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For a long time, cannabis was not regarded as a chemically addictive chemical. More recent studies have shown that cannabis withdrawal syndrome is indeed a real condition and, more importantly, the demand for treatment for cannabis dependence has increased substantially.
This paper reviews the evidence surrounding cannabis withdrawal and explores the best known ways to cease cannabis use and to treat cannabis withdrawal symptoms. The recent findings of neurobiologists have developed a substantial model for the action of cannabis in the brain and present potential methods of treating symptoms.
Here is the full scientific article if you wish to download it.
Long considered a “soft” drug, cannabis was not believed to be addictive in the way that heroin, tobacco, or cocaine are. This was because withdrawal symptoms from those drugs are severe and impossible to ignore. This paper reviewed the evidence and concludes that cannabis withdrawal symptoms do indeed exist but are subtler than for other drugs, possibly the reason that they were ignored for so long.
It is with the development of a neurobiological model that understanding of cannabis withdrawal syndrome has evolved. The molecular models for drug dependency have been established, and when examined, withdrawal from cannabis appears to be consistent with these other drugs, albeit less severely. Regular use of cannabis makes observable changes to the brain and the limbic system, which has adjusted itself to the higher concentrations of cannabinoids that occur during use of the drug.
When the extra cannabinoids are not replenished, the system falls into disarray, producing mild emotional and behavioral changes, like irritability, nervousness, depression, difficulty sleeping, and anger. Appetite change, loss of weight, and physical discomfort can also occur.
In the studies that the authors brought together and compared, these symptoms were consistently found with few variants. The severity was never more than mild, and they usually went away after a few days. Withdrawal symptoms are not rare.
Although it is unclear why, cannabis withdrawal symptoms are not as severe as for most other recreationally used drugs. It is possible that this is due to the body’s familiarity with cannabinoids compared to the unfamiliarity of heroin or cocaine. However, it is unknown at this time.
The main addictive constituent of cannabis appears to be the psychoactive THC, the part of cannabis that delivers the “high”. However, the neurobiological interactions of other cannabinoids is not as well known, so it is thought that there is more to understand here.
This review could only find four clinical studies in which drugs were assayed for use in treating cannabis withdrawal syndrome. The studies were small and inconclusive. Some drugs, like nefazodone, had some effect on some withdrawal symptoms but not the majority of them. It was found that doses of reduce withdrawal symptoms significantly but it was not clear whether they reduced the length of the withdrawal period.
Before cannabis withdrawal syndrome can be adequately treated, there needs to be established a stronger evidence base for the symptoms themselves. Then what affects relapse and abstinence, and how patients with severe psychiatric disorders, who are common users of cannabis, will be affected by withdrawal.
Furthermore, the safety of patients undergoing cannabis withdrawal will have to be established. Whether there are any drugs available that will help relieve symptoms; whether “cold turkey”, or quitting in one step, or a graded reduction in cannabis use will be most effective; and what affects the likelihood of starting to use cannabis again.
This paper is relatively inconclusive. It confirms that cannabis withdrawal syndrome is indeed a real condition but offers little in the way of guidance or assistance to those who would seek to cease cannabis use safely. The authors highlight the lack of solid research and make the case for further trials to be carried out with some urgency.