Teens in Treatment Report Marijuana Withdrawal Symptoms

Heavy Users Report More Intense Withdrawal Symptoms

Teen Boy Smoking Joint
Teens Who Quit Report Having Withdrawal Symptoms. © Getty Images

Teens that use marijuana frequently may face the same withdrawal symptoms that have been found to challenge adult marijuana users trying to quit. If they smoke frequently enough those withdrawal symptoms can be similar to the symptoms people experience when they quit smoking cigarettes.

Nearly 50 percent of U.S. teenagers try marijuana before they graduate high school, and by 12th grade, about 21 percent are regular users.

Consequently, treatment for marijuana dependence is on the rise, but, researchers have discovered, there's a catch – withdrawal symptoms, much like those experienced by people quitting cigarettes, cocaine or other drugs, may make abstinence more difficult to achieve.

Most Experience 4 or More Symptoms

Ryan Vandrey and Alan Budney of the University of Vermont studied 72 adolescent marijuana users seeking outpatient treatment for substance abuse.

Participants in the study were heavy marijuana users ages 14 to 19, who were primarily male Caucasians, and who completed study questionnaires. Nearly two-thirds of the participants reported experiencing four or more symptoms of marijuana withdrawal, including anxiety, aggression, and irritability. More than one-third of participants reported four or more symptoms that occurred at a moderate or greater severity level.

Anxiety, Aggression, Irritability

"In the adolescents who provided information, we observed a lot of variability regarding the presence and severity of withdrawal symptoms, which is consistent with what we have seen in several studies of adults who use marijuana frequently," said Vandrey.

"Overall, our research indicates that the majority of people who abruptly stop daily or near-daily marijuana use experience some withdrawal symptoms"

"Though there is anecdotal evidence that withdrawal makes it more difficult to quit using marijuana and that people use marijuana to suppress withdrawal effects, we still need to more carefully investigate how withdrawal impacts the quitting process," Vandrey said.

Withdrawal Compares to Tobacco Withdrawl

In later research, Vandrey and colleagues in a Johns Hopkins University School of Medicine studied the intensity of marijuana withdrawal.

For heavy marijuana smokers -- those who smoke 25 days or more per month -- withdrawal symptoms when they try to quit smoking can be similar to those experienced by people who quit smoking cigarettes, the researchers found. Marijuana smokers who quit report irritability, anger and trouble sleeping, just as tobacco smokers report when they quit.

Related to Heavy Marijana Use

"These results indicate that some marijuana users experience withdrawal effects when they try to quit and that these effects should be considered by clinicians treating people with problems related to heavy marijuana use," Vandrey said.

"Since tobacco withdrawal symptoms are well documented and included in the DSM-IV and the IDC-10, we can infer from the results of this comparison that marijuana withdrawal is also clinically significant and should be included in these reference materials and considered as a target for improving treatment outcomes," said Vandrey.

Clinically Significant Withdrawal Symptoms

For the Johns Hopkins study, Vandrey selected six men and six women who were heavy marijuana and cigarette smokers. During the first week of the study, they maintained their normal use of cigarettes and marijuana.

During the next five weeks, they were randomly chosen to refrain from using either cigarettes, marijuana or both for five-day periods separated by nine-day periods of normal use. In order to confirm abstinence, they were given daily urine toxicology tests for tobacco and marijuana metabolites.

Using a withdrawal symptom checklist, each day participants self-reported aggression, anger, appetite change, depressed mood, irritability, anxiety/nervousness, restlessness, sleep difficulty, strange dreams and other, less common withdrawal symptoms.

Similar Frequency and Intensity

The study reported the following results:

  • Withdrawal severity associated with marijuana alone and tobacco alone was of similar frequency and intensity.
  • Sleep disturbance seemed to be more pronounced during marijuana abstinence.
  • General mood effects (anxiety, anger) seemed to be greater during tobacco abstinence.
  • Six participants reported that quitting both marijuana and tobacco at the same time was more difficult than quitting either drug alone, whereas the remaining six found that it was easier to quit marijuana or cigarettes individually than it was to abstain from the two substances simultaneously.

"Given the general consensus among clinicians that it is harder to quit more than one substance at the same time, these results suggest the need for more research on treatment planning for people who concurrently use more than one drug on a regular basis," Vandrey said.

Sources:

Vandrey, RG, et al. "A within-subject comparison of withdrawal symptoms during abstinence from cannabis, tobacco, and both substances." Drug and Alcohol Dependence January 2008

Vandrey, RG, et al. "Cannabis withdrawal in adolescent treatment seekers." Drug and Alcohol Dependence May 2005

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