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The cannabis withdrawal syndrome

Budney, Alan Ja; Hughes, John Rb

Current Opinion in Psychiatry: May 2006 - Volume 19 - Issue 3 - p 233–238
doi: 10.1097/01.yco.0000218592.00689.e5
Addictive disorders

Purpose of review The demand for treatment for cannabis dependence has grown dramatically. The majority of the people who enter the treatment have difficulty in achieving and maintaining abstinence from cannabis. Understanding the impact of cannabis withdrawal syndrome on quit attempts is of obvious importance. Cannabis, however, has long been considered a ‘soft’ drug, and many continue to question whether one can truly become dependent on cannabis. Skepticism is typically focused on whether cannabis use can result in ‘physiological’ dependence or withdrawal, and whether withdrawal is of clinical importance.

Recent findings The neurobiological basis for cannabis withdrawal has been established via discovery of an endogenous cannabinoid system, identification of cannabinoid receptors, and demonstrations of precipitated withdrawal with cannabinoid receptor antagonists. Laboratory studies have established the reliability, validity, and time course of a cannabis withdrawal syndrome and have begun to explore the effect of various medications on such withdrawal. Reports from clinical samples indicate that the syndrome is common among treatment seekers.

Summary A clinically important withdrawal syndrome associated with cannabis dependence has been established. Additional research must determine how cannabis withdrawal affects cessation attempts and the best way to treat its symptoms.

aCenter for Addiction Research (CAR), Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas

bDepartment of Psychiatry, College of Medicine, University of Vermont, Burlington, Vermont, USA

Correspondence to Alan J. Budney PhD, Center for Addiction Research (CAR), Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 843, Little Rock, AR 72205, USA Tel: +1 501 686 5207; e-mail: ajbudney@uams.edu

Supported by NIDA grants DA12471, DA12157, K02-00109, K05-00450, and T32-DA07242.

© 2006 Lippincott Williams & Wilkins, Inc.