Marijuana is an intoxicating substance that has become increasingly popular over the past few decades. This is seen by the push, in many places, to legalize the substance, both for medical and recreational use. Although there are few studies proving this substance’s effectiveness in treating pain or illness, medical marijuana strains focus on a different substance – cannabidiol, or CBD – while recreational marijuana strains focus on increasing the intoxicating, euphoric chemical: tetrahydrocannabinol, or THC.
Is Marijuana Addictive?
Marijuana is the most commonly used illicit substance in the US, according to the 2014 National Survey on Drug Use and Health, with the main users being teenagers and young adults. Thanks in large part to efforts of groups lobbying to end marijuana prohibition, many people believe this substance to be safe and nonaddictive. However, like other intoxicating substances, including legal ones like alcohol and tobacco, marijuana has an incidence rate of dependence and addiction. According to Mayo Clinic, about 9 percent of all marijuana users will become dependent, compared to 16 percent of all alcohol drinkers.
Dependence and tolerance are not the same as addiction, although many researchers use dependence as a method of examining potential addiction. Rather than using the term addiction to describe disordered use of marijuana, researchers often use the term marijuana use disorder. This disorder occurs in a small percentage of marijuana users, and it is more common among those who begin to use marijuana earlier in their lives. People who begin to use the drug before the age of 18, according to the National Institute on Drug Abuse (NIDA), are 4-7 times more likely to develop marijuana use disorder.
Physical dependence on marijuana typically leads the brain to adapt to large amounts of endocannabinoid neurotransmitters. These brain chemicals help neurons transmit signals to each other, and scientists have found that they play a role in insulin sensitivity, energy and fat metabolism, and inflammation. When the brain is flooded with these neurotransmitters with the help of THC, it gets used to not having to produce them at normal levels. When a person who is dependent on marijuana stops using the drug, the brain will not immediately begin to produce endocannabinoids on its own, and this can lead to withdrawal symptoms.
Marijuana Withdrawal Symptoms
When a person uses marijuana regularly or in large amounts for a long period of time, it is likely that they will develop physical dependence on the substance. Withdrawal symptoms include:
- Weight loss due to appetite changes
- Mood swings
A study from the Journal of Addiction Medicine surveyed 127 teenagers, 90 of whom heavily used marijuana. Researchers found that 84 percent qualified as dependent on the substance, and 40 percent of them experienced withdrawal symptoms when they ceased using it.
Length of Marijuana Detox
Marijuana metabolites remain in the body for between 4 and 21 days after the final dose. THC is processed quickly, but there are dozens of chemicals that process much more slowly and may still affect brain chemistry. Typically, people who go through marijuana withdrawal do not completely clear marijuana’s metabolites from their bodies for 90 days. Withdrawal symptoms do not, for the most part, last that long. A general timeline for marijuana withdrawal follows:
- The first three days: Withdrawal symptoms can begin within a day or two after the last time the person ingested marijuana. These symptoms include anxiety, depression, appetite changes, mood swings, sweating, nausea or abdominal pain, headaches, shakiness, fever, and chills.
- The first week: Withdrawal symptoms are the most intense during the first week. After 7-10 days, however, physical symptoms will begin to diminish, and mood will stabilize. Cravings, depression, and some mood swings will likely continue, however.
- The second week: The last physical symptoms, like aches, insomnia, or appetite problems, will dissipate. Mood will continue to stabilize, although cravings may still continue for another week.
- The third week: Marijuana metabolites will mostly be gone from the body, so most of the withdrawal symptoms should be gone.
- The first month: It is unlikely that symptoms should continue past the first month, as marijuana’s metabolites will be flushed from the body. However, for long-time, heavy users, brain chemistry may still not be completely back to normal, so symptoms could take longer to clear.
A 2011 study conducted by the National Cannabis Prevention and Information Centre at the University of New South Wales in Australia found that marijuana withdrawal symptoms were on par with nicotine withdrawal symptoms. Everyone can react differently to the physical and psychological symptoms. Although the experience is not physically dangerous, the discomfort could lead to relapse. A different survey of 500 marijuana users who tried to quit found that one-third resumed marijuana use to avoid the discomfort of withdrawal symptoms.
Complications of Marijuana Withdrawal
Cannabis withdrawal syndrome is the term for the host of withdrawal symptoms marijuana users experience if they have become dependent on or addicted to the substance and then quit cold turkey. Although uncomfortable, this syndrome is not physically dangerous.
The true complications come as a result of ongoing marijuana use. Some complications of continued use include:
Medical detox is, in general, the process of working with a medical professional to safely detox from a substance of abuse. For some substances, like opioid or alcohol addictions, doctors will prescribe medications to ease symptoms or to replace the chemicals in the brain to lessen withdrawal symptoms.
Medical professionals are investigating the potential of substances like anticonvulsant medications, such as gabapentin and divalproex, as well as the anti-smoking medication bupropion, being used for marijuana withdrawal. Other research suggests that oral synthetic THC, dronabinol, is effective for some patients for tapering off the drug. The National Cannabis Prevention and Information Centre in Australia suggests that tapering cannabis use may also be effective, especially as using marijuana becomes legal in many places. However, there are no drugs currently approved for use in detoxing from marijuana, even on an off-label basis.
Instead, what seems to work for the majority of individuals ending their addiction to marijuana are various types of therapy. Medications like antidepressants and anti-anxiety prescriptions can ease psychological symptoms associated with withdrawal, while the individual works with a therapist. The National Institute on Drug Abuse (NIDA) recommends the following forms of therapy:
- Cognitive Behavioral Therapy: This type of therapy teaches the person to identify problematic behaviors and develop strategies to correct these behaviors and increase self-control.
- Contingency Management: Instead of identifying problem behaviors, this therapy targets good behaviors and puts a system of rewards in place for following through on positive behavioral changes.
- Motivational Enhancement Therapy: Rather than attempting to change the person, this type of therapy focuses on the individual’s internal resources to produce behavioral changes.
Getting help from a medical professional improves long-term outcomes for sobriety. People who attempt to quit marijuana alone are more likely to relapse, while those with social support and access to therapy are more likely to successfully go through marijuana detox and remain sober.