Self-reported sleep disturbances during cannabis withdrawal in cannabis-dependent outpatients with and without opioid dependence

Abstract

A cannabis withdrawal syndrome (at least two symptoms) occurs in more than 50% of dependent smokers after cessation (1). The typical withdrawal pattern is composed of 6 symptoms: anger or aggression, decreased appetite or weight loss, irritability, nervousness/ anxiety, restlessness, and sleep difficulties (1). The rate of sleep disturbances during cannabis cessation was found to be 32% in non-treatment seeking dependent smokers (2). The two most frequent sleep symptoms are reduced sleep duration and strange or vivid dreams. These have been related to longer sleep onset latency, reduced slow wave sleep, and REM rebound (3).Cannabis use is more frequent among opioid-dependent patients than in the general population. Opioid dependence might be expected to influence cannabis withdrawal, given the known interactions of the endogenous opioid and cannabinoid systems in the central nervous system (CNS). Cannabinoid CB1 and mu-opioid receptors are often co-localized in the same postsynaptic neurons in the nucleus accumbens and in the dorsal striatum.We compared the frequency of self-reported cannabis withdrawal symptoms using questionnaires in 43 cannabis-dependent outpatients with current opioid dependence and 56 cannabis-dependent outpatients without history of opioid dependence (Table 1 in The two groups are comparable in terms of sex ratio (male 70%, chi 2 p=.51), age of first cannabis use (16 ±4 years, ANOVA p =.09), and number of cannabis joints smoked at the time

Sleep abnormalities associated with alcohol, cannabis, cocaine, and opiate use: a comprehensive review

“…As noted above, the desirable effects of cannabis on sleep are reported less frequently in chronic cannabis users compared to naïve users [ 91 ], Chronic users also report difficulty sleeping and strange dreams among other symptoms associated with abstinence [ 11 , 28 , 43 , 58 , 175 , 194 ]. These subjective findings have been correlated to longer sleep onset latency, reduced slow-wave sleep, and REM rebound observed in PSG studies [ 27 , 198 ].…”

Prevalence of Cannabis Withdrawal Symptoms Among People With Regular or Dependent Use of Cannabinoids

“…We screened a total of 3848 unique citations, of which 86 were screened in full, and 47 were included in the review (Figure 1), reporting on 50 unique cohorts. In total, 23 518 participants were 32,47,52 the Customary Drinking and Drug Use Record, 50 the Composite International Diagnostic Interview-Substance Abuse Module, 17,20,25,30,36,39 the Cannabis Withdrawal Scale, 37,51,54,56 the Marijuana Quit Questionnaire, 28,41,43,45,46,58 the Marijuana Withdrawal Symptom Checklist, 6,7,27,33,34,42,49,53,55,60 the Semi-Structured Assessment for the Genetics of Alcoholism, 18,40,48 the Structured Clinical…”

Time-course of the DSM-5 cannabis withdrawal symptoms in poly-substance abusers

“…Finally, the cannabis withdrawal syndrome has not yet been studied in poly-substance using patients with the exception of one small cross-sectional study by Vorspan and colleagues that indicated that sleep disturbances, but not other cannabis withdrawal symptoms, were exacerbated in patients with co-morbid opioid dependence [ 26 ]. Arguably, there are good reasons for the omission of poly-substance using patient samples when establishing the validity and time course of the cannabis withdrawal syndrome.…”