The cannabis withdrawal syndrome

Budney, Alan J.; Hughes, John R.

doi:10.1097/01.yco.0000218592.00689.e5

Cited by 313 publications

(247 citation statements)

References 47 publications

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“…These findings complement the growing body of literature supporting the existence of the cannabis dependence syndrome and cannabis withdrawal, as well as the validity of the DSM IV dependence criteria as they apply to cannabis dependence (Budney, 2006;Budney and Hughes, 2006). The findings of fair reliability for cannabis withdrawal criteria, despite the heterogeneity of the sample, complement recent findings showing that cannabis withdrawal is both clinically significant and readily identified even in non-treatment seeking populations (Copersino et al, 2006).…”

Section: Discussionsupporting

confidence: 79%

Reliability of DSM-IV diagnostic criteria using the semi-structured assessment for drug dependence and alcoholism (SSADDA)

Pierucci‐Lagha

Gelernter

Chan

et al. 2007

Drug and Alcohol Dependence

129

139

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The Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA) yields reliable DSM-IV diagnoses for a variety of psychiatric disorders, including alcohol and drug dependence. This study examines the reliability of individual DSM-IV criteria for lifetime substance dependence diagnoses and the impact of those criteria on diagnostic reliability.Methods-Two hundred ninety-three subjects (52.2% women; 38.2% African American, 46.8% European American, 7.5% Hispanic) were interviewed twice over a two-week period to examine the inter-rater reliability (n = 173) or test-retest reliability (n = 120) of the SSADDA. Cohen's κ statistic and its confidence interval were used to assess the reliability of individual diagnostic criteria.Results-Overall, the inter-rater reliability estimates were excellent for individual DSM-IV criteria for nicotine and opioid dependence; good for alcohol and cocaine dependence, and fair for dependence on cannabis, sedatives and stimulants. The impact of any individual criterion on diagnostic reliability was minimal, consistent with the notion that the DSM-IV diagnosis of substance dependence measures an underlying construct that is relatively consistent across specific groups of substances.Conclusions-These results, combined with results from a study of the SSADDA's diagnostic reliability (Pierucci-Lagha et al., 2005), show that the instrument can be used reliably to assess substance dependence.

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Section: Discussionsupporting

confidence: 79%

Reliability of DSM-IV diagnostic criteria using the semi-structured assessment for drug dependence and alcoholism (SSADDA)

Pierucci‐Lagha

Gelernter

Chan

et al. 2007

Drug and Alcohol Dependence

129

139

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“…Monkeys that previously self-administered intravenous Δ9-THC demonstrate abstinent symptoms of aggressiveness, hyperirritability, and anorexia [220], as well as impaired operant behavior [221]. Results from human studies demonstrated symptoms of anxiety, aggression, dysphoria, irritability, anorexia, sleep disturbances, and sweating during abstinence from chronic Δ9-THC usage, rescued by Δ9-THC re-administration [222]. Withdrawal from cannabis use can trigger rebound seizures in several preclinical animal and human studies [203,209,210,[223][224][225][226], although other studies show no proconvulsant effect of cannabis withdrawal [178,227].…”

Section: Tolerance and Withdrawalmentioning

confidence: 99%

Cannabinoids and Epilepsy

et al. 2015

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Cannabis has been used for centuries to treat seizures. Recent anecdotal reports, accumulating animal model data, and mechanistic insights have raised interest in cannabisbased antiepileptic therapies. In this study, we review current understanding of the endocannabinoid system, characterize the pro-and anticonvulsive effects of cannabinoids [e.g., Δ9-tetrahydrocannabinol and cannabidiol (CBD)], and highlight scientific evidence from pre-clinical and clinical trials of cannabinoids in epilepsy. These studies suggest that CBD avoids the psychoactive effects of the endocannabinoid system to provide a well-tolerated, promising therapeutic for the treatment of seizures, while whole-plant cannabis can both contribute to and reduce seizures. Finally, we discuss results from a new multicenter, open-label study using CBD in a population with treatment-resistant epilepsy. In all, we seek to evaluate our current understanding of cannabinoids in epilepsy and guide future basic science and clinical studies.

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“…However, its reliability and validity have since been demonstrated in preclinical, clinical, and epidemiologic studies (Agrawal et al, 2008;Budney & Hughes, 2006;Budney et al, 2004;Copersino et al, 2006;Goldstein & Volkow, 2011;Hasin et al, 2008;Martinez et al, 2007). The clinical significance of cannabis withdrawal is indicated by the use of cannabis or similar substances to relieve withdrawal symptoms, its association with difficulty quitting (Budney et al, 2004;Copersino et al, 2006;Levin et al, 2010), and worse treatment outcomes with greater withdrawal severity Cornelius et al, 2008).…”

Section: Cannabis Withdrawalmentioning

confidence: 99%

Nosologic Comparisons of DSM-IV and DSM-5 Alcohol and Drug Use Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions–III

Goldstein

Chou

Smith

et al. 2015

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: The purpose of this study was to examine prevalences and concordances between Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and Fifth Edition (DSM-5) substance use disorders (SUDs) in a newly completed U.S. epidemiologic survey. Method: The National Epidemiologic Survey on Alcohol and Related Conditions-III surveyed 36,309 civilian, noninstitutionalized adults. SUDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Concordances between DSM-IV and DSM-5 disorders were assessed using kappa statistics. Results: Prevalences of past-year substance-specific DSM-5 disorders (2+ criteria) were modestly higher than those of DSM-IV dependence and abuse combined for alcohol, sedatives/ tranquilizers, opioids, and heroin, but lower for cannabis, cocaine, and stimulants. Lifetime prevalences were lower under DSM-5. Prevalences were similar between moderate to severe (4+ criteria) DSM-5 disorders and dependence, whereas prevalences of DSM-5 disorders at 3+ criteria (DSM-5 [3+]) were higher, particularly for cannabis. Past-year concordances were excellent for DSM-IV dependence and abuse combined versus any DSM-5 and DSM-IV dependence versus DSM-5 moderate to severe disorders; lifetime concordances were fair to excellent. Past-year concordances between DSM-IV and DSM-5 (3+) were generally similar to or modestly higher than those with any DSM-5 disorder; lifetime concordances were mostly lower. Conclusions: Findings are consistent with those informing the development of DSM-5. Future research should examine differences in patterns between past-year and lifetime disorders, particularly for cannabis. Other questions warranting investigation include whether different combinations of the same numbers of criteria carry different clinical or nosologic implications, whether changes in nosology yield changes in treatment demand, and whether changes in characteristics of individuals with DSM-5 SUDs dictate modifications to screening and intervention. (J. Stud. Alcohol Drugs, 76, 378-388, 2015)

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The cannabis withdrawal syndrome

Abstract: A clinically important withdrawal syndrome associated with cannabis dependence has been established. Additional research must determine how cannabis withdrawal affects cessation attempts and the best way to treat its symptoms.

Cited by 313 publications

References 47 publications

Reliability of DSM-IV diagnostic criteria using the semi-structured assessment for drug dependence and alcoholism (SSADDA)

Reliability of DSM-IV diagnostic criteria using the semi-structured assessment for drug dependence and alcoholism (SSADDA)

Cannabinoids and Epilepsy

Nosologic Comparisons of DSM-IV and DSM-5 Alcohol and Drug Use Disorders: Results From the National Epidemiologic Survey on Alcohol and Related Conditions–III

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