Cannabis withdrawal in the United States: results from NESARC.
paper
Cited
Public
- Authors
- Hasin, Deborah S; Keyes, Katherine M; Alderson, Donald; Wang, Shuang; Aharonovich, Efrat; Grant, Bridget F
- Year
- 2008
- Journal
- The Journal of clinical psychiatry
- PMID
- 19012815
- DOI
- 10.4088/jcp.v69n0902
- PMCID
- PMC2777674
OBJECTIVE: Although cannabis is the most widely abused illicit drug, little is known about the prevalence of cannabis withdrawal and its factor structure, clinical validity, and psychiatric correlates in the general population. METHOD: National Epidemiologic Survey on Alcohol and Related Conditions participants were assessed, in 2001-2002, with structured in-person interviews covering substance history, DSM-IV Axis I and II disorders, and withdrawal symptoms after cessation of use. Of these, 2613 had been frequent cannabis users (> or = 3 times/week), and a "cannabis-only" subset (N = 1119) never binge-drank or used other drugs > or = 3 times/week. RESULTS: In the full sample and subset, 44.3% (SE = 1.19) and 44.2% (SE = 1.75), respectively, experienced > or = 2 cannabis withdrawal symptoms, while 34.4% (SE = 1.21) and 34.1% (SE = 1.76), respectively, experienced > or = 3 symptoms. The symptoms formed 2 factors, one characterized by weakness, hypersomnia, and psychomotor retardation and the second by anxiety, restlessness, depression, and insomnia. Both symptom types were associated with significant distress/impairment (p < .01), substance use to relieve/avoid cannabis withdrawal symptoms (p <.01), and quantity of cannabis use (among the cannabis-only users p < .05). Panic (p < .01) and personality (p > .01) disorders were associated with anxiety symptoms in both samples, family history of drug problems was associated with weakness symptoms in the subset (p = .01), and depression was associated with both sets of symptoms in the subset (p < or = .05). CONCLUSION: Cannabis withdrawal was prevalent and clinically significant among a representative sample of frequent cannabis users. Similar results in the subset without polysubstance abuse confirmed the specificity of symptoms to cannabis. Cannabis withdrawal should be added to DSM-V, and the etiology and treatment implications of cannabis withdrawal symptoms should be investigated.
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| Name | Type |
|---|---|
| 53 men hospitalized cohort local | cohort |
| Adolescent males cohort local | cohort |
| adolescents | cohort |
| age | phenotype |
| age of onset | phenotype |
| Age of onset of cannabis use local | phenotype |
| alcohol | phenotype |
| alcohol dependence | phenotype |
| Alcohol Use Disorder | phenotype |
| alcohol withdrawal | phenotype |
| Another substance local | drug |
| antisocial personality disorder | phenotype |
| anxiety | phenotype |
| Anxiety/Depression factor local | phenotype |
| Anxiety/depression symptoms local | phenotype |
| Anxiety/depression withdrawal symptoms local | phenotype |
| Anxiety/Depression withdrawal symptoms local | phenotype |
| Anxiety withdrawal symptoms local | phenotype |
| Appetite changes local | phenotype |
| avoidant personality disorder | phenotype |
| Baby boomers | cohort |
| bad headaches local | phenotype |
| Better educated local | phenotype |
| cannabis dependence | phenotype |
| Cannabis disorders local | phenotype |
| Cannabis-only Subsample local | cohort |
| Cannabis-only users local | cohort |
| cannabis use | phenotype |
| cannabis use disorder | phenotype |
| Cannabis use quantity local | phenotype |
| Cannabis users without other substance abuse local | cohort |
| cannabis withdrawal | phenotype |
| Cannabis withdrawal symptom local | phenotype |
| Cannabis withdrawal symptoms (β₯3) local | phenotype |
| Census Bureau | cohort |
| clinical significance indicators local | phenotype |
| cocaine | phenotype |
| cocaine dependence criteria local | phenotype |
| cocaine withdrawal | phenotype |
| Delta-9 THC local | drug |
| demographic variables local | cohort |
| Dependence on other substances local | phenotype |
| dependent personality disorder | phenotype |
| depression | phenotype |
| Depression/anxiety local | phenotype |
| Depression/anxiety symptoms local | phenotype |
| Distress/Impairment local | phenotype |
| drug dependence | phenotype |
| DSM-IV cannabis abuse | phenotype |
| DSM-IV cannabis dependence | phenotype |
| Duration of heaviest use local | phenotype |
| Duration of heaviest use (<1 year) local | phenotype |
| education | phenotype |
| epilepsy | phenotype |
| Family history of drug problems local | phenotype |
| fatigue | phenotype |
| feeling weak or tired local | phenotype |
| Feeling weak/tired | phenotype |
| fever | phenotype |
| frequent cannabis-only users local | cohort |
| Frequent cannabis only users local | cohort |
| Frequent cannabis use | phenotype |
| frequent cocaine users local | cohort |
| Frequent Users local | cohort |
| Full group local | cohort |
| full sample | cohort |
| Full sample of frequent cannabis users local | cohort |
| full syndrome local | phenotype |
| generalized anxiety disorder | phenotype |
| general population | cohort |
| general population sample | cohort |
| hallucinations | phenotype |
| Healthy volunteers for research studies local | cohort |
| heavy drinking | phenotype |
| Hispanic | phenotype |
| histrionic personality disorder | phenotype |
| hypersomnia | phenotype |
| insomnia | phenotype |
| International population local | cohort |
| irritability | phenotype |
| Large nationally representative survey local | cohort |
| Less frequent cannabis users local | phenotype |
| major depressive disorder | phenotype |
| marijuana | phenotype |
| marital status | phenotype |
| mental retardation | phenotype |
| muscle aches | phenotype |
| muscle cramps local | phenotype |
| National Epidemiologic Survey on Alcohol and Related Conditions | cohort |
| nausea | phenotype |
| negative affect | phenotype |
| NESARC | cohort |
| NESARC sample local | cohort |
| NIAAA | cohort |
| obsessive-compulsive personality disorder | phenotype |
| Other cannabinoids local | drug |
| other drugs | drug |
| other substances | phenotype |
| panic disorder | phenotype |
| paranoid personality disorder | phenotype |
| Patients in substance abuse treatment local | cohort |
| Patients seeking treatment for marijuana problems local | cohort |
| personality disorders | phenotype |
| Physical component local | phenotype |
| Physical discomfort local | phenotype |
| Polysubstance abusers local | cohort |
| Polysubstance frequent cannabis users local | cohort |
| Poor outcome of dependence local | phenotype |
| Post-hospital marijuana use local | phenotype |
| Postural hypertension local | phenotype |
| psychiatric disorders | phenotype |
| psychiatric history | phenotype |
| Psychological component local | phenotype |
| Quantity of cannabis local | phenotype |
| race/ethnicity | phenotype |
| restlessness | phenotype |
| Reward properties of cannabis local | phenotype |
| runny eyes or nose local | phenotype |
| schizoid personality disorder | phenotype |
| sedatives | drug |
| sex | phenotype |
| shaking local | phenotype |
| Shorter duration of cannabis use local | phenotype |
| Significant distress or impairment local | phenotype |
| Sleep changes local | phenotype |
| Sleep disturbance | phenotype |
| Sleeping local | phenotype |
| stimulants | drug |
| Subsample local | cohort |
| Subset of frequent cannabis users that did not abuse other substances local | cohort |
| Subset of respondents local | cohort |
| substance use | phenotype |
| sweating | phenotype |
| tremor | phenotype |
| United States | cohort |
| Unmarried | phenotype |
| Untreated cannabis users local | cohort |
| Use of a substance to relieve/reduce cannabis withdrawal local | drug |
| vivid or unpleasant dreams local | phenotype |
| weakness local | phenotype |
| Weakness local | phenotype |
| Weakness factor local | phenotype |
| Weakness/fatigue local | phenotype |
| Weakness symptoms local | phenotype |
| Weakness withdrawal symptoms local | phenotype |
| withdrawal | phenotype |
| Withdrawal symptom local | phenotype |
| yawning | phenotype |
| younger cohort | cohort |
| Ξ9-THC | drug |
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