Numerous factor- and item-response analyses also indicate a high factor-loading for cannabis withdrawal on the underlying liability to cannabis use disorders (Lachenbucher et al. 2004; Lynskey & Agrawal, 2007; Compton et al. 2008; Gillespie et al. 2011) – as such, it is now well recognized that cannabis withdrawal is, phenotypically, an integral aspect of cannabis use disorders (abuse/dependence). These factor analytic findings, together with clinical observations, resulted in the recommended inclusion of the cannabis withdrawal syndrome in the fifth iteration of the Diagnostic and Statistical Manual (DSM-5, see www.dsm5.org). Accordingly, the proposed DSM-5 definition of cannabis withdrawal includes (A) cessation of prolonged (or less frequent but chronic) pattern of use; (B) emergence of 3 or more of 7 withdrawal symptoms within a week of cessation; (C) impairment or distress attributable to (B); and (D) the symptoms are not attributable to other medical or psychiatric conditions.
