What are the symptoms of withdrawing from smoking marijuana?

Symptoms of Quitting Smoking Marijuana

Cannabis withdrawal syndrome occurs within 3 days after cessation of marijuana use and typically lasts up to 14 days, characterized by irritability, anxiety, sleep disturbances, decreased appetite, restlessness, and physical discomfort. 1, 2

Common Withdrawal Symptoms

• Psychological symptoms:

  • Irritability or anger 2, 3
  • Anxiety 2, 4
  • Restlessness 2, 5
  • Depressed mood 3, 4
  • Sleep disturbances and unusual dreams 2, 5
  • Cravings for marijuana 3, 5

• Physical symptoms:

  • Decreased appetite 2, 5
  • Abdominal pain or stomach discomfort 2, 3
  • Tremors 2, 4
  • Sweating 2, 5
  • Fever or chills 2, 3
  • Headaches 3, 4
  • Physical tension 3

Timeline of Withdrawal Symptoms

• Onset: Symptoms typically begin 24-48 hours after cessation 3, 5
• Peak intensity: Days 2-6 after quitting 3, 5
• Duration: Most symptoms resolve within 1-2 weeks, though some may persist up to 3 weeks in heavy users 2, 3
• Pattern: Symptoms often decrease sharply during the first few days followed by a slower decline over the second and third weeks 6, 5

Factors Affecting Withdrawal Severity

• Usage amount: Severity correlates directly with the amount of cannabis used before cessation 2, 3
• Risk thresholds for withdrawal:
  • More than 1.5 g/day of inhaled cannabis 1, 2
  • More than 300 mg/day of CBD-dominant oil 1, 2
  • More than 20 mg/day of THC-dominant cannabis oil 1, 2
  • Using cannabis products with unknown CBD/THC content more than 2-3 times daily 1, 2
• Low risk: Withdrawal symptoms are unlikely in those consuming 300 mg/day or less of smoked CBD-dominant cannabis (approximately one cigarette) 1, 2
• Gender differences: Women often report stronger withdrawal symptoms than men, including more pronounced physical symptoms like nausea and stomach pain 4

Clinical Significance

• Cannabis withdrawal is recognized in the DSM-5 as a diagnosable condition requiring at least three characteristic symptoms following cessation 2, 4
• Approximately 10% of adults with chronic cannabis use develop cannabis use disorder, characterized by clinically significant impairment or distress 1, 7
• Withdrawal symptoms may contribute to relapse to cannabis use, though some studies suggest withdrawal severity doesn't necessarily predict relapse 8
• Withdrawal from cannabis used for analgesic or anxiolytic purposes may contribute to increased pain perception 1
• Cannabis users with concurrent opioid dependence are less likely to experience withdrawal symptoms 1

Special Considerations

• Early onset of cannabis use, especially weekly or daily use, strongly predicts future dependence 1, 7
• Withdrawal may exacerbate existing psychiatric disorders in vulnerable individuals 1, 2
• Heavy smokers tend to report more withdrawal symptoms than light smokers, with irritability showing the most significant difference 6
• Complicated withdrawal may occur in people with concurrent mental health issues and polysubstance use 3