Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN
Written By: Phillippe Greenough
Article Updated: 11/09/2021
Number of References: 14 Sources
Marijuana use has been on the rise in America over the last 20 years. It is often seen as a safe form of substance abuse although it can be dangerous. Many people don't even believe that marijuana dependence exists. Withdrawal from marijuana can be a long process sometimes taking several weeks. Symptoms of marijuana withdrawal can include headaches, nausea, depression, anxiety, and sometimes psychosis. We will examine marijuana withdrawal including symptoms, timeline, and psychological or physical effects.
In This Article:
Marijuana withdrawal is usually a drawn-out process compared to withdrawal from other drugs. On average, it takes around 28 days to complete. While 4 weeks is the average withdrawal duration there is great variability in this timeline between people. It ranges from 3 days for physicahttps://www.detoxlocal.com/what-is-paws/l symptoms to 5 weeks for post-acute symptoms. The symptoms of marijuana withdrawal typically peak at around 4 days since the last use. The side effects usually decline gradually over the next several weeks.
The majority of the symptoms of marijuana withdrawal are psychological. It is almost unheard of for dangerous or life-threatening symptoms to arise from marijuana withdrawal. That being said, it is by no means “easy” to undergo cannabis withdrawal. The very fact that these symptoms are so protracted can make the experience exhausting and extremely stressful.
A general overview of the marijuana withdrawal timeline may look like this:
Excessive sweating and insomnia are usually the first symptoms to appear. The first 4 days are commonly the most difficult since the symptoms peak during this time. Anxiety, restlessness, and cravings are usually the most severe symptoms. Anger and irritability may become more pronounced during this time as well. Depression may appear but typically remains stable and mild during the first week. Nausea and stomach pain may begin and increase in the first few days. Appetite may be nonexistent for the first few days and then begin to normalize very slowly.
Some marijuana withdrawal symptoms during week one could include:
The second week is usually much less intense. Symptoms are usually reduced between the middle of the first week and the beginning of the second week. Insomnia, excessive sweating, vivid dreams, and abdominal pain may begin to resolve. Cravings, anxiety, and restlessness usually remain but should be greatly reduced. Anger, irritability, and depression will typically begin resolving over the course of the second week.
Some common symptoms that may be experienced during the second week can include:
The third and fourth weeks will follow a common trend of symptom reduction. The worst of the symptoms during this time may be excessive sweating, insomnia, and vivid dreams. Anxiety may remain until the end of the fourth week but continue to decrease in severity. Loss of appetite should be well on its way to resolving by this time. By the end of the first month of marijuana withdrawal the physical symptoms should be fully resolved. There is usually a substantial improvement in the psychological symptoms as well.
The symptoms of withdrawal that may accompany the third and fourth weeks can include:
Post-acute marijuana withdrawal can be a very drawn-out process, sometimes taking months or years to fully resolve. The unique properties of THC play a role, but there is also substantial variability among different people. Different people may experience different symptom intensities and duration during post-acute withdrawal.
Some of the symptoms common during post-acute marijuana withdrawal may include:
The severity of marijuana withdrawal symptoms can differ quite a lot between people. There are several contributing factors that play a role. Some of these are influenced by someone’s substance use habits while others are genetic and are completely out of someone’s control. Some people seem to recover quickly in just a week or two while others may experience symptoms for many months. Some people will only experience mild symptoms while others can have severe psychological issues.
Some of the factors which contribute to the intensity and duration of the withdrawal period include:
The amounts of marijuana someone used play a large role in the withdrawal process. This is due to the fact that the more marijuana someone uses, the greater the degree of downregulation the brain undergoes. This means that if someone uses a lot of marijuana their brain has higher consistent levels of dopamine and serotonin. When this happens, the brain will make greater changes to bring those higher levels down.
The length of time that someone uses marijuana will affect this process as well. Cannabis use disorder can be a long-term issue. The longer someone uses marijuana the more pronounced these downregulated neurotransmitter levels become. This means that during marijuana withdrawal the brain will take longer to complete the recovery process. Since there is more downregulation to undo this leads to more intense symptoms that last longer.
While use habits are influenced by a marijuana user’s behaviors genetic predisposition is out of their control. Genetics play a large role in the ease and speed with which someone may become addicted. The exact manner and amount of influence that this effect has is still unclear but it certainly has many repercussions. Someone with a family history of addiction may become addicted more quickly than someone who has no family history of addiction.
Previous mental health conditions may also play a role in the intensity of withdrawal symptoms. This could also affect the range of symptoms that someone may experience. Marijuana use disorders are known to accelerate the onset of psychological conditions such as schizophrenia. There is a wealth of documentation that marijuana may accelerate the progression of these conditions. Medical professionals advise anyone with a history of mental health issues to avoid using marijuana.
To get a more comprehensive picture of marijuana withdrawal it will be helpful to understand more about how marijuana works. Marijuana has a very complicated mechanism of action that affects a wide range of neurological systems. Some of these systems include the brain’s endocannabinoid system, serotonin, dopamine, and the opioid system.
The endocannabinoid system moderates the function of other neurotransmitters. It plays a role in cognition, pain management, memory, motor functions, appetite, and the immune system. The two major cannabinoids that are produced by the body are anandamide and 2-arachidonoylglycerol (2-AG). There are over 60 cannabinoid compounds in the marijuana plant. The most well-understood of these are delta-6-tetrahydrocannabinol (THC) and cannabidiol (CBD).
The main way that THC utilizes the cannabinoid system is through interactions at the CB1 receptors. CB1 receptors are found all throughout the brain. These receptors are found in the hippocampus, basal ganglia, cerebellum, and cerebral cortex in large numbers. These areas of the brain have a wide range of functions including memory, emotions, motor control, and consciousness.
The euphoric properties of marijuana use are produced through THC-induced dopamine release. Dopamine is an excitatory neurotransmitter that produces feelings of pleasure and reward. Through chronic marijuana use, the brain will reduce sensitivity to dopamine. This process is known as downregulation.
CBD is less psychologically active than THC but may be able to increase the brain’s sensitivity to serotonin. Serotonin is a mood regulator in the brain and increased sensitivity can produce a mood-elevating effect. CBD-induced serotonin receptor stimulation can result in decreased sensitivity to serotonin.
Through the chronic use of marijuana, the brain will begin to adapt to the changes that marijuana produces. Once these changes have occurred someone will begin to feel withdrawal symptoms when they do not use marijuana. These symptoms will worsen the longer marijuana is used as these changes become more difficult to reverse.
Entering a marijuana detox can make the withdrawal experience much less unpleasant. It may also reduce the risks, which are commonly low to begin with. These centers provide a variety of treatment options that can help. Any co-occurring mental health issues someone may be struggling with can be addressed and treated as well. Once detox is complete it is recommended to enter an outpatient treatment program. Following up detox with an addiction treatment program or inpatient can improve someone’s chances of sobriety. If you or a loved one is seeking help then marijuana detox is a significant first step.
There are several other depressant drugs that can produce uncomfortable or even dangerous withdrawal symptoms. We have more in-depth withdrawal guides for drugs such as:
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