title: Prolonged cannabis withdrawal in young adults with lifetime psychiatric illness.
abstract: Young adults with psychiatric illnesses are more likely to use cannabis and experience problems from use. It is not known whether those with a lifetime psychiatric illness experience a prolonged cannabis withdrawal syndrome with abstinence. Participants were fifty young adults, aged 18-25, recruited from the Boston-area in 2015-2016, who used cannabis at least weekly, completed the Structured Clinical Interview for DSM-IV to identify Axis I psychiatric diagnoses (PD+ vs PD-), and attained cannabis abstinence with a four-week contingency management protocol. Withdrawal symptom severity was assessed at baseline and at four weekly abstinent visits using the Cannabis Withdrawal Scale. Cannabis dependence, age of initiation, and rate of abstinence were similar in PD+ and PD- groups. There was a diagnostic group by abstinent week interaction, suggesting a difference in time course for resolution of withdrawal symptoms by group, F(4,46)=3.8, p=0.009, controlling for sex, baseline depressive and anxiety symptoms, and frequency of cannabis use in the prior 90days. In post hoc analyses, there was a difference in time-course of cannabis withdrawal. PD- had significantly reduced withdrawal symptom severity in abstinent week one [t(46)=-2.2, p=0.03], while PD+ did not report improved withdrawal symptoms until the second abstinent week [t(46)=-4.1, p=0.0002]. Cannabis withdrawal symptoms improved over four weeks in young people with and without a lifetime psychiatric diagnosis. However, those with a psychiatric illness reported one week delayed improvement in withdrawal symptom severity. Longer duration of cannabis withdrawal may be a risk factor for cannabis dependence and difficulty quitting.
authors.affiliation: Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: Rschuster@mgh.harvard.edu.
authors.forename: Randi Melissa
authors.initials: RM
authors.lastname: Schuster
authors.affiliation: Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Fontaine
authors.affiliation: Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Nip
authors.affiliation: Department of Biostatistics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Haiyue
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Ailish
authors.initials: A
authors.lastname: Hanly
authors.affiliation: Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: A Eden
authors.initials: AE
authors.lastname: Evins
mesh_terms: D001900:Boston / Q000453:epidemiology; D002188:Cannabis; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology; D001523:Mental Disorders / Q000453:epidemiology*; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult
keywords: Abstinence; Anxiety; Cannabis; Cannabis withdrawal syndrome; Depression; Marijuana; Mental health