Marijuana use is often considered harmless, and with the recent legalization, more Americans are turning to this drug to relax and unwind after a long day or stressful event. Some patients may rely on marijuana to treat chronic pain, arthritis, fibromyalgia, cramps, depression, anxiety and more, as it’s often advertised as a natural, miracle remedy that comes with no strings attached.
But it’s not without it’s side effects, and care should be taken to make sure it’s used responsibly.
The Cause of Marijuana Withdrawal Symptoms
Unfortunately, like with all drugs, it’s possible to develop a dependence on marijuana, as the cannabinoids, like delta-9-tetrahydrocannabinol, will alter brain chemistry levels. This cannabinoid will play a role in adjusting dopamine levels in the brain. Dopamine is the reward system and an increase in dopamine will encourage you to seek out the same experience again and again. The dopamine pathway will also lead to many downstream effects that release even more neurotransmitters into your brain.
Your body adjusts to the artificial influx or blockage of the brain chemicals by either reducing or increasing what it can naturally produce. Over time, it will become dependent on this artificial influx. Once you no longer receive any artificial influx from using marijuana, your body will go haywire and that’s when the marijuana withdrawal symptoms will begin to emerge. It’s basically your body’s way of coping, and its way of telling you that it’s missing something.
Fortunately, marijuana withdrawal symptoms aren’t usually lethal or too damaging to the body. With time, your body will readjust the amount of brain chemicals it can naturally produce back to its original baseline levels, and the withdrawal symptoms will go away.
What Are Cannabinoid Receptors and the Endocannabinoid System?
If you do a little more research on marijuana withdrawals, you’ll likely run into the terms ‘cannabinoid receptors’ and ‘endocannabinoid system’ rather regularly. The endocannabinoid system is involved in many different physiological and cognitive processes, like pregnancy, immune system activity, appetite, mood regulation, memory and fertility, and cannabinoid receptors are basically keys that activate the system. Marijuana is one of the many substances that can turn on this key.
Marijuana Withdrawal Symptoms
Although marijuana is often touted as one of the safest drugs out there, regular abuse can lead to marijuana withdrawals to emerge when the abuser is no longer consuming this drug. Recent studies show that as many as 50% of regular smokers who use cannabis to ease pain experience some form of withdrawal. Marijuana withdrawal symptoms are as much psychological, as they are biological. Some of the most common withdrawal symptoms that users report experiencing include:
- Anxiety
- Appetite loss
- Chills
- Cravings
- Difficulties sleeping
- Excessive sweating
- Extreme mood swings
- Fatigue
- Headaches
- Insomnia
- Irritability
- Loss of appetite
- Nausea
- Stomach pains
- Restlessness
- Tremors and overall shakiness
The more often you use marijuana, the more likely you are to experience withdrawal symptoms when you quit. The severity of the withdrawal symptoms will also depend on one’s natural biology, the tolerance that they’ve developed, the length of time that they’ve smoked or used cannabis-related products and their weight and age.
It can be difficult to guess the type and severity of the withdrawal symptoms that each smoker may experience. Some smokers are able to quit using marijuana without suffering much, while others may have an incredibly difficult time.
Marijuana Withdrawal Timeline
The length of time that withdrawals last will depend on many factors. The physical symptoms will rely mostly on how long it takes for the receptors and brain levels in your brain to return to normal activity.
Many studies have looked at how some receptors in the brain are downregulated with chronic cannabis dependence. In particular, the amount of cannabinoid receptor type 1, also known as CB1, will be significantly reduced for about 4 weeks with chronic marijuana use. Those who are able to abstain from smoking or using cannabis-related products for 4 weeks will start to recover.
In most cases, the withdrawal symptoms will peak after 1 to 2 weeks. This is when the withdrawal symptoms are at their worst and when most patients will want to quit. After this time period has passed, the withdrawal symptoms will slowly subside and gradually become more and more bearable.
This means that it can take up to an entire month before most marijuana users start to get over the withdrawal symptoms. The length of the withdrawals will also depend on the amount of marijuana consumed, the length of the consumption, the method of consumption and other factors. It can vary quite significantly from one individual to another. The same can be said for the intensity of the withdrawal symptoms. The more severe the dependence, the more intense the symptoms will be.
The psychological symptoms, however, can last quite a bit longer. Some marijuana users report experiencing cravings and other psychological symptoms, like depression, for months if not years after using marijuana. This is because the psychological symptoms can also emerge with mental health illnesses and disorders.
THC Deposit in Fat Tissues
Most drugs will usually peak after several days, so marijuana withdrawal symptoms do take a bit longer to peak and can last quite a bit longer. The main reason for this is because THC is deposited in fatty tissues in the body and released slowly into the bloodstream. Depending on when the THC is released, the marijuana user may either experience cravings out of nowhere or a longer withdrawal timeline.
If the user is placed under conditions of enhanced fat metabolism, like with stress and food deprivation, the THC will be released much more quickly. Before an individual can fully recover from dependence on marijuana, their bodies must first process and remove all traces of THC naturally, and this can vary significantly depending on the user’s metabolism.
Treatment for Marijuana Abuse
Because marijuana is often seen as such a harmless drug, not many recreational or medical users ever think to seek help. Many people don’t realize that they’re dependent on the substance until it’s too late. The average patient who is seeking help for a cannabis use disorder will usually have used marijuana daily for at least 10 years and will have tried to quit unsuccessfully more than 6 times.
By then, these individuals will experience some pretty severe and harsh withdrawal symptoms. To prevent recreational and medical marijuana users from reaching this point, it’s important that more awareness is brought to the possible chemical dependence that can come from regular marijuana use. It’s not as safe as many people believe it to be.
The road to recovery is often paved with uncertainties and other obstacles. A study that looked at the insights from recovered users has found that success in recovery can usually be attributed to several key things: having a clear reason for change, being committed to a goal of changing and conquering any self-denial that may be associated with the marijuana use.
The easiest way to not only become committed to accepting one’s dependence, but also finding a reason to want to change, is to seek therapy and counseling. A rehab center that utilizes evidence-based approaches can help with that.
Levels of Care
Depending on the intensity of the withdrawal symptoms and the amount of help that the marijuana users need to achieve sobriety, an addiction expert will recommend varying levels of care after the initial assessment. The varying levels of care include:
- Residential rehab. With these rehab programs, patients will usually live at an addiction treatment facility for about 28 days, if not longer. This is the highest level of care available, and patients will receive around-the-clock medical supervision and help.
- Partial Hospitalization Program (PHP). This is a step down from residential rehab. Instead of living at the facility, patients are only expected to visit the facility when it’s time for their treatment. These types of programs are fairly intensive and require a commitment of about 6 hours a day for 5 days a week.
- Intensive Outpatient Program (IOP). An IOP requires less commitment than a PHP, and patients are expected to only visit the addiction treatment facility whenever they’re scheduled to receive treatment. With an IOP, this will equate to at least 3 hours a day for 3 days a week. An IOP allows patients to stay at home or continue school or work.
- Outpatient treatment program. This is the least intense level of care available. Patients can pick and choose when they would like to receive a wide range of evidence-based treatment modalities. In general, most patients only opt for this option if they have already completed one of the more intense types of treatment or if they are only struggling with a very mild dependence on a substance.
Patients can move from one level of care to another depending on their experience and any changing needs. It’s not unusual for some patients to fluctuate between attending an IOP and a standard outpatient program when they feel more stressed and more likely to relapse.
Many patients will slowly graduate from a more intense level of care, like residential rehab, to a less intense level of care, like an IOP or a standard outpatient treatment program. At the more intense levels of care, patients learn how to change their habits, thoughts and behaviors and how to stay committed to their goal. Once they are confident in their resolve and are feeling healthier physically and mentally, they can graduate to a less intense program, which gives them more freedom and time to themselves.
Recommended Therapies for Marijuana Withdrawal
Regardless of the level of care that’s chosen, a successful recovery will involve treating the mind as well as the body. A healthy mind is the key to long-term recovery, and in order to achieve that, patients are expected to participate in one of the following if not more:
- Individual therapy. Patients participate in one-on-one sessions with a therapist in order to explore the reasons why they might have started abusing marijuana in the first place. For many people, this could be because they were looking for a means to escape from a stressful life or for a way to treat chronic pain. It’s vital to learn how to handle these psychological barriers to prevent relapse.
- Group therapy or a 12-step program. Some studies show that group therapy can be even more successful than individual therapy. Oftentimes, substance users feel alone and disconnected from the world. In group therapy, they receive the support that they need.
- Art therapy, which is more creative than practical, but can help some patients get in touch with their underlying spirituality. This type of therapy is also great at relieving stress and may be a self-soothing technique that patients may want to carry on after treatment.
- Dialectical Behavior Therapy (DBT), which teaches patients how to cope with stress and negative behaviors and feelings through mindfulness and emotional regulation.
- Cognitive Behavioral Therapy (CBT), which mainly focuses on teaching patients how to modify negative behaviors and thoughts, as well as identify triggers.
- Contingency Management, which is a therapeutic management approach that uses positive rewards to encourage certain goals, like sobriety.
- Motivational Enhancement Therapy, which mainly focuses on drawing out the internal motivations and desires of each patient. This gives many patients the drive they need to avoid harmful behaviors.
What works for one person may not necessarily work for everyone, so it’s vital that each patient gets an opportunity to try out different treatment modalities in order to get firsthand experience on what may be a more suitable choice. Combining several different types of treatment modalities together can increase the overall effectiveness of the treatment.
Potential Medications for Marijuana Withdrawal
There aren’t any medications approved by the FDA for specifically treating a cannabis use disorder; however, many recovery centers, especially ones with detox programs, may prescribe medications that can help ease some of the withdrawal symptoms. Some of the more popular medications that are often used include:
- Buspirone, which is one of the only medications that is approved to treat cannabis dependence. In controlled clinical trials, this medication significantly reduced the frequency and duration of cravings, as well as mood swings like depression and anxiety.
- Entacapone, which is a dopamine agent that may help reduce cravings.
- Fluoxetine, which can reduce cannabis use amongst patients in long-term clinically controlled trials. This drug is also often prescribed to patients struggling with co-occurring mental health illnesses and disorders, like depression.
- N-Acetylcysteine (NAC), which has shown success with reduced self-reported use amongst young cannabis users.
There isn’t really a set medication schedule for addiction experts and specialists to follow, so healthcare professionals will prescribe medications at their own discretion. It’ll also be based on the intensity and severity of the withdrawal symptoms. Unfortunately, more research is needed in this area.
The good news is that marijuana withdrawal symptoms are not deadly, nor do they usually lead to any severe health complications as long as the patient is otherwise healthy. Due to this reason, medical supervision is merely there to ensure that patients are more comfortable while on the road to recovery.
Marijuana Withdrawal Resources
At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.
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