How to Wean Off THC
Gradual reduction of THC consumption over at least 7 days is the recommended approach for weaning off tetrahydrocannabinol (THC), with the goal of reducing to below 1.5 g/day of smoked cannabis or 20 mg/day of THC oil. 1
Assessment of Current THC Use
Before beginning the weaning process, assess:
- Daily consumption amount (grams/day for smoked cannabis or mg/day for THC oil)
- Method of consumption (smoking, vaping, edibles, oils)
- Duration of regular use
- Frequency of use per day
- Presence of cannabis use disorder (if using more than once daily)
Weaning Protocol
Step 1: Set Target Reduction Goals
- For smoked cannabis >1.5 g/day: Aim to reduce to 1.5 g/day initially
- For THC oil >20 mg/day: Aim to reduce to 20 mg/day initially
- For unknown THC content products used >2-3 times daily: Reduce frequency first
Step 2: Implement Gradual Reduction Schedule
- Timing: Begin weaning at least 7 days before any planned surgery 1
- Rate: Reduce by approximately 10-25% of original dose every 2-3 days
- Guidance: Let patient tolerance guide the rate of reduction
Step 3: Monitor for Withdrawal Symptoms
Common withdrawal symptoms include:
- Anxiety
- Irritability
- Sleep disturbances
- Decreased appetite
- Restlessness
Step 4: Consider Adjunctive Therapies
If withdrawal symptoms are significant:
- Consider CBD-dominant products (CBD:THC ratio >10:1) to help manage withdrawal symptoms
- Do not wean CBD while maintaining THC consumption, as this may exacerbate adverse effects of THC 1
Special Considerations
Perioperative Context
- Do not attempt to wean or stop cannabis within 24 hours before surgery 1
- Abrupt cessation close to surgery may increase risk of cannabis withdrawal syndrome
- Involve the cannabis-authorizing healthcare provider in weaning discussions if THC was medically prescribed
Pharmacokinetic Considerations
- THC has a long half-life with effects lasting 2-3 hours when inhaled and 4-12 hours when ingested 2
- This extended duration must be considered when planning the weaning schedule
Monitoring Success
- Track reduction in frequency and amount of use
- Monitor improvement in withdrawal symptoms
- For high-dose users (>3 times the recommended weaning thresholds), consider referral to addiction medicine or psychiatry services 1
Pitfalls to Avoid
- Avoid abrupt cessation: This increases risk of withdrawal symptoms
- Avoid weaning CBD while maintaining THC: This can worsen THC adverse effects 1
- Avoid weaning too quickly: Rapid reduction may lead to withdrawal symptoms and reduced compliance
- Avoid delaying necessary medical procedures: Surgery should not be delayed for cannabis weaning 1
Following this structured approach will help minimize withdrawal symptoms while successfully reducing THC consumption to safer levels or achieving complete cessation.