An evaluation of the history of a marijuana withdrawal syndrome in a large population

Abstract

Case reports and laboratory research indicate the existence of a cannabis withdrawal syndrome. However, the data tell us little about the prevalence and clinical characteristics of a marijuana withdrawal syndrome in people who have used the drug but who did not enter treatment for cannabis dependence. Face-to-face semi-structured interviews applying standard diagnostic criteria were used in the present study to gather data from 5611 men and women, recruited between 1991 and 1995 through the Collaborative Study of the Genetics of Alcoholism (COGA). Almost 41% of the sample had no history of marijuana use (Group 1), 28% had consumed this drug less than 21 times in any single year (Group 2), and 31% used it at least that frequently (Groups 3 and 4). Almost 16% of the more frequent marijuana users related a history of a marijuana withdrawal syndrome, and these Group 4 subjects had used the drug almost daily for an average of almost 70 months. The typical withdrawal symptoms included "nervous, tense, restlessness", "sleep disturbance" and "appetite change". While Group 4 subjects were more likely to have developed dependence on most types of drugs, even when alcohol and drug use patterns were statistically taken into account, marijuana use was still significantly related to a self-report of a history of marijuana withdrawal.

Abstinence symptoms following smoked marijuana in humans

“…These symptoms are similar to the pattern of abstinence effects following oral THC administration (Jones et al 1976(Jones et al , 1981Haney et al 1999), and are similar to the effects seen in laboratory participants smoking marijuana repeatedly for at least 3 weeks (Nowlan and Cohen 1977;Georgotas and Zeidenberg 1979;Mendelson et al 1984). The present findings are also consistent with interview data obtained in daily marijuana smokers, who report feeling ''nervous, tense, and restless'' when abstinent from marijuana (Wiesbeck et al 1996). Although there were no significant self-reports of sleep disturbance during marijuana abstinence, we have recently completed a study with portable sleep monitors (Respironics, Atlanta, Go., USA), showing that abstinence following exposure to four to five marijuana cigarettes/ day (1.8-3.1% THC) for even a shorter period of time (3 days) was associated with a substantially increased latency to fall asleep and latency to rapid eye movement (Ward et al, in preparation).…”

The CB receptor agonist WIN 55,212-2 fails to elicit disruption of prepulse inhibition of the startle in Sprague-Dawley rats

“…No effect on PPI was observed in our experiment, confirming clinical data in which this syndrome does not include cognitive alterations (Wiesbeck et al 1996). Nonetheless, we cannot exclude that treatment with rimonabant (SR 141716A), the CB 1 receptor selective antagonist, may elicit alterations of ASR and PPI, in accordance with other findings that showed this compound reliably precipitates withdrawal syndromes in animals repeatedly treated with cannabinoids (Cook et al 1998;Lichtman and Martin 2002).…”

“…In light of these controversial premises, the goal of the present study was to elucidate the effects of acute, subchronic, and chronic treatment of WIN on PPI. In addition, since withdrawal can be observed on cannabis discontinuation in humans (Mendelson et al 1976;Wiesbeck et al 1996), as in animals (Lichtman and Martin 2002;Maldonado and Rodriguez de Fonseca 2002), we devised an investigation of the effects of WIN abstinence on the same paradigm, in order to assess eventual effects of this condition on startle reflex as well as on sensorimotor gating and attentional filtering.…”

Abstinence symptoms following oral THC administration to humans

“…These symptoms mimic those reported in an earlier controlled laboratory study administering 210 mg / day of THC for 10-20 days (Jones et al 1976(Jones et al , 1981, but occurred with smaller doses and a shorter duration of THC administration. This pattern of symptoms also corresponds with interview data obtained in daily marijuana smokers, who report feeling "nervous, tense, and restless" when abstinent from marijuana (Wiesbeck et al 1996), suggesting that the present results may have relevance to marijuana users, despite the pharmacokinetic differences between oral THC and smoked marijuana.…”