Withdrawal

Cannabis withdrawal is a DSM-5-TR–recognized syndrome arising after cessation or reduction of heavy, prolonged cannabis use. Diagnostic criteria require ≥3 of the following within approximately one week: irritability/anger/aggression, nervousness or anxiety, sleep difficulty (often with vivid or unpleasant dreams), decreased appetite or weight loss, restlessness, depressed mood, and at least one physical symptom (abdominal pain, tremors, sweating, fever, chills, or headache). Symptom onset typically occurs 24–72 hours after last use, peaks at days 2–6 (Budney et al. 2004, American Journal of Psychiatry), and resolves over 1–3 weeks, though sleep disturbance and vivid dreams may persist longer (Connor et al. 2022, Addiction). Approximately half of individuals in treatment for CUD and roughly one-third of regular community users report clinically meaningful withdrawal. NIDA and NASEM 2017 recognize withdrawal as evidence of neuroadaptation and a contributor to relapse. No medication is FDA-approved for cannabis withdrawal; management is supportive. → See also: CUD, Tolerance, Dependence.