Cannabis Withdrawal Syndrome: What to Expect


Sober Recovery Expert Author


For many years, there has been confusion surrounding Cannabis Withdrawal Syndrome (CWS). Is it real? Could marijuana users actually suffer disabling and complicated withdrawals after quitting? Pot isn't that strong of a drug, right?

Part of this debate stems from the varied beliefs in recovery and medical circles that marijuana (pot, reefer, Mary Jane) is not physically addictive the way alcohol, heroin or other hard drugs and some prescription medications are.

Recovery is a process and quitting any drug can be hard.

Now, cannabis is gaining renewed attention as a popular drug that many users struggle to withdraw from. CWS was recently included by The American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders in its latest edition, DSM-5.

New data was shared by researchers at the American Psychiatric Association’s annual meeting.

“Our findings suggest that cannabis withdrawal syndrome is highly comorbid and disabling,” researchers reported. “Its shared symptoms with depressive and anxiety disorders call for clinician awareness of cannabis withdrawal syndrome and the factors associated with it to promote more effective treatment among frequent cannabis users.”

Cannabis Withdrawal Symptoms

According to researchers, CWS is tied to significant disability, mood and anxiety disorders, in addition to personality disorders and family history of depression. Yet, there is no link to "a personal history of other substance use disorders or a family history of substance use problems."

The symptoms present within one week after a user stops smoking and include:

  • Feelings of anger, irritability, and/or aggressiveness
  • Extreme nervousness, anxiety, restlessness
  • Sleep disturbances including insomnia, vivid/disturbing dreams and nightmares
  • Loss of appetite
  • Weight loss
  • General malaise
  • The onset of feelings of depression

Duration Of Withdrawal

The symptoms peaks within 10 days after a user has quit marijuana. Following the height of the symptoms, a gradual decline in severity often occurs over a period of 10-20 days. The severity of symptoms is related to the amount and frequency of marijuana use in the individual.

The presence of at least one physical symptom that causes serious discomfort, such as abdominal pain, fever, chills, sweating, headache, and/or tremors or shakiness helps further define the criteria.

Criteria For Identifying CWS

The user withdrawing must suffer from three or more of the above symptoms and one must be a physical symptom.

Some former users may have ongoing symptoms of lethargy, mild depression, mood swings, trouble motivating themselves, and intermittent cravings for marijuana for weeks, months or possibly even years after they quit.

Treatment Options

Despite marijuana now being fully legal (age 21 and over) for recreational use in 11 states, 1 in 10 users become addicted. With more states legalizing, it may give people (especially teens) the idea that pot is safer to try than other drugs or alcohol.

Treatment options are much the same as for alcohol and other substances and may consist of rehab, 12-step meetings, and counseling. Withdrawal from marijuana often happens alongside quitting other substances.

Medications (such as anti-anxiety meds) aimed at treating symptoms may be used as a way to ease or minimize feelings of distress, restlessness or anxiety. The medications may not hasten the withdrawal process but can provide some relief from intense symptoms.

My Experience

It has been several decades since I smoked my last joint, and it was a brutal withdrawal. This new research validates my symptoms that at the time were unexpected for me. I was ill-prepared and confused due to the lack of information available back then.

Everything I had read assured me that marijuana was not physically addictive and I would easily sail through quitting. I believe now that I was one of those who suffered through CWS.

My worst symptoms were vivid dreams, headaches, cravings, and chronic insomnia. Although my anxiety returned with a vengeance, after the first 30 days I could feel the haze in my brain lifting. I was thinking more clearly and able to focus on goals and the future again.

It took several attempts (including relapses) until I finally quit for good. I continued to have intense cravings, and a few years later tried to convince myself I could become a recreational user. That bright idea sent me straight to the emergency room with a severe panic attack. After that, I never smoked again.

I would encourage anyone planning to quit toplan to quit, meaning carve-out time off from work and family responsibilities, let your friends know you are quitting, start keeping a journal and record any new insights you gain during this process. You may find it necessary to seek out professional treatment from a counselor or recovery center.

If you're a heavy smoker like I was, consider cutting down first before you quit altogether. Try to focus on the ultimate outcome which is a healthier you. A positive outlook will help you get through the bad days. But remember to be gentle with yourself as well.

Recovery is a process and quitting any drug can be hard.

If you or someone you know is seeking help from addiction, please visit our directory of treatment centers or call 800-891-8171 to speak to a treatment specialist.

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