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Marijuana withdrawal among adults seeking treatment for marijuana dependence.
Abstract
AIMS: The clinical relevance of marijuana withdrawal has not been established. This study is the first to document the incidence and severity of perceived marijuana withdrawal symptoms in a clinical sample of marijuana-dependent adults. MEASUREMENTS: Fifty-four people seeking outpatient treatment for marijuana dependence completed a 22-item Marijuana Withdrawal Symptom checklist based on their most recent period of marijuana abstinence. FINDINGS: The majority (57%) indicated that they had experienced > or = six symptoms of at least moderate severity and 47% experienced > or = four symptoms rated as severe. Withdrawal severity was greater in those with psychiatric symptomatology and more frequent marijuana use. CONCLUSIONS: This study provides further support for a cluster of withdrawal symptoms experienced following cessation of regular marijuana use. The affective and behavioral symptoms reported were consistent with those observed in previous laboratory and interview studies. Since withdrawal symptoms are frequently a target for clinical intervention with other substances of abuse, this may also be appropriate for marijuana.
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“six-session CBT produced superior results when compared with a single CBT session in another clinical trial 25.”
From Psychosocial and pharmacological interventions for the treatment of cannabis use disorder (2018) · cites this paper as [25]
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“[6] The general impression supported by many studies is that cannabis causes cognitive decline, particularly with long-term usage.”
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Self-citationIntermediate cannabis dependence phenotypes and the FAAH C385A variant: an exploratory analysis
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BackgroundMethodInfluentialSex as a biological variable: Drug use and abuse
Riley, A. L., Hempel, B. J., & Clasen, M. M. (2017) · Physiology & Behavior · doi:10.1016/j.physbeh.2017.10.005 · Cited by 66
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“This produced a total withdrawal score out of 40. Withdrawal symptoms were assessed via an adaptation of the Marijuana Withdrawal Checklist (adapted from Budney et al. 1999; Vandrey et al. 2005).”
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“The withdrawal criterion was presented as 10 brief symptoms, previously described by Budney, with four Likert scale choices for each, ranging from not at all to severe (19).”
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MethodMarijuana withdrawal and aggression among a representative sample of U.S. marijuana users
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“During the other weekly visit, participants underwent several assessments including: Cannabis Withdrawal Checklist (CWC) (Budney et al., 1999), Cannabis Craving Questionnaire (CCQ) (Heishman et al., 2001), Timeline Follow-back (TLFB) for cannabis, tobacco, caffeine, and alcohol (Sobell et al., 1988).”
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“Sleep-Related Cannabis Withdrawal Symptoms—were assessed with two items from the Marijuana Withdrawal Checklist (Budney et al., 1999) that asked about the experience and severity of a) sleep difficulty, and 2) strange dreams “the last time you went a significant time without using marijuana.””
MethodA Cross‐study Comparison of Cannabis and Tobacco Withdrawal
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Self-citationCocaine Dependence and Concurrent Marijuana Use: A Comparison of Clinical Characteristics
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Quetiapine treatment for cannabis use disorder
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“Furthermore, only a subset of regular marijuana users experience a clustering of symptoms upon cessation of use; estimates range from 1 in 6 to half of all such users (Budney et al. 1999; Wiesbeck et al. 1996).”
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BackgroundSelf-citationCannabis Careers Reconsidered: Transitions and Trajectories of Committed Long-Term Users
Hathaway, A. D. (2004) · Contemporary Drug Problems · doi:10.1177/009145090403100302 · Cited by 32
The effect of high-dose dronabinol (oral THC) maintenance on cannabis self-administration
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BackgroundAssessment of Cannabis Craving Using the Marijuana Craving Questionnaire
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BackgroundEffects of Smoked Marijuana in Healthy and HIV+ Marijuana Smokers
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“Nevertheless, some human subjects have complained of inner unrest, irritability, insomnia, and hot flashes as symptoms of cannabis withdrawal (Budney et al. 1999).”
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Progression of cannabis withdrawal symptoms in people using medical cannabis for chronic pain
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Psychosocial and Pharmacological Interventions for the Treatment of Cannabis Use Disorder
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“A previous report found that 93% of treatment-seeking MD individuals had mild cravings, and 44% had rated past cravings as severe (Budney et al, 1999).”
BackgroundAdolescent use and misuse of marijuana.
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“The steep rise in cannabis admissions between 1992 and 2004 overlaps temporally with increased scientific acceptance that cannabis can form a dependency syndrome and subsequent public health initiatives advocating for increased referrals to treatment over solely judicial penalties (Budney et al., 1999; Budney and Hugh…”
BackgroundOpen-label pilot study of quetiapine treatment for cannabis dependence
Mariani, J. J., Pavlicová, M., Mamczur, A. K., Bisaga, A. M., Nunes, E. V., & LEVIN, F. R. (2014) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2014.884102 · Cited by 19
“Most adults seeking treatment for marijuana dependence report experiencing marijuana withdrawal symptoms of moderate severity (31), including, depression, irritability, anxiety, insomnia and anorexia (32).”
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Montgomery, L., McClure, E. A., Tomko, R. L., Sonne, S. C., Winhusen, T. M., Terry, G. E., Grossman, J. T., & Gray, K. M. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.01.041 · Cited by 19
“Given that approximately 50-95% of adolescents and adults enrolled in treatment for heavy cannabis use report cannabis withdrawal (Budney et al., 1999; Coffey et al., 2002; Crowley et al., 1998; Vandrey et al., 2005), it is important to gain a better understanding of factors that are associated with cannabis withdrawa…”
BackgroundNava, F. A., Manzato, E., & Lucchini, A. (2007) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2007.03.013 · Cited by 19
Dependence on Cannabis—An Ever Lasting Issue
Soellner, R. (2005) · Substance Use & Misuse · doi:10.1081/ja-200030810 · Cited by 19
“In studies dealing with withdrawal symptoms after cessation of cannabis use, symptoms like nervousness, restlessness, sweating, headaches, etc., are reported (Budney et al., 1999; Coffey et al., 2002).”
BackgroundSex and Strain Variation in Initial Sensitivity and Rapid Tolerance to Δ9–Tetrahydrocannabinol
Parks, C., Jones, B. C., Moore, B. M., II, & Mulligan, M. K. (2020) · Cannabis and Cannabinoid Research · doi:10.1089/can.2019.0047 · Cited by 20
The effect of cannabis edibles on driving and blood THC
Zhao, S., Brands, B., Kaduri, P., et al. (2024) · Journal of Cannabis Research · doi:10.1186/s42238-024-00234-y · Cited by 17
Screening Medications for the Treatment of Cannabis Use Disorder
Panlilio, L. V., Justinová, Z., Trigo, J. M., & Foll, B. L. (2016) · International review of neurobiology · doi:10.1016/bs.irn.2016.02.005 · Cited by 18
Manning, K. F., Paulus, D. J., Hogan, J., Buckner, J. D., Farris, S. G., & Zvolensky, M. J. (2017) · Addictive Behaviors · doi:10.1016/j.addbeh.2017.11.041 · Cited by 18
Manning, K. F., Rogers, A. H., Bakhshaie, J., Hogan, J., Buckner, J. D., Ditre, J. W., & Zvolensky, M. J. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.05.009 · Cited by 17
Knapp, A. A., Allan, N. P., Cloutier, R. M., Blumenthal, H., Moradi, S., Budney, A. J., & Lord, S. (2020) · Journal of Behavioral Medicine · doi:10.1007/s10865-020-00182-x · Cited by 20
Self-citationNeuroanatomical alterations in people with high and low cannabis dependence
Lorenzetti, V., Chye, Y., Suo, C., Walterfang, M., Lubman, D. I., Takagi, M., Whittle, S., Verdejo‐García, A., Cousijn, J., Pantelis, C., et al. (2019) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867419859077 · Cited by 16
“A series of analyses of variance (ANOVAs) were run to compare groups on demographics (i.e. age), global function, psychopathology symptom scores (e.g. CAPE depressive, positive and negative psychotic symptoms), STAI-Trait anxiety and substance use (e.g. alcohol standard drinks/month, cannabis smoking days/month, cumul…”
MethodInfluentialAn Interpretable and Predictive Connectivity-Based Neural Signature for Chronic Cannabis Use
Kulkarni, K. R., Schafer, M., Berner, L. A., Fiore, V. G., Heflin, M., Hutchison, K. E., Calhoun, V. D., Filbey, F. M., Pandey, G. S., Schiller, D., et al. (2022) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2022.04.009 · Cited by 17
Gall, A. J., & Shuboni‐Mulligan, D. D. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.911153 · Cited by 18
Perron, B. E., Holt, K. R., Yeagley, E. E., & Ilgen, M. A. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.09.029 · Cited by 17
Sarkar, S., Parmar, A., & Singh, A. (2020) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_132_19 · Cited by 16
“Interestingly, the pattern of withdrawal symptoms has not been uniform across all heavy users who quit cannabis.[12] Studies in treatment-seeking and nontreatment-seeking cannabis users have found considerable heterogeneity in the symptoms of cannabis withdrawal.”
BackgroundManagement of cannabis use disorder and related issues. A clinician’s guide.
Copeland, J., Frewen, A. R., & Elkins, K. (2009) · Cited by 16
Characteristics of cannabis users seeking treatment in São Paulo, Brazil
Jungerman, F. S., & Laranjeira, R. (2008) · Revista Panamericana de Salud Pública · doi:10.1590/s1020-49892008000600003 · Cited by 16
Yeap, Z. J. S., Marsault, J., George, T. P., Mizrahi, R., & Rabin, R. A. (2023) · American Journal on Addictions · doi:10.1111/ajad.13394 · Cited by 15
Metadata
- Authors
- Budney, A. J., Novy, P. L., & Hughes, J. R.
- Affiliations
- University of Vermont (US)
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 1999-09
- Volume
- 94
- Issue
- 9
- Pages
- 1311-1322
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W2119758521
- Cited by
- 348
- References
- 0
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 11 · 2023: 15 · 2022: 12 · 2021: 11 · 2020: 18 · 2019: 12 · 2018: 22 · 2017: 15 · 2016: 10 · 2015: 17 · 2014: 15 · 2013: 11 · 2012: 16
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r29da008655-05)
- National Institute on Drug Abuse (R-29DA08655)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Keywords
- cannabis use disorder, withdrawal symptom severity, psychiatric comorbidity, addiction treatment, cannabis
- MeSH terms
- Adult, Analysis of Variance, Marijuana Abuse, Female, Humans, Male, Patient Acceptance of Health Care, Regression Analysis, Stress, Psychological, Substance Withdrawal Syndrome
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