Systematic review uncovers cannabis withdrawal syndrome among 47% of regular cannabis users

By August 13, 2020 Recent News

PsyPost 11 August 2020
Our additional comment: More harms – which will increase with legalisation…
“The findings suggest that almost half of regular marijuana users will experience cannabis withdrawal, something the authors say many people are unaware of. Cannabis withdrawal appears to be highly prevalent among people who consume cannabis regularly, or who are heavy consumers. Clinicians should be aware of its existence so that they can provide support to people who are considering cessation of or reduction in cannabis use. The literature suggests that cannabis withdrawal may be a driver of continued use…”

A literature review of 47 studies found that nearly half of cannabis users met criteria for cannabis withdrawal syndrome. The review was published in The Journal of the American Medical Association.

Although cannabis is typically seen as a relatively safe drug, research has pointed to various risks associated with regular use. Short-term risks include memory impairment and paranoia and long-term risks range from addiction and cognitive impairment to suicide. More recently, researchers have identified the presence of cannabis withdrawal syndrome (CWS) in a subset of regular users.

Despite the emerging evidence of CWS, little is known about the prevalence or risk factors associated with its occurrence. “Cannabis withdrawal is a fascinating topic. We were not certain on the prevalence or risk factors for cannabis withdrawal, which was the basis of the study,” said study author Anees Bahji, an addiction psychiatry fellow at the University of Calgary.

The researchers consulted 8 electronic databases and ended up with 47 studies that met criteria to be included in their review. All studies included a validated assessment of CWS or CWS symptoms. In total, the studies involved 23,518 participants, 69% of whom were men. The studies involved 50 different cohorts; half of them were users seeking treatment and most (76%) were from North America.

The meta-analysis revealed an overall prevalence of cannabis withdrawal syndrome of 47%. The researchers further analyzed the results by study setting, to see if the likelihood of CWS differed depending on the sample used in the study. The highest prevalence of CWS (87%) was found in inpatient samples. Outpatient samples had a prevalence of 54% and population-based samples had a 17% prevalence of CWS.

“The finding that the prevalence of CWS was substantially higher in clinical populations—particularly inpatient samples—is consistent with the notion of a bidirectional association between cannabis use and mental health disorders . . . This finding may indicate that people with CWS are more likely to present to clinicians for help compared with those without CWS, notwithstanding the fact that CWS can be diagnosed and untreated,” Bahji and colleagues say.