Illness Index; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires