Marijuana Withdrawal Among Emerging Adults Receiving Outpatient Substance Use Disorder Treatments

Objectives: As more liberal marijuana policies are enacted, it is important to address the safety and side effects of this drug. Much debate centers on whether a withdrawal syndrome specific to marijuana use exists, leading some to question whether physiological dependence truly exists for marijuana (Benyamnia et. al, 2008). Furthermore, many self-reported withdrawal symptoms overlap with symptoms of co-occurring psychiatric and physical health problems, rendering the possibility that these symptoms may mediate the relationship between marijuana use and withdrawal symptoms.  Therefore, the two purposes of this study are to investigate the prevalence of withdrawal symptoms among young adult marijuana users, as well as to examine whether co-occurring health and mental health symptoms may mediate the association between substance use and withdrawal.  

Method.Young adults (ages 18-25; N=343) were eligible for this study if they used marijuana in the past year, met cannabis abuse or dependence criteria, and reported a past week quit attempt.  We examined the prevalence of each of the 22 withdrawal symptoms included on the Current Withdrawal Scale (CWS; a =0.85). We used stepwise regression to predict CWS scores with the following variables in ascending order, including: gender, past 90 day marijuana use, marijuana dependence diagnosis an interaction variable between marijuana dependence and days of use, emotional problem scale, general mental health distress scale, and health problems scale.

Results. On average, young adult marijuana users reported 2.93 (SD = 3.6) past week withdrawal symptoms, with those with marijuana dependence reporting a higher (M = 3.4, SD =3.6) average.  The most commonly endorsed withdrawal symptoms were feeling tired (31.6%),having trouble sleeping (29.6%), and forget things or have problems remembering (24.3%).  The most infrequently endorsed symptoms were having convulsions (0.6 %), having a fever (0.9%), and having diarrhea (2.1%). Past 90 day marijuana use (df=3, 336, β=0.18, 95% CI = .008-.029  p=0.001), and past year mental health symptoms (df=3, 336, β=0.352, 95% CI= .282-.482, p=0.000) were both significant predictors (R²=.289) of CWS scores. Past year mental health symptoms partially mediated the association between past 90 day use and withdrawal symptoms. 

Conclusion: It appears that marijuana withdrawal symptoms are common among past year marijuana users, but most (87.7%) report that these symptoms do not interfere with daily living activities. As mental health symptoms accounted for more variance in withdrawal symptoms than recent substance use, it is unclear whether a marijuana-specific withdrawal syndrome existed for this sample.  Alternatively, these findings may signal problems with how we measure withdrawal among marijuana users. Additional research is needed that addresses this study’s limitations.