Marijuana Withdrawal: Effects & Timeline


Often, marijuana is deemed harmless, with many people unaware that it is possible to become physically dependent, even addicted. With changing marijuana laws and increased public acceptance, the rates of marijuana use have been climbing over the last 20 years.1 In fact, even though the National Institute on Drug Abuse states that up to 30% of those who use marijuana have some degree of marijuana use disorder, over 68% of regular users said they didn’t think it was addictive in a 2019 survey.2,3

Those who attempt to quit using weed may be surprised to find that they suffer a range of withdrawal symptoms when they do. The cannabis withdrawal syndrome can make quitting marijuana more difficult and is a risk factor for relapse.1,4

The Weed Withdrawal Timeline

Man feeling depressed

When you are trying to significantly reduce your use of marijuana or stop entirely, you may begin to experience acute withdrawal symptoms relatively quickly. The general timeline for weed withdrawal symptoms is as follows:

  • Most symptoms of marijuana withdrawal will begin with the first 1-3 days.
  • Symptoms will peak in severity at some point during week 1.
  • Within 2 weeks, most acute symptoms will resolve.

In some cases, the symptoms of marijuana withdrawal, particularly the psychological/mood symptoms, may persist up to 5 weeks after quitting.5 Sleep issues are among the most troubling for those in early sobriety from marijuana.4,6 Difficulty sleeping, including insomnia and strange dreams, may persist for a 30-45 days or more.6,7 Of all the cannabis withdrawal symptoms (see below), problems with sleep are the most likely to lead to a relapse back to marijuana use.4

Marijuana Withdrawal Symptoms

The symptoms of marijuana withdrawal are mostly psychological and include:1,4,8

  • Irritability/hostility.
  • Nervousness and anxiety.
  • Restlessness.
  • Decreased appetite/weight loss.
  • Insomnia.
  • Strange or unsettling dreams.
  • Depression.

The less common physical discomforts that some people experience during withdrawal include:1,4,6

  • Sweating.
  • Headaches.
  • Tremors.
  • Stomach pain.
  • Nausea/vomiting.

Older and middle-age individuals may experience fewer and less severe withdrawal symptoms than younger adults.

Who Goes Through Cannabis Withdrawal?

Woman smoking marijuana

Cannabis withdrawal is likely to occur in those who have greatly reduced their intake or stopped using marijuana after using regularly (daily or several times per week) and heavily.4,9 Among regular or dependent users, the prevalence of cannabis withdrawal syndrome is 47%, according to a meta-analysis of studies involving more than 23k participants.1

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that withdrawal is generally more common and more severe among adult marijuana users than among adolescents. The reason for the discrepancy is likely due to adults using more frequently and in higher amounts than adolescents/teens.6

Among heavy cannabis users and those enrolled in rehab for marijuana, 50-95% report experiencing cannabis withdrawal symptoms. Among non-treatment seekers who report having used marijuana regularly during a period of their lives, up to 33% report experiencing marijuana withdrawal. Those in treatment for marijuana are likely to have been heavier users, which may explain the large difference in how many people report withdrawal in and out of treatment settings.6

Polysubstance use may also plays a role in marijuana withdrawal. Several studies have shown that cannabis withdrawal symptoms may be more likely to arise in those who use marijuana in combination with tobacco, alcohol, or other drugs; however, those individuals with an opioid dependence who also use marijuana may be less likely to experience withdrawal symptoms.1,4

Those with mood, anxiety, and personality disorders, as well as those with PTSD, may also be more likely to experience cannabis withdrawal.10 They may also experience more severe symptoms than those without.6

More Potent Marijuana May Mean Worse Withdrawal

The potency of marijuana being sold for recreational use is increasing in the United States. Marijuana potency may be associated with a greater severity of not only the side effects of marijuana but also with the severity of the withdrawal syndrome.4

Marijuana users who engage in “dabbing,” where concentrations of THC are particularly high (20-80%) often report higher tolerance and more severe withdrawal than those who smoke marijuana flowers where the concentrations of TCH are usually between 2% and 6%.4

Help Quitting Weed  

Cannabis withdrawal rarely requires medical intervention; however, inpatient detox may be helpful for individuals who are unable to abstain from using marijuana due to withdrawal symptom distress.

Do I Need Detox?

Factors influencing the need for inpatient detox include:4,6

  • Co-occurring mental health disorders (depression, schizophrenia, etc.)
  • Comorbid physical health problems.
  • Severe cannabis use disorder (addiction).
  • Interpersonal problems and lack of social community and support.

If an individual has a comorbid substance use disorder and an addiction to other drugs like alcohol, opioids and benzodiazepines, medical detox may be warranted as the withdrawal syndromes may be more severe and pose a health threat.11

An individual requiring inpatient detox may also need more intensive addiction treatment, such as spending time in a residential rehabilitation program, and intensive outpatient program or some other form of treatment. They may be able to step down to less intensive forms of care (e.g., residential to outpatient) as progress in their recovery made.

Because some individuals experience distressing psychological symptoms of marijuana withdrawal that lasts for several weeks,5 ongoing support after detox, such as group or individual therapy or mutual-help groups can help to reduce the risk of relapse in an effort to alleviate those symptoms.

At Recovery First, our staff work with you every step of the way, beginning in day 1 of detox, to ensure you receive the care you need to experience sustained sobriety from any and all substances you’ve been abusing. Call us at 954-526-5776 today to learn more about our treatment offerings, including our medical detox program.

References

  1. Bahji A, Stephenson C, Tyo R, Hawken ER, Seitz DP. (2020). Prevalence of Cannabis Withdrawal Symptoms Among People With Regular or Dependent Use of Cannabinoids: A Systematic Review and Meta-analysisJAMA Net, 3(4), e202370.
  2. National Institute on Drug Abuse. (2020). Is Marijuana Addictive?
  3. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  4. Bonnet, U., & Preuss, U. W. (2017). The cannabis withdrawal syndrome: current insightsSubstance abuse and rehabilitation, 8, 9–37.
  5. Davis, J. P., Smith, D. C., Morphew, J. W., Lei, X., & Zhang, S. (2016). Cannabis Withdrawal, Posttreatment Abstinence, and Days to First Cannabis Use Among Emerging Adults in Substance Use Treatment: A Prospective StudyJournal of drug issues46(1), 64–83.
  6. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
  7. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal.
  8. Livne, O., Shmulewitz, D., Lev-Ran, S., & Hasin, D. S. (2019). DSM-5 cannabis withdrawal syndrome: Demographic and clinical correlates in U.S. adults. Drug and alcohol dependence195, 170–177.
  9. Gorelick, D. (2020). Cannabis withdrawal: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis.
  10. Hasin D. S. (2018). US Epidemiology of Cannabis Use and Associated Problems.   Neuropsychopharmacology43(1), 195–212.
  11. Center for Substance Abuse Treatment. Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.

 



About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


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