Cannabis withdrawal symptoms

Smith, N. T. (2002). A review of the published literature into cannabis withdrawal symptoms in human users. Addiction, 97, 621-632. 

Research on CBl knockout mice demonstrated the pivotal role of CBl receptors in cannabis dependence knockout mice have been shown not to self-administer cannabinoids (Ledent et al. 1999) and also to fail to exhibit symptoms ofSRl417l6A-precipitated withdrawal (Ledent et al. 1999 Lichtman et al. 2001). Although the research summarized earlier is consistent in reporting the occurrence of a variety of withdrawal symptoms following cessation of exposure to cannabinoids (which were injected), precipitated withdrawal in mice following chronic exposure to marijuana smoke was more recently reported (Lichtman and Martin 2002). 

In summary, research on the use of antidepressants to treat cannabis dependence, particularly among individuals with comorbid major depressive disorder, although limited, offers a promising avenue for the development of pharmacological aids to assist in the treatment of cannabis withdrawal. There are clear parallels between this literature and the existing research on the use of antidepressants in the treatment of alcohol dependence comorbid with major depressive disorder (see Chapter 1, Medications to Treat Co-occurring Psychiatric Symptoms or Disorders in Alcoholic Patients). 

Cannabis Withdrawal is not usually Symptoms are generally mild and... 

Given the low incidence of severe withdrawal symptoms and the modest effects on the mesolimbic dopamine (reward) system, most investigators have found that cannabis has a low abuse or addiction potential. However, it has been argued that if cannabis is a non-addictive substance, why is its use so widespread and why are there so many longterm and heavy users Finally, contrary to the evidence that cannabis can produce chronic tolerance, some regular users report that they require less drug to achieve the same high, or sensitisation (Chapter 3). Three possible explanations may account for this. First, chronic users may focus on the effects that they wish to achieve. Second, the... 

Human newborns of mothers who smoke cannabis during pregnancy experience mild withdrawal symptoms and some autonomic disruption upon childbirth (Fried 1995a, 1995b). Although behavioral consequences are not apparent until 3 years of age, decrements in languange comprehension, sustained attention, memory, and behavior are related to in utero cannabis exposure. 

Tolerance develops to many of A -THC s effects in heavy marijuana users. Although chronic cannabis use does not result in severe withdrawal symptoms, numerous case reports attest to development of dependence in subjects taking high doses of THC for several weeks. The most prominent symptoms were irritability and restlessness others included insomnia, anorexia, increased sweating, and mild nausea. Cessation of mild or moderate use of marijuana, however, does not produce a withdrawal syndrome. 

In this book there have not been systematic examinations of the conceptual status and details of dependent states on the various drugs, but it is certainly worth noting that a condition comprising true dependence on cannabis is now recognized. In many ways the three cardinal features of dependence on a substance are tolerance, craving and withdrawal symptoms, and these have clearly been shown particularly in users presenting for treatment. 

Carpenter, Siri. The Changing Face of Marijuana Research. Monitor on Psychology, June 2001, pp. 40-42. Some people consider marijuana to be highly addictive and a gateway to harder drugs, while others believe it to be a social drug no more harmful than alcohol. Between these two positions lies the reality that marijuana affects individuals differently, as shown by variation in withdrawal symptoms. The identification of cannabis receptors in the brain has led to the realization that some marijuana users may be motivated to continue use in order to avoid withdrawal symptoms. However, about 40 percent of users seem not to experience drug dependence or withdrawal symptoms. Treatment plans need to take these different responses into account. 

This term is used to describe the phenomenon in which abnormal behavioural and autonomic symptoms occur when the drug is abruptly withdrawn or its effects are terminated by the administration of a specific antagonist. Most drugs of abuse (e.g. the opioids, sedatives, alcohol) produce some physical dependence, although withdrawal symptoms are relatively mild following the abrupt withdrawal of cannabis, the stimulants, and cocaine. 

Vandrey, R. G., Budney, A. J., Hughes, J. R., and Liguori, A. (2008). A within-subject comparison of withdrawal symptoms during abstinence from cannabis, tobacco, and both substances. Drug Alcohol Depend. 92, 48-54. 

Currently, oral THC appears to be the best candidate agent to treat marijuana dependence. Of significance, THC was also shown to ameliorate withdrawal symptoms in both monkeys and mice (Beardsley et al. 1986 Lichtman et al. 2001a). However, none of the other agents listed in Table 1 has been evaluated in preclinical models of cannabinoid withdrawal. Thus, it will be important to establish whether the various animal models of cannabinoid dependence are relevant to marijuana-dependent humans. Clearly, the availability of a viable animal model could facilitate the development of effective pharmacotherapies to treat cannabis dependence. 

Fraser JD (1949) Withdrawal symptoms in cannabis-indica addicts. Lancet 257 747-748 Freedland CS, Whitlow CT, Miller MD, Porrino LJ (2002) Dose-dependent effects of delta9-... 

There are anecdotal reports that cannabis is useful in countering both the withdrawal symptoms (Labigalini et al. 1999) and paranoia and weightless (Dreher 2002) associated with smoking crack cocaine. 

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