Study register · detailProspektive Beobachtungsstudie · Addiction · 2003
The time course and significance of cannabis withdrawal.
Budney et al.·Journal of Abnormal Psychology
Clear benefitGRADEVery low445 citations
Samplen = 18 Pat.
Duration50 days
ControlParallel observation of 12 ex-users
EndpointWithdrawal symptoms
Blindingn.a.
DesignProspektive Beobachtungsstudie
Cannabinoidvollspektrum
Routeinhalativ
”Key finding
Cannabis withdrawal produces a clinically relevant, temporally defined withdrawal syndrome with onset day 1–3 and duration 4–14 days.
Summary
50-day outpatient study (n=18 active users + n=12 ex-users): Cannabis withdrawal syndrome with onset typically day 1-3, peak day 2-6, duration 4-14 days; symptoms: aggression, anxiety, appetite loss, weight loss, irritability, sleep problems, stomach pain. Time course and extent comparable to tobacco and other withdrawal syndromes.
P
PopulationHeavy cannabis users (active) and ex-users as comparison group; n=30 (18 active users, 12 ex-users)
I
InterventionControlled abstinence over 45 days after 5-day smoking phase (naturalistic)
C
ControlParallel observation of 12 ex-users
O
OutcomeWithdrawal symptoms (aggression, anxiety, loss of appetite, irritability, sleep disturbances among others) with onset day 1–3, peak day 2–6, duration 4–14 days
Confidence in the evidence
Very lowLowModerateHigh
Very low
The lowest GRADE level, the effect estimate remains uncertain.
Withdrawal symptoms following cessation of heavy cannabis (Cannabis) use have been reported, yet their time course and clinical importance have not been established. A 50-day outpatient study assessed 18 Cannabis users during a 5-day smoking-as-usual phase followed by a 45-day abstinence phase. Parallel assessment of 12 ex-users was obtained. A withdrawal pattern was observed for aggression, anger, anxiety, decreased appetite, decreased body weight, irritability, restlessness, shakiness, sleep problems, and stomach pain. Onset typically occurred between Days 1-3, peak effects between Days 2-6, and most effects lasted 4-14 days. The magnitude and time course of these effects appeared comparable to tobacco and other withdrawal syndromes. These effects likely contribute to the development of dependence and difficulty stopping use. Criteria for cannabis withdrawal are proposed.