Cannabis Withdrawal and Detox
Cannabis is a plant, containing a psychoactive substance, that is widely produced, trafficked and consumed in almost every country in the world. The primary psychoactive chemical – the part of cannabis that makes people “high” – is tetrahydrocannabinol (THC). The potency level differs across cannabis products, but THC is found in varying degrees found in plants, hash oil, hashish and other forms.
Depending on the specific form of the drug, cannabis can be smoked, inhaled as a vapour, or eaten or drunk. When you smoke cannabis, THC enters your lungs, is absorbed into your bloodstream and makes its way to your brain. The effect is slower (but can be longer-lasting) when you use it to cook or put it in drinks.
Cannabis (also known as marijuana, weed, dope, grass or pot) is the most widely-used illegal substance in the UK. Data from the Home Office reveals that 6.5% of Britons aged 16-59 (about 2 million people) used cannabis in 2014; in the same year 15.8% of all young people aged 16-24 used the drug. Scientists continue to study the plant, looking for the benefits in treating cancer, depression, AIDS, nausea and neurological diseases. So far, the only cannabis-based product approved for medical use is Sativex – a buccal spray containing extracts of the hemp plant, Cannabis Sativa L.
As the production and supply of cannabis has become more sophisticated and profitable, the strength of the drug has tended to increase. Some varieties of cannabis now available are more than ten times as potent (ie, with more than ten times the concentration of THC) than those typically consumed in the 1960s.
Research shows that 10% of people using cannabis develop drug dependence on it, which increases the risk of addiction. When you suddenly stop using cannabis after prolonged use, you’ll experience withdrawal symptoms, because your body has developed a tolerance.
Cannabis Withdrawal: What You Should Know
People consume cannabis because it reduces anxiety and produces mild euphoria. With continued usage, you’ll need to increase the quantity you consume to feel the ‘high’ effect. This leads to drug dependence in some users. After a while, you’ll be taking higher doses frequently and may lack the ability to stop using cannabis, which is a sign of addiction.
Withdrawal symptoms can occur when an individual has used cannabis for a long time and suddenly stops. People who started using at a younger age experience harsher types of withdrawal. For mild to moderate users, the symptoms might take up to a week to appear; for longer-term users or those with other substance abuse problems, it takes 24 to 48 hours to experience withdrawal signs.
Why does Someone go Through Withdrawal after Quitting Cannabis?
Contrary to public opinion, it’s possible to develop a dependence on marijuana. Research shows that between 10% and 20% of those using cannabis every day can become addicted. Those who used when they were younger (14-15 years old) are seven times more likely to be addicted than individuals who started when they were older.
Withdrawal occurs when you’ve used cannabis for a long period and suddenly quit.
The body adapts to the effects of drugs in your system and becomes numb to some neurotransmitters in the brain, including endocannabinoid, a naturally occurring neurotransmitter.
Prolonged usage causes withdrawal symptoms. However, those who use cannabis just once a week might also experience withdrawal. Many people who try to quit start using again, possibly because of the effect of withdrawal symptoms. Research reveals that a third of cannabis users relapse because of withdrawal.
Duration of Cannabis Withdrawal
Withdrawal symptoms differ across individuals. Some individuals experienced withdrawal for periods of up to two weeks, while in others it lasted over a year. For heavy users, the symptoms likely start within 24 hours after their last use and peak inside two to three days. Physical symptoms last two to three weeks and lessen over time.
How Long does it take Before Cannabis Withdrawal Starts?
For people who started using as adults or have a mild dependence on cannabis, the symptoms may show after a week, with minor psychological discomfort and manageable physical effects.
Individuals who’ve taken cannabis since they were teenagers – or those mixing cannabis with cigarettes or alcohol – can experience withdrawal from both substances, which manifest within 24 hours. Young users may not be able to sleep or eat, unless they smoke. They may also notice withdrawal symptoms like abdominal pain, increased irritability and anxiety. Many users resume cannabis use mid-way through withdrawal, because the experience is a rough one.
Cannabis Withdrawal Timeline
Many people who attempt to detox from cannabis addiction never make it past the withdrawal phase, because unlike other addictions where symptoms pass within a week, cannabis withdrawal lasts between two weeks to a month.
First day: the first signs of withdrawal include anxiety, irritability, lack of focus, tremors, restlessness, insomnia and loss of appetite.
Second and third day: withdrawal symptoms usually peak within this timeframe. The cravings are very strong, as the brain fights with the body to wrestle back control and encourages you to seek the next dose of cannabis. You’ll experience stomach pains, sweating, chills, weight loss, nausea, headaches and loss of appetite.
Fourth to fourteenth days: The intensity of the physical symptoms reduces, as psychological symptoms manifest. Depression sets in when the brain readapts to working without THC. Other signs include cravings, aggression, sleep disorders, mild depression, mood swings, loss of concentration and irritability.
Two weeks after and beyond: by the third week, withdrawal symptoms in most people have subsided, but recovering addicts might experience insomnia, coughing, mild depression and anxiety. People with psychological addictions sometimes feel the lingering effect of depression and anxiety even months after they’ve quit cannabis.
Cannabis Cravings Timeline
Cannabis cravings start showing two days into the withdrawal timeline and continue for up to a month. For individuals with Post-Acute Withdrawal Syndrome, cravings may last months or even years. The craving for cannabis is the major reason why a third of recovering addicts relapse within a week of withdrawal.
Cravings are intrusive, persistent thoughts that urge you to use cannabis. This mostly happens with long-term marijuana users when they try to quit. Some people believe that the only way to reduce the craving is to use cannabis. However, cravings are normal and can be treated when you undergo detox treatment and rehab as an inpatient.
Treating Cannabis Withdrawal Symptoms
The best treatment for managing withdrawal symptoms and preventing a relapse is to detox at a medically supervised centre. Medical doctors, experienced nurses, caregivers and other professionals provide a safe environment to complete the withdrawal process.
Currently, there are no medically approved pharmacology treatments for managing withdrawal symptoms for cannabis abuse disorder. Scientists have experimented with THC replacements, sleep aids, anxiety medication, mood stabilisers and antidepressants, but the most promising medicine is Ambien (sleep aid), Neurontin (anti-convulsant) and BuSpar (anti-anxiety).
The Detox Process
There are three steps in the detox process: evaluation, stabilisation and transition into treatment. During evaluation, a medical professional collects information that will be used to create an individual detox treatment for you. There will also be blood tests, assessment of your medical and psychological status, risk assessment of withdrawal severity, screening for co-occurring disorders and assessment of your social status.
Stabilisation is where detox occurs. You’ll be provided with medication and healthy nutrition for safe detox. Transition prepares you for cannabis abuse treatment, where you’ll work with psychologists, clinical psychiatrists, therapists and mental health professionals to identify negative behaviours that encourage drug use and learn how to live a sober life.
Why Detox is a Must
You can’t receive treatment for cannabis addiction if the drug is in your body. It’s an exercise in futility. Detox is the first step to recovery. It cleans your body of toxic chemicals and helps your brain learn to perform normal functions without relying on drugs.
Medically Assisted Cannabis Detox
Medically assisted detox is only required if there are complicating circumstances that might lead to severe or life-threatening withdrawal symptoms. If the user has a polydrug disorder, where they’re using cannabis alongside nicotine, alcohol, heroin or other substances, they’ll be experiencing withdrawal symptoms for those substances.
Medically supervised detox is also recommended for long-term or chronic cannabis users who consume huge amounts of the substance regularly. Other situations that require medical supervision include cannabis-induced disorders, such as anxiety and psychosis.
Treatment for Cannabis: Where to Start
Cannabis is difficult to quit when you try to do it on your own. People with substance abuse disorders won’t seek treatment if they don’t see their drug habit as being addictive. Those who seek treatment do so because they are unable to maintain sobriety for days, or are motivated by family to get help or when they realise the negative consequences of abusing cannabis outweigh the positive.
Which Treatments work for Cannabis Addiction?
After detox, psychological dependence should be treated at a rehab facility. The best treatment that works for cannabis addiction includes a combination of medical detox, pharmacology, psychotherapy in rehab and after-care programmes.
Psychotherapy and behavioural therapies for treating cannabis addiction include:
Cognitive Behavioural Therapy (CBT): CBT helps you become more aware of your actions, thoughts, behaviour and consequences of each. In therapy sessions, you’ll understand your motivation for using drugs and the role of substance abuse in your life. You’ll identify negative thought patterns and behaviour directed towards yourself, other humans and the world at large. Once you’ve identified the cognitive distortions, you can alter your thought process to become more positive, which in turn influences your actions and behaviour. CBT also helps to solve the real reasons why you started abusing cannabis and prevents future relapse.
Contingency Management: Contingency management works on the principle that cannabis use is influenced by environmental, social and biological factors. Most substances target the reward centre of the brain to encourage addiction, even in the face of negative consequences. CM replaces the reward for drugs with reward for good behaviour. When recovering addicts attend treatment and reach milestones, the chance of reward increases.
Motivational Enhancement Therapy (MET): There is often ambivalence about making life-changing decisions, such as the desire to quit cannabis. Ambivalence derails you from seeking treatment. In this treatment, you’ll work with a therapist to examine your current behaviour, personal values and goals and identify where they clash or mesh with your long-term goals for the future. This helps you find reasons and motivation to commit to sobriety and take the necessary steps to make it permanent.
Other Help for Cannabis Addiction
Apart from traditional treatment, additional models include:
Clinical Psychiatrists and Psychologists: after detox and rehab, former cannabis users with protracted withdrawal symptoms visit a clinical psychiatrist to seek help for drug usage. Therapy methods include individual therapy and family therapy.
Support Groups: support groups are an effective way to gain motivation for sobriety and learn coping strategies for long-term recovering addicts. Therapists and addiction specialists always advise people coming out of addiction treatment to join a support group, where they can listen to others and share their experience with substance abuse. For cannabis users, Marijuana Anonymous or Narcotics Anonymous (NA) is the best fit. Other options include 12-step groups, SMART Recovery, Ration Recovery or religious recovery groups.
Where will I Have my Treatment?
When seeking help for cannabis addiction, the first thing to consider is a treatment option that caters to your needs and preferences. Places where you can have your treatment include:
Long-Term Residential Treatment: Usually in a non-hospital setting, this is a rehab facility with 24-hour care for residents. Also referred to as the therapeutic community, the duration of stay ranges from 6-12 months. The highly-structured treatment is recommended for people who have a long-term history with substance abuse, individuals who are experiencing post-acute withdrawal symptoms due to heavy drug usage, people who need more time to finish the withdrawal process and those with pre-existing mental health issues or co-occurring disorders.
Treatment focuses on creating personal responsibility and accountability in an individual, because addiction is viewed as an addict’s psychological and social deficiencies. Most facilities also offer support services and employment training that equip you with skills and coping strategies to re-enter the real world.
Short-Term Rehab Treatment: Short-term residential programmes are recommended for cannabis users with mild to moderate dependency. Individuals experience withdrawal symptoms within a week and after the second week, the symptoms have diminished. They’ve not used drugs for a long time, so it’s easier to get help within a brief window of one or two months’ rehab stay. After rehab, the resident continues with aftercare therapy sessions and group counselling.
Outpatient Treatment Programme : Outpatient treatment programmes can be just as effective as inpatient treatment. The major difference is that the programme is less restrictive and individuals can detox from home, while attending rehab at a treatment centre. The type of care and intensity of treatment varies according to your treatment needs and it’s advised for those who need to keep working or going to school during rehab.
Intensive day treatment offers the same programmes as residential rehabs. You’ll attend the same group counselling, therapy sessions and any alternative programmes in place for residents. Some models treat patients in the early morning or evening after work for better cohesion with your employment and domestic responsibilities.
How to Care for Someone going through Cannabis Withdrawal
Like many stimulants, the effect of the drug makes it very difficult to quit for users who’ve developed dependence. Signs of cannabis abuse include panic attacks, concentration difficulty, hallucinations, lower IQ in students and risk of psychosis.
Conduct your own research and learn all you can concerning cannabis abuse and dependency. When the person stops using the substance, you’ll be able to identify withdrawal symptoms such as mood changes, cravings, physical discomfort, irritability, restlessness, loss of appetite and sleeping difficulties.
Cannabis users often don’t see their drug habit as a problem, so prepare yourself for excuses. It helps to have talking points that include sudden behavioural changes you’re worried about and the health dangers of cannabis addiction. Remind them of the past, when they functioned without cannabis, and the goals they want to achieve in life. Set healthy boundaries and encourage them to seek treatment either as an inpatient or outpatient at a rehab facility.
Don’t preach, avoid judgment and be patient without enabling their drug habit and remain persistent until they’re ready to get help.
Key Facts about Cannabis Abuse
Ten per cent of people who smoke cannabis become dependent on the substance. Cannabis is neurotoxic to an adolescent brain. This means their IQ will decline and damage might not be reversible when they stop using.
People who use cannabis are more likely to develop depression and psychotic symptoms. There are about 158.8 million people around the world who use cannabis. After alcohol, cannabis is the most common mind-altering substance found in the bodies of drivers involved in car accidents.
What makes Cannabis Addiction so Hard to Beat?
Cannabis is a difficult addiction – not because THC possesses more addictive components than other drugs, but because many addicts see it as their final vice and are unwilling to let it go. Just like alcohol, social acceptance makes it harder for users to quit, because they don’t see cannabis abuse as a problem.
What can I do to Succeed at Therapy?
The best way to succeed is to enter drug rehabilitation the moment you notice you’ve developed a dependency on cannabis. Take prescribed medication, actively participate in rehab programmes, eat brain-nourishing food and follow through with an aftercare plan.
What are the Drawbacks of Medication Therapy for Cannabis Abuse?
Most medication treats specific symptoms such as anxiety, insomnia and depression. Physical side effects you might experience include muscle spasms, sweating and constipation. Medication has to be administered by a medical professional to ensure you get the right dose and avoid substituting one addiction for another.
What are some Popular Slang or Street Names for Cannabis?
Some of the countless nicknames of cannabis include: Aunt Mary, ashes, skunk, herb, dope, hash, ganja, pot, weed, grass, boom, baby bhang, broccoli, dagga, jay, flower tops, ding, joystick, green, jolly green, trees and roach.
Is Detox from Cannabis Dangerous?
Unlike opioids, heroin, alcohol and other illicit substances, cannabis withdrawal symptoms are more psychological than physical. Hence, the detox process isn’t dangerous for mild or short-term users. Heavy users sometimes experience depression and anxiety during detox. Those who experience depression usually develop a dependency on marijuana faster than others and may relapse to relieve feelings of depression.
How long does Cannabis Detox last?
There is no specific timeframe for the period of detox from cannabis. For mild to moderate users, withdrawal signs occur one week after the last drug usage and subside after two weeks. In chronic or heavy users, symptoms sometimes last a month or more, depending on the length of time they’ve been using and the potency, frequency and amount of cannabis they consumed.
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