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Marijuana Smokers Experience Significant Withdrawal
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Animal
research and controlled studies of marijuana smokers
during inpatient treatment suggest that marijuana
dependence, like dependence on other addictive drugs, is
associated with withdrawal symptoms -- such as
irritability, anger, depressed mood, headaches,
restlessness, lack of appetite, and craving -- that can
make it difficult to stop using the drug. Now, NIDA-supported
research conducted by Dr. Alan Budney and colleagues at
the University of Vermont in Burlington has found that
marijuana smokers |
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who stop using the
drug while in their home environment suffer withdrawal
symptoms that appear as severe as those associated with
tobacco-smoking. These findings represent a
significant step toward general acceptance of withdrawal
as a key aspect of chronic marijuana use," says Dr. Jag Khalsa of NIDA's
Center on AIDS and Other Medical Consequences of Drug
Abuse.
"Treatment providers
may not address the problem of marijuana withdrawal
because the condition is not currently included in the
Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition (DSM-IV), the standard reference
published by the American Psychiatric Association.
Dr. Budney and his colleagues evaluated withdrawal
symptoms in 12 adult marijuana smokers (7 male, 5
female, average age 30 years) over 3-day abstinence
periods that followed 5-day periods when participants
could smoke marijuana at will. "We found consistent
emotional and behavioral symptoms that increased during
abstinence and dramatically decreased when marijuana
smoking resumed, suggesting that these types of symptoms
are the hallmark of acute marijuana withdrawal," Dr.
Budney says. "The symptoms most closely resembled many
of those observed during nicotine withdrawal."
During the study, participants lived at home and made
daily records rating the intensity of withdrawal
symptoms (on a scale from 0, "not at all," to 3,
"severe") over the preceding 24 hours. In addition, each
participant designated an observer -- a friend or family
member who spent at least 2 hours each day with the
participant -- to provide an independent rating of the
participant's withdrawal symptoms. The participants made
daily laboratory visits during which their abstinence
was confirmed by urine tests.
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Marijuana smokers living at home reported
"clinically significant" withdrawal symptoms --
such as sleep difficulty, marijuana craving,
aggression, and irritability -- during periods
of abstinence from the drug. The participants'
self-reports were confirmed, in part, by
observers who reported increased restlessness
and irritability among the marijuana users when
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During the abstinence
periods, participants reported increases in the severity
of craving and sleep difficulty, decreased appetite, and
increased aggression, anger, and irritability. In
addition, participants reported an increase in "strange
dreams" during the second abstinence period. Observers
reported increased irritability and restlessness among
the participants during abstinence.
"Marijuana withdrawal doesn't include dramatic physical
symptoms such as the pain, nausea, heavy sweating, and
cramps associated with opiate withdrawal. Nevertheless,
the symptoms of marijuana withdrawal appear clinically
significant. It seems clear now that withdrawal from
marijuana produces identifiable behavioral and emotional
distress that may be as important as, if not more
important than, physical symptoms in the development of
dependence and undermining attempts to quit using the
drug," Dr. Budney says.
"Confirming withdrawal as part of marijuana dependence
will increase the likelihood that treatment providers
will alert patients to its symptoms and will help them
cope with it through behavioral or pharmacological
treatments," says Dr. Khalsa. |
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By Patrick Zickler, NIDA
NOTES Staff Writer
Source
Budney, A.J.; Hughes, J.R.; Moore, B.A.; Novy, P.L.
Marijuana abstinence effects in marijuana smokers
maintained in
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