Categories
BLOG

quitting cigarettes with weed

How Long Does Withdrawal From Marijuana Last?

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Cannabis (marijuana) is the most commonly used illicit drug. For many years, marijuana has been considered a soft drug, exempt from the usual concerns about addiction. However, recent research has shown that cannabis withdrawal can and does occur when heavy pot smokers discontinue its use.

As a result, the diagnostic criteria for cannabis withdrawal is included in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).  

Overview

If you have been smoking pot heavily for at least a few months—whether as a regular pattern, in binges, or if you have become addicted—you may experience cannabis withdrawal if you abruptly stop using.

A Duke University study of 496 adult marijuana smokers who tried to quit found that 95.5% of them experienced at least one withdrawal symptom while 43.1% experienced more than one symptom. The number of symptoms the participants experienced was significantly linked to how often and how much the subjects smoked prior to trying to quit.

Those who were daily smokers experienced the most symptoms, but even those who reported using marijuana less than once a week experienced some withdrawal symptoms of moderate intensity.

Signs & Symptoms

Marijuana withdrawal symptoms are not life-threatening—their main danger is causing someone who really wants or needs to quit cannabis to relapse.

You might feel extra edgy and irritable, have trouble sleeping and eating, and may even get a stomachache or headache. Some people compare it to the feeling you get when you try to quit caffeine.

Although marijuana withdrawal typically lasts one to two weeks, some marijuana users experience several weeks or months of withdrawal symptoms, known as Post-Acute Withdrawal Syndrome (PAWS).

One person’s experience of cannabis withdrawal might be quite different from another’s, and the severity depends on a whole host of factors, including frequency of use as well as overall health. However, there are certain common withdrawal symptoms that usually occur within 24 to 72 hours of stopping heavy use.

Cravings

Although many regular smokers of marijuana do not believe they are addicted to the drug, many former marijuana users report drug cravings in the early days of abstinence. The experience of cravings will vary from person to person, but tend to include a persistent desire to use the substance.

This is a hallmark of addiction, whether it’s heroin, alcohol, gambling, or sex addiction. In one study, 75.7% of participants trying to quit reported an intense craving for marijuana.

Irritability

Irritability can range from mild and relatively easy to control annoyance to excessive anger and even aggression. This is a normal reaction to withdrawing from marijuana.

If the irritability lasts for more than a week, it is a good idea to seek support from a doctor, drug counselor, or psychologist, as the symptom may be part of another issue that your cannabis use was masking.

More than half of those who try to quit marijuana report mood swings, irritability, or anxiety. Others report aggression, nervousness, restlessness, and a loss of concentration.

Anxiety

Anxiety can be a symptom of both cannabis intoxication and cannabis withdrawal.   The distinctive paranoid feelings that occur when high on marijuana are well known among users,.

It can be worrying when anxiety continues or worsens even after you quit. As with the irritability, it can be helpful to remember that your fears are probably a natural part of drug withdrawal.

If you continue to feel anxious after a week of discontinuing cannabis, see a doctor. Cannabis use can sometimes cause substance-induced anxiety disorders, and there may have been an existing anxiety problem before you started using cannabis.  

If you experience extended paranoia, especially if you also experience hallucinations or delusions, it is very important to be properly assessed by a mental health professional, ideally with expertise in substance issues   such as an American Board of Addiction Medicine (ABAM)-certified physician or a psychiatrist.

Depression

Depression, characterized by a persistently sad mood accompanied by several other symptoms like decreased interest in daily activities and difficulty concentrating, is another possibility of cannabis withdrawal.

Occasional depressed feelings are natural. It is not unusual for people coming off cannabis to also become more aware of some of the negative consequences of their drug use as well as emotional states the marijuana has been masking.

For example, some people who cease marijuana after using for several years can feel they have wasted a considerable part of their life. These feelings are normal and can often be used to bring about positive changes you want to make in your life.

If the feelings of depression don’t lift after a week or two, are impacting your functioning, or if making changes in your life seems overwhelming, seek help from your doctor or a drug counselor. As with other mood changes, depression can be substance-induced or pre-existing to your cannabis use, and it is treatable.

If you or a loved one are struggling with depression and addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Sleep Problems

An estimated 46.9% of former pot smokers report sleep disruption problems, including insomnia (trouble getting to sleep or staying asleep), unusually vivid or disturbing dreams, and night sweats during cannabis withdrawal.

Others who have quit smoking report having “using dreams” in which they dream they smoke marijuana. Frequent, vivid dreams typically begin about a week after quitting and can last for about a month before tapering off. Although some former users have reported having these types of dreams years after they stopped smoking pot.

Insomnia symptoms after you stop using weed can last a few days or a couple of weeks. Some people find that they can experience occasional sleeplessness for a few months after quitting.

Headaches

Not everyone who stops smoking marijuana experiences headaches, but for those who do, the headaches can be very intense, especially during the first few days after quitting.

Headaches, like most other symptoms of withdrawing from marijuana use, will usually begin one to three days after quitting and will peak two to six days after stopping. Symptoms usually fade after two weeks, but some former smokers report continued symptoms for several weeks or even months later.

Other Physical Symptoms

Physical symptoms of marijuana withdrawal tend to be less intense, peak sooner, and fade more quickly than the psychological symptoms associated with quitting. The frequency and amount of marijuana used prior to stopping affect the severity and length of the withdrawals, which may include:

  • Stomach pain
  • Changes in appetite
  • Weight loss or gain
  • Flu-like symptoms, such as headache, sweating, shakiness and tremors, fever and chills

Coping & Relief

Making a few healthy lifestyle changes and employing some coping strategies can help you get through this period of withdrawal:

  • Stay physically active to help ease bodily tension.
  • Let friends and family members know when you need support or space.
  • Avoid situations that you find anxiety-provoking, such as loud, crowded parties.
  • Practice relaxation techniques, such as meditation.
  • Establish sleep rituals and avoid caffeine too close to bedtime.

Warnings

There are no worrisome dangers in quitting marijuana cold-turkey or detoxing on your own. That said, consulting a medical professional can help you better manage the physical and psychological symptoms of withdrawal and prevent relapse.

Just as people with alcohol use disorder who are trying to quit drinking may pick up a drink to relieve the symptoms of alcohol withdrawal, marijuana users may be tempted to light up a joint to relieve the discomfort they experience when they try to stop smoking pot.

One study found that 70.4% of users trying to quit smoking marijuana relapsed to relieve the withdrawal symptoms.

Long-Term Treatment

In many cases, the symptoms of marijuana withdrawal will dissipate with time and can be treated without medical attention. However, if your symptoms last for more than a couple of weeks, you should see your doctor or mental health professional.

Make sure you tell your doctor that marijuana withdrawal is playing a role in how you are feeling. If you just say you are depressed or anxious, you may be prescribed medication, like benzodiazepines, that can present its own set of dependence issues.

Fortunately, many non-addictive pharmacologic options exist for anxiety, as well as non-drug treatments, such as cognitive-behavioral therapy (CBT).  

Resources

If you have decided to quit smoking weed after regular use, chances are you will experience some kind of withdrawal symptoms. Depending on how much and how often you have been smoking, these symptoms could become intense enough to drive you to relapse to find relief.

But you don’t have to do it on your own. Seek help from your healthcare provider to deal with the physical symptoms of withdrawal or seek help from a support group like Marijuana Anonymous to handle the psychological symptoms.

A Word From Verywell

Experiencing the symptoms of cannabis withdrawal can be unpleasant and may temporarily interfere with performance at work, school, and daily life. While withdrawing from marijuana use can present challenges, remember that what you are going through will pass. Be patient. Making life changes is always challenging, but with the right support, they can be transformative.

Withdrawal from marijuana isn’t always easy, so here is everything you need to know about withdrawal symptoms, the timeline, and how to get help.

A ‘joint’ problem: Investigating marijuana and tobacco co-use

Tobacco isn’t the only thing being smoked in the Deep South, and for many, it’s only half of their habit.

Marijuana, long thought to be a gateway drug to harder substances, turns out to be popular among cigarette smokers, with rates of co-use of the two substances increasing among adults from 2003-2012. Researchers don’t yet know how much of a problem that could pose for people trying to quit tobacco.

As more states move to legalize medicinal marijuana and some to decriminalize recreational use, a better understanding is needed of how co-use of marijuana affects quit attempts by smokers.

To learn more, a team of addiction investigators at the Medical University of South Carolina (MUSC) led by Erin A. McClure, Ph.D., assistant professor in the Department of Psychiatry and Behavioral Sciences, conducted an online survey of those who had used both marijuana and tobacco within a 30-day period about their smoking habits. Their results were published online on November 27, 2018 in Addictive Behaviors.

“We focused on marijuana and tobacco because of the high prevalence of their co-use,” says Saima Akbar, first author on the article. “We don’t fully understand how these substances interact and what the implications are for treatment.”

The MUSC team found that more participants used marijuana and tobacco sequentially than simultaneously. For example, more participants used a tobacco cigarette as a “chaser” to marijuana than smoked joints mixing both marijuana and tobacco, known as spiffs.

The study also found that the degree to which marijuana and tobacco use were interrelated differed greatly by user. However, 26 percent of users reported they had smoked most of their cigarettes around the time they were using marijuana or were high. They were more likely to have a greater tobacco dependence and to smoke more cigarettes per day.

“So, if somebody’s trying to quit smoking cigarettes, but they always use marijuana and tobacco together, it’s probably going to be much, much harder for them if they are still using marijuana than for somebody who uses both, but their use is not related in any way,” says McClure.

The finding also raises the question of whether smoking tobacco after marijuana use enhances its subjective effects. More than 50 percent of those surveyed reported using tobacco cigarettes as a chaser. However, another 35 percent reported not doing so. It is possible that co-users of marijuana and tobacco who feel a more intense high because of the tobacco use would be more likely to use them closer together. They could have a harder time quitting smoking than those who did not feel such an enhanced high. This possibility requires further study.

What is clear from the researchers’ findings is that everyone’s habit is a little different, and cessation programs will need to be personalized if they are to be effective.

McClure hopes to focus on tobacco cessation as she continues her research but also identify the people who will likely struggle with quitting due to their marijuana use. She then plans to further tailor treatment to these individuals to improve the likelihood that their smoking cessation efforts will be successful.

“We need to tailor a treatment strategy for each individual rather than doing this one-size-fits-all approach that doesn’t always work very well,” says McClure.

For instance, in an age of medical marijuana and increasing legalization, not all users wanting to quit tobacco will want to discontinue marijuana as well. For some, with a lesser degree of interrelatedness between their use of the two substances, this may be possible. But for those with a higher degree of interrelatedness, dual cessation strategies could be needed.

McClure is pursuing funds for a prospective clinical trial that would further explore how marijuana co-use affects tobacco cessation and compare quit attempts and cessation rates in co-users and tobacco-only users.

“That trial would help us identify the people who are going to have more difficulty with quitting smoking cigarettes because of their marijuana use, and how we can tailor treatment for them,” says McClure. “It would also help clarify how we can tailor treatment for those not interested in quitting marijuana so that they still have the best chances of stopping cigarette smoking.”

A survey of marijuana and tobacco co-users investigators found that co-users with high degree of interrelatedness between their use of the two substances had greater tobacco dependence and smoked more cigarettes per day. However, the finding of a strong link between the two substances was not universal. These finding suggest that highly personalized treatments are needed for co-users who want to quit smoking.