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Withdrawal is best understood in context of physical dependence and addiction. As the National Institute on Drug Abuse explains, when individuals regularly consume an addiction-forming drug over time, they will become physically dependent on that drug. Physical dependence is a natural process and part of the body’s way of habituating to the environment.
There is no test for physical dependence per se; when people are physically dependent on a drug, they will experience its two hallmarks. First, individuals will build a tolerance to the drug that they regularly use. When tolerance sets in, individuals need more of the familiar drug in order to achieve the desired high. Second, when individuals stop consuming the drug they regularly used, or radically reduce the familiar intake amount, they will likely experience withdrawal symptoms.
Withdrawal is the body’s natural way of maintaining the status quo. As the body is now conditioned to drug use, when consumption is stopped, the body will send out messages for the drug in the form of cravings. Depending on a host of factors, including the particular drug of abuse, the body will experience different withdrawal symptoms. The most common mild withdrawal symptoms individuals experience across all drug types are nausea, sleep troubles, anxiety, sweating, vomiting, and changes in eating patterns.
Individuals who are physically dependent on a drug are not necessarily addicted to it. In order to receive a diagnosis of addiction (in clinical terms, a severe-grade substance use disorder), an individual must have a psychological attachment to the drug of abuse. This distinction can help people to understand the difference, for example, between a person suffering from addiction and a person who is on a pain management program and physically dependent on a prescription pain reliever (such as oxycodone) but not abusing the pills (i.e., not manifesting the hallmark symptoms of psychological addiction).
The question of whether individuals will experience withdrawal symptoms if they stop using marijuana doesn’t inherently ask the question of whether they are physically dependent or addicted to this drug. After a review of the above discussion, it is clear that a person who is physically dependent on marijuana will experience withdrawal as will a person who is addicted to this drug. However, to provide a short answer: Those who are either physically dependent on, or addicted to, marijuana will likely experience withdrawal symptoms if they discontinue use of this drug or significantly reduce the familiar volume of consumption.
The reason a person will experience withdrawal is that marijuana is an addiction-forming drug.
As the National Institute on Drug Abuse (NIDA) notes, an estimated 9 percent of individuals who use marijuana will become physically dependent on it. The rate increases under certain circumstances. Among individuals who use marijuana daily (i.e., heavy, chronic users) 25-50 percent will become physically dependent. Among marijuana users who started using this drug in their teens, it is estimated that 17 percent will become physically dependent on this drug.
Note: There is often a lack of clarity in research as to whether a person is physically dependent or addicted. For this reason, the foregoing statistics likely include individuals who are either physically dependent or addicted.
As a general principle, the more potent an addictive drug, the higher the odds a recreational user will become addicted over time. In terms of marijuana use, now more than ever, regular users of this drug face an increased risk of addiction because marijuana has become more potent (strong strains are sometimes referred to as super pot.) Based on the analysis of law enforcement seizures of marijuana, in the early 1990s, the THC content (the psychoactive ingredient in marijuana) was approximately 3.7 percent. In 2013, THC content rose to 9.6 percent.
Aside from the potency of newer strains of marijuana, certain types of marijuana are more potent than others. For example, marijuana extracts, such as hash oil, may have THC levels over 50 percent. Lab findings show that some samples have THC content above 80 percent. Based on the rising THC levels of marijuana, it is important to think about this drug diachronically (i.e., as it changes over time). The marijuana of yesteryear was associated with a lower addiction profile compared to some marijuana today. In this way, the more accurate response to a question about whether a person will experience withdrawal is: Yes, but it’s a stronger “yes” with increased potency of the strain of marijuana (i.e., THC richness).
Marijuana withdrawal is not a myth. Marijuana, possibly more so than any drug, has a benign association. The fact that some states have legalized even recreational use of marijuana (i.e., residents don’t need a medical reason to use this drug) has led to confusion, especially among adolescents and young adults. Like alcohol, marijuana is addictive; the legality of this drug in some states does not alter its addiction potential. Since people can become physically dependent on or addicted to marijuana, they will likely experience withdrawal after regular use. But what is the withdrawal experience like?
Although everyone experiences withdrawal differently, people will typically experience more severe symptoms if they engaged in chronic heavy use of marijuana. Individuals who regularly used marijuana or a marijuana extract with a high THC content may experience the more severe end of the spectrum of withdrawal symptoms. Typically, marijuana remains in a person’s body for 4-21 days after last use. However, cannabis metabolites may be detected in a hair sample for up to 90 days after last use. The presence of trace amounts of cannabis in a person’s system is not sufficient to stop withdrawal; again, withdrawal happens when the body does not receive its familiar amount of marijuana consumption. After 90 days, most people do not experience withdrawal symptoms. It is important to note, however, that even after individuals are fully detoxed from marijuana, they may still relapse.
Marijuana is considered to typically have a mild to moderate withdrawal profile compared to other drugs of abuse. According to NIDA, the following are the most common withdrawal symptoms associated with marijuana that affect a person’s mood:
The following are some of the most common physical symptoms associated with marijuana withdrawal:
When people re experiencing withdrawal from marijuana, they may experience any of the previously discussed side effects as well as cravings for marijuana. The discomfort associated with side effects, and the cravings that can arise, place people at risk for a relapse. The withdrawal process can be engaged on one’s own or medically managed. Ultimately, it is a private decision but medical advisement is that it is always safer to detox in a medically supervised environment.
Detox is a critical part of the recovery process, but this step alone is not sufficient to overcome addiction. Individuals who go through a supervised medical detox process as part of a stay in a structured rehab will have several assurances that an at-home detox cannot provide. First, withdrawal from any drug of abuse can bring unanticipated health problems. During medical detox, trained professionals monitor the person in withdrawal to ensure safety throughout the process.
Secondly, many individuals who use marijuana also use other drugs of abuse. Withdrawal from polydrug use can be more complicated and potentially more dangerous than withdrawal from marijuana alone. Further, it can be difficult for one to gauge the potential severity of withdrawal when separate drugs of abuse are present in the body and interact with one another. It is critical for a person who is withdrawing from different drugs not to simply follow advisements for withdrawal from one of the drugs alone.
Thirdly, it is well established in the addiction treatment community that detox alone is not sufficient as a standalone treatment. After detox in a rehab program, the recovering person progresses to the abstinence maintenance phase of treatment that involves individual therapy, group therapy, and supportive treatments, such as group recovery work and family therapy. Lastly, medical detox provides safeguards against relapse. Individuals who have a supportive staff of professionals around them may be less likely to relapse than if they are going through withdrawal in a nonclinical setting, such as at home.
To revisit an earlier point about marijuana, a pervasive attitude of acceptance around this drug can prevent a person from thinking about marijuana abuse as a health condition that can benefit from rehab and medical attention. From a medical standpoint, marijuana abuse is certainly a health condition.
A person who is using marijuana can talk with a trusted medical professional or contact an accredited rehab center to receive sound advisement on the most effective and safe ways to stop using this drug.
Although information abounds online about marijuana, the most advisable practice is to approach recovery from this drug as one would any other drug of abuse. Substance abuse recovery in a structured rehab program is currently the recommended course of treatment for abuse of marijuana and other drugs.