How Common is Cannabis Withdrawal Syndrome? Interview with:

Dr. Bahji

Anees Bahji, MD
PGY5, Department of Psychiatry, Queen’s University
M.Sc. Candidate, Department of Public Health Sciences,
Queen’s University
Kingston, ON, Canada What is the background for this study?

  • There has been much speculation into the existence of a withdrawal syndrome involving cannabis much like withdrawal syndromes from opioids or alcohol. Our goal for this study was to estimate the prevalence of cannabis withdrawal syndrome (CWS) and to identify any risk factors for CWS.
  • There has been a lot of research into cannabis withdrawal syndrome (CWS) in the past. A big part of this review involved understanding where the CWS field is in terms of the shared understanding on its epidemiology and physiology.
  • To that end, we were not surprised to find that the prevalence of cannabis withdrawal syndrome was high. However, we found that some of the characteristics of CWS are consistent with other substance use disorders, which really serves to legitimize the decision to classify CWS and cannabis use disorders as psychiatric conditions. What are the main findings?

  • Our findings suggest that the experience of cannabis withdrawal syndrome cannabis withdrawal syndrome is highly prevalent among people who use cannabis.
  • We also found that cannabis withdrawal syndrome was more common among daily cannabis users, and among those with other forms of substance use disorders.
  • The high prevalence is clinically relevant, and clinicians who provide support to patients who use cannabis should be aware of cannabis withdrawal syndrome, particulars for patients who are considering reducing their use of cannabis. What should readers take away from your report?

  • It is difficult to state with certainty how much cannabis one must consume in order to develop cannabis use disorder or withdrawal. In our study, we found an association between higher levels of cannabis consumption and higher prevalence of withdrawal. What that suggests is that individuals who consume more cannabis (e.g., daily cannabis use) are more likely to experience cannabis withdrawal upon cessation.
  • Ideally, the study will help to legitimize the experience of cannabis withdrawal syndrome among those who use cannabis. Hopefully, this article will encourage discourse and dialogue between people who use cannabis with physicians, friends, and family. Perhaps also, it will serve to increase awareness of CWS among users of cannabis.
  • If someone experiences cannabis withdrawal syndrome and would like to obtain support for reducing their use, or feels that cannabis has affected their life in a negative way, our advice would be to reach out for help from a physician or other healthcare provider.
  • We also hope that the article will reduce stigma around cannabis withdrawal syndrome and cannabis use, and increase the likelihood that people who have problematic use of cannabis will reach out for support.
  • We hope that everyone who uses cannabis is aware of its effects and that they know where to obtain help should they need it. There is a lot of information available and often, knowing where to look is a good first step. However, this is not always easy to do and often, it’s difficult to be able to appraise the information that is available and know what’s right and what’s not evidence-based. What recommendations do you have for future research as a result of this work?

    • While we did not specifically explore the relationship between potency and withdrawal, it stands to reason that future studies might find that there is a relationship between higher potency of cannabis and higher prevalence of CWS. However, with an experience as complex as CWS, a variety of other genetic and environmental factors also must be considered.
    • Our study primarily examined smoked cannabis, so it would be interesting if future studies explored cannabis withdrawal syndrome with cannabis edibles.
    • We have actually made a TED-Ed video on cannabis and the brain that tries to answer some of these questions too.
    • There is a lot of great data on the Government of Canada site that can also be checked regularly for updates.
    • There’s a fantastic position statement that was put out by the Canadian Psychiatric Association on the implications of cannabis legalization that provides a lot of great information. It also serves to address some misconceptions too. There is a lot of information out there, and often, it is difficult to know where to look or to not get overwhelmed by the sheer volume of information. Is there anything else you would like to add?

    • First, we need to empathize that right now—during the COVID-19 pandemic—is a highly anxiety-provoking time for many. And it’s very understandable that people will cope with anxiety in the way that they feel is best for them. Unfortunately, using cannabis to cope with anxiety—while appealing in the short-term—is actually associated with worse anxiety (and depression) in the long-run. At present there is a lack of evidence to support cannabis use as a management strategy for anxiety.
    • However, for people who consume weed for coping with anxiety, perhaps reaching out for help for the underlying anxiety might be a good first step.
    • There’s a fantastic position statement that was put out by the Canadian Psychiatric Associationon the implications of cannabis legalization that provides a lot of great information. There is a lot of information out there, and often, it is difficult to know where to look or to not get overwhelmed by the sheer volume of information.
    • But asking for help is a good first step, and know that you’re not alone.


Bahji A, Stephenson C, Tyo R, Hawken ER, Seitz DP. Prevalence of Cannabis Withdrawal Symptoms Among People With Regular or Dependent Use of CannabinoidsA Systematic Review and Meta-analysisJAMA Netw Open. 2020;3(4):e202370. doi:10.1001/jamanetworkopen.2020.2370



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Last Updated on April 10, 2020 by Marie Benz MD FAAD