If Cannabis Becomes a Problem, How to Manage Withdrawal

Cannabis, commonly known as marijuana, is a drug derived from the cannabis plant. Its use has gained popularity over the years, with some countries legalizing its use for recreational purposes. However, cannabis abuse has become a major public health concern due to its potential risk of addiction and other long-term health effects. In this article, we will delve into the topic of cannabis withdrawal and how to manage withdrawal symptoms. We will discuss the symptoms of cannabis withdrawal, treatment options, management of withdrawal symptoms, recovery, and future research directions.

Symptoms of Cannabis Withdrawal

Withdrawal symptoms can occur when one stops using cannabis after using it for an extended period or in large quantities. Cannabis withdrawal is not life-threatening, but it can be uncomfortable and challenging to manage without proper support. Understanding the symptoms of cannabis withdrawal is essential in developing effective treatment and management plans.

General Overview of Withdrawal

Cannabis withdrawal often occurs in heavy users who abruptly stop using the drug. Symptoms can begin as early as one day after the last use and can persist for several weeks. Withdrawal symptoms are thought to be caused by the body's adjustment to the absence of THC (tetrahydrocannabinol), the active ingredient in cannabis that causes intoxication and other effects.

Common Symptoms of Withdrawal

The symptoms of cannabis withdrawal can vary depending on the individual, the frequency and amount of cannabis use, and the duration of use. Some of the common symptoms of cannabis withdrawal include:

  • Insomnia or difficulty sleeping
  • Irritability
  • Depression or anxiety
  • Decreased appetite and weight loss
  • Cravings for cannabis
  • Restlessness
  • Sweating
  • Tremors

Most withdrawal symptoms typically peak within the first week and gradually lessen as time goes by, with over 50% of symptoms gone by 10 days after cessation.

Differentiation from Other Substance Withdrawal

Cannabis withdrawal symptoms are similar to those of other substances such as tobacco, alcohol, and opioids. However, the symptoms are generally less severe when compared to those of other substances. Cannabis withdrawal symptoms can also be mistaken for other mental health disorders such as depression and anxiety when they occur during abstinence.

It is important to seek medical advice when experiencing withdrawal symptoms to rule out other underlying conditions and receive appropriate support and treatment.

Treatment of Cannabis Withdrawal

Seriousness of Withdrawal

Although cannabis withdrawal is not considered life-threatening, it can be uncomfortable and disruptive to one's daily life. Withdrawal can also lead to relapse when symptoms become too difficult to manage. It is essential to take withdrawal seriously and seek appropriate support and treatment when needed.

Medical Treatment

Medical treatment for cannabis withdrawal is typically reserved for individuals with severe withdrawal symptoms or those with an underlying medical condition. Treatment options may include medication-assisted therapy (MAT), where medications are used to ease withdrawal symptoms and decrease the risk of relapse. Common medications used for cannabis withdrawal include:

  • Bupropion: an antidepressant used to reduce withdrawal symptoms and cigarette cravings
  • Mirtazapine: an antidepressant used to reduce anxiety and insomnia
  • Nabilone: a synthetic cannabinoid used to manage nausea and vomiting

It is important to note that medication-assisted treatment should only be used under the guidance of a medical professional.

Natural or Alternative Treatments

Many individuals prefer to use natural or alternative treatments for cannabis withdrawal, particularly those who have reservations about using prescription medications. Some commonly used natural and alternative treatments for cannabis withdrawal include:

  • Exercise: physical activity can help to reduce anxiety and depression, increase appetite, and improve sleep
  • Meditation and mindfulness: these practices can help to reduce stress, anxiety, and depression
  • Acupuncture: this alternative treatment can help to reduce nausea, headaches, and other physical symptoms of withdrawal
  • Nutritional supplements: certain supplements, such as omega-3 fatty acids, may help to reduce anxiety, depression, and other withdrawal symptoms

While natural or alternative treatments can be helpful for some individuals, it is important to note that they may not be as effective as prescription medications. It is also essential to speak with a healthcare professional before using any natural or alternative treatments to ensure their safety and efficacy.

Management of Withdrawal Symptoms

Importance of Withdrawal Management

Effective withdrawal management is essential for individuals who are attempting to quit cannabis use. Sudden cessation of cannabis use can lead to a range of withdrawal symptoms, including anxiety, irritability, depression, insomnia, nausea, and decreased appetite. These symptoms can become quite severe, leading to relapse or other negative outcomes. Therefore, it is essential to manage withdrawal symptoms effectively to minimize discomfort and improve the chances of successful recovery.

Strategies to Manage Withdrawal Symptoms

There are several strategies that individuals can use to manage their withdrawal symptoms effectively. These include:

  • Gradual reduction of cannabis use: reducing cannabis use gradually can help to minimize the severity of withdrawal symptoms.
  • Distract the mind with other activities: activities such as exercise, reading, or watching a movie can help to distract the mind from withdrawal symptoms
  • Drink water: make sure to stay hydrated by drinking plenty of water, as dehydration can worsen anxiety and other withdrawal symptoms.
  • Eat a healthy diet: consuming a healthy diet rich in fruits, vegetables, and lean proteins can help to decrease withdrawal symptoms and improve overall health.
  • Rest: make sure to get adequate rest, as sleeplessness can worsen symptoms such as irritability and depression.

Tips for Coping with Pain and Discomfort

Individuals who experience more severe withdrawal symptoms may require additional support strategies to manage pain and discomfort. These may include:

  • Over-the-counter pain relievers: medications such as ibuprofen or acetaminophen can help to decrease pain and discomfort.
  • Aromatherapy: certain essential oils, such as lavender, can help to reduce anxiety and promote relaxation.
  • Stress management techniques: regular practice of stress management techniques such as yoga or meditation can decrease anxiety and improve overall well-being.
  • Professional counseling: for individuals experiencing severe psychological or emotional symptoms, professional counseling can provide valuable support and guidance.

Recovery from Cannabis Withdrawal

Cannabis use disorder is a chronic condition, and recovery from it requires a long-term commitment to changing behaviors and developing coping mechanisms. Individuals who have successfully completed the cannabis withdrawal phase need to plan for recovery carefully. Recovery may take several weeks or months and requires ongoing support and treatment to avoid relapse.

Importance of Recovery

The recovery stage of cannabis use disorder is just as essential as the withdrawal stage. If an individual does not focus on maintaining abstinence, they may slide back into regular cannabis use, which would reverse the gains made during the withdrawal stage. Individuals in recovery often face a high risk of relapse, particularly in the early recovery period, so it is important to develop coping strategies and obtain support from loved ones, support groups or inpatient or outpatient treatment programs.

Aftercare and Contingency Plan

Aftercare and contingency plans are crucial elements of recovery. They enhance the chances of staying sober and anticipating and avoiding possible relapse triggers. Aftercare programs may include support groups, outpatient treatment, and individual counseling. These programs help individuals to develop new behaviors that help them stay sober and cope with changes in mood or situations that can lead to relapse. Additionally, they learn how to anticipate possible triggers that may lead to relapse and how to respond to such triggers in a healthy way.

Contingency plans are developed by identifying possible triggers that may lead to relapse and anticipating potential solutions. They may include creating a new routine, developing new social activities, finding a new hobby, or setting up appointments with a therapist or counselor to provide support in the event of relapse.

Lifestyle Changes to Remain Sober

Successfully navigating a cannabis withdrawal requires a commitment to changing behaviors and making lifestyle changes that support sobriety. Establishing new routines that do not involve cannabis use, avoiding cannabis-related environments and triggers, and engaging in activities that promote physical and mental health are some of the ways to maintain sobriety. The following are additional lifestyle changes individuals can adopt:

  • Engaging in regular exercise: Exercise helps to relieve stress, promote overall wellbeing and can be an excellent replacement for cannabis use.
  • Maintaining a healthy diet: A healthy diet can help to improve mental and physical wellbeing and support recovery from cannabis use disorder.
  • Getting enough sleep: Sufficient sleep is critical to mental and physical health. Aim for 7-9 hours of sleep each night.
  • Engaging in stress-relieving activities: Activities such as yoga, meditation, or deep breathing can help reduce stress and promote relaxation.
  • Developing new social support: Finding new friends or reconnecting with non-drug-using family members, joining a support group, and engaging in life-enhancing activities can provide social support and help individuals maintain their sobriety.

Conclusion

Successfully navigating cannabis withdrawal is no easy feat, but with the right support and strategies, it is definitely possible. To recap, individuals going through withdrawal should be aware of the common symptoms of withdrawal and understand that it is a challenging but achievable process that requires a lot of hard work and dedication. Different treatments are available, including medication-assisted treatment and natural remedies. The most important thing is to choose a treatment plan that works best for your unique needs and circumstances.

Recovery from cannabis use disorder is a long-term process that requires focus on maintaining abstinence, establishing a support system, having contingency plans, and developing healthy habits that support sobriety. Engaging in regular exercise, maintaining a healthy diet, getting enough sleep, engaging in stress-relieving activities, and developing new social supports are some of the strategies that can help in this regard.

Future Research Directions

The treatment and management of cannabis withdrawal are still evolving, and future research is necessary to improve the available treatments and interventions further. For instance, more research is needed to determine the most effective behavioral therapies or pharmacological interventions to improve the chances of successful recovery from cannabis use disorder. Additionally, studies comparing the efficacy of different treatments and interventions for cannabis withdrawal are necessary.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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