More threads by David Baxter PhD

David Baxter PhD

Late Founder
Marijuana Withdrawal As Bad As Withdrawal From Cigarettes
Jan. 25, 2008

Research by a group of scientists studying the effects of heavy marijuana use suggests that withdrawal from the use of marijuana is similar to what is experienced by people when they quit smoking cigarettes. Abstinence from each of these drugs appears to cause several common symptoms, such as irritability, anger and trouble sleeping - based on self reporting in a recent study of 12 heavy users of both marijuana and cigarettes.

"These results indicate that some marijuana users experience withdrawal effects when they try to quit, and that these effects should be considered by clinicians treating people with problems related to heavy marijuana use," says lead investigator in the study, Ryan Vandrey, Ph.D., of the Department of Psychiatry at the Johns Hopkins University School of Medicine.

Marijuana is the most widely used illicit drug in the United States. Admissions in substance abuse treatment facilities in which marijuana was the primary problem substance have more than doubled since the early 1990s and now rank similar to cocaine and heroin with respect to total number of yearly treatment episodes in the United States, says Vandrey.

He points out that a lack of data, until recently, has led to cannabis withdrawal symptoms not being characterized or included in medical reference literature such as the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, (DSM-IV) or the International Classification of Diseases, 10th edition (ICD-10).

Since the drafting of the DSM-IV in 1994, an increasing number of studies have surfaced suggesting that cannabis has significant withdrawal symptoms. What makes Vandrey's recent study unique is that it is the first study that compares marijuana withdrawal symptoms to withdrawal symptoms that are clinically recognized by the medical community - specifically the tobacco withdrawal syndrome.

"Since tobacco withdrawal symptoms are well documented and included in the DSM-IV and the IDC-10, we can infer from the results of this comparison that marijuana withdrawal is also clinically significant and should be included in these reference materials and considered as a target for improving treatment outcomes," says Vandrey.

Vandrey added that this is the first "controlled" comparison of the two withdrawal syndromes in that data was obtained using rigorous scientific methods - abstinence from drugs was confirmed objectively, procedures were identical during each abstinence period, and abstinence periods occurred in a random order. That tobacco and marijuana withdrawal symptoms were reported by the same participants, thus eliminating the likelihood that results reflect physiological differences between subjects, is also a strength of the study.

Interestingly, the study also revealed that half of the participants found it easier to abstain from both substances than it was to stop marijuana or tobacco individually, whereas the remaining half had the opposite response.

"Given the general consensus among clinicians that it is harder to quit more than one substance at the same time, these results suggest the need for more research on treatment planning for people who concurrently use more than one drug on a regular basis," says Vandrey.

Vandrey's study, which appears in the January issue of the journal Drug and Alcohol Dependence, followed six men and six women at the University of Vermont in Burlington and Wake Forest University School of Medicine in Winston-Salem, N.C., for a total of six weeks. All were over 18 (median age 28.2 years), used marijuana at least 25 days a month and smoked at least 10 cigarettes a day. None of the subjects intended to quit using either substance, did not use any other illicit drugs in the prior month, were not on any psychotropic medication, did not have a psychiatric disorder, and if female, were not pregnant.

For the first week, participants maintained their normal use of cigarettes and marijuana. For the remaining five weeks, they were randomly chosen to refrain from using either cigarettes, marijuana or both substances for five-day periods separated by nine-day periods of normal use. In order to confirm abstinence, patients were given daily quantitative urine toxicology tests of tobacco and marijuana metabolites.

Withdrawal symptoms were self reported on a daily basis Monday through Friday using a withdrawal symptom checklist that listed scores for aggression, anger, appetite change, depressed mood, irritability, anxiety/nervousness, restlessness, sleep difficulty, strange dreams and other, less common withdrawal symptoms. Patients also provided an overall score for discomfort they experienced during each abstinence period.

Results showed that overall withdrawal severity associated with marijuana alone and tobacco alone was of similar frequency and intensity. Sleep disturbance seemed to be more pronounced during marijuana abstinence, while some of the general mood effects (anxiety, anger) seemed to be greater during tobacco abstinence. In addition, six of the participants reported that quitting both marijuana and tobacco at the same time was more difficult than quitting either drug alone, whereas the remaining six found that it was easier to quit marijuana or cigarettes individually than it was to abstain from the two substances simultaneously.

Vandrey recognizes that the small sample size is a limitation in this study, but the results are consistent with other studies indicating that marijuana withdrawal effects are clinically important.


Re: Marijuana Withdrawal As Bad As Withdrawal From Cigarettes

I used to smoke both and I'm happy to say that I no longer do either. Quitting marijuana was much easier for me than quitting cigarettes. I fought trying to quit smoking cigs for a long time. It was hard!!! I could put down the marijuana anytime, no problem.

I used to drink on top of that. I medicated myself because of past issues. I got past those issues and was able to break the dependency.

David Baxter PhD

Late Founder
Re: Marijuana Withdrawal As Bad As Withdrawal From Cigarettes

I suspect this article would have been better titled Marijuana Withdrawal Can Be As Bad As Withdrawal From Cigarettes.

Like anything, I'm sure it will turn out to be a function of several factors, including how often and how much the individual uses marijuana, how long s/he has been using, whether or not s/he also smokes tobacco, and undoubtedly personality factors and the presence or absence of either a mood disorder or an anxiety disorder.

I have seen individuals stop marijuana use and experience little or no difficulty doing so and others struggle in a way similar to that suggested by the article.

But I can say the same thing about quitting smoking.


It was easier for me to come up with money for a pack of cigs vs money to come up with a certain amount of marijuana. When you don't have the money, it's easier to quit. I've always thought it was more of a mental addiction than a physical one. Once I got it out of of my head it was easy to put down. Plus, I no longer had anything driving that urge to suppress past feelings since I had already put behind me what had happened in the past. When those feelings of hurt and anger were finally put to rest, everything else fell into place.


When I used to smoke marijuana, I found that I didn't experience noticeable withdrawals if I embarked readily on a regular exercise program, starting on the first day I stopped smoking. In my case, the exercise was always long-distance running. It seemed to replace something I was seeking to obtain from the marijuana, only the effect of the running was, to my sensibilities, far superior to the effect of the marijuana.

If I didn't or couldn't exercise right away, I would experience pretty serious withdrawals, mostly in the area of feeling constantly uptight and tense. Running relieved that sense of tension.
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