Guide to Cannabis Withdrawal: Symptoms and Timeline

Cannabis Identification

Cannabis is the most popular illicit drug in the United States.[1] It comes from the cannabis sativa plant, commonly known as Indian hemp, and is available in various forms. Cannabis is frequently adulterated to enhance the potency of the active ingredient tetrahydrocannabinol (THC), which produces a “high.” This occurs because THC possesses psychoactive properties that interact with areas in the brain responsible for thought, mood, motivation, and movement.[1]

Mechanism of Action: Mental and Physical Effects of Cannabis Use

People frequently smoke marijuana to experience its effects. Once the smoke enters the lungs, it is rapidly absorbed into the bloodstream, where it is then distributed to various tissues and organs that comprise the endocannabinoid system. [2] Here, it interacts with receptors that regulate pain, memory, metabolism, appetite, immunity, and even the cardiopulmonary system.

After ingestion, the user will immediately experience a mellow mood, followed by profound physical relaxation. Their perception of time will slow down, along with physical movements, due to motor skill impairment. Conversely, some users may feel startled by the abrupt change in their mood, leading to feelings of anxiety and paranoia. However, this reaction is more common with concentrated or potent strains of cannabis, such as hashish or ganja.[3]

Other symptoms people are likely to experience after ingesting cannabis include:[4]

• Restlessness
• Increased appetite
• Elevated heart rate
• Impaired thinking
• Impaired memory
• Shakiness
• Sleep disturbances

According to Northwestern University, a marijuana high can last a lot longer than expected, and that time differs depending on the route of administration.[5]

These times are as follows (especially with regular use):[5]

• Smoking: Effects peak by 10 minutes but generally last one to three hours.
• Eating: Effects peak at two hours but can last up to 24 hours.
• Dabbing: Effects last one to three hours, though higher concentrations can produce a high lasting 24 hours.

Note: Effects may differ depending on the amount taken, how it is ingested, underlying medical conditions, age, sex, and potency.[4] 

What Causes Cannabis Withdrawal?

A problematic pattern of cannabis use can lead to tolerance, necessitating a higher amount of cannabis to achieve intoxication. Individuals who develop tolerance through regular cannabis use may have cannabis use disorder (CUD). According to the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), people with cannabis use disorder often experience a strong desire to use cannabis or a preoccupation with wanting to use it during periods of cessation.[6] They may continue using cannabis despite facing social or interpersonal issues and may engage in increased risk-taking to obtain it.

Aside from building a tolerance to marijuana, chronic users may also develop dependence. Besides developing a tolerance to marijuana, chronic users may also become dependent. According to the Florida Board of Medicine, marijuana dependence occurs when the brain decreases the production of endocannabinoid neurotransmitters due to the continuous presence of cannabis, which affects their levels.[7] This leads to the user experiencing uncomfortable symptoms in its absence and even some mental health disorders.

Cannabis Withdrawal Symptoms

Symptoms of withdrawal can range from mild to severe and include physical symptoms and psychological symptoms. According to the National Library of Medicine, people with cannabis withdrawal syndrome (CWS) experience the following common symptoms:[8]

• Nervousness
• Anxiety
• Hostility
• Insomnia
• Restlessness
• Depressed mood
• Decreased appetite
• Weight loss

Severe withdrawal symptoms are less commonly experienced with regular marijuana use. However, individuals who engage in polysubstance use, such as combining opioids with marijuana, are more likely to experience them. [8]

They include adverse effects such as:[8]

• Fever
• Chills
• Stomach pain
• Sleep problems

Researchers found CWS to be highly comorbid and disabling due to its overlapping symptoms with anxiety disorders and depression.[8] They also discovered that individuals who used cannabis recreationally were not the only ones facing withdrawal side effects after cessation. Dr. Lara Coughlin, PhD – assistant professor of Psychiatry at Michigan University – along with her colleagues, found that even those using cannabis for medicinal purposes experienced CWS. Hours and days after their last use, these medicinal marijuana users faced moderate to severe symptoms.[9]

Cannabis Withdrawal Timeline 

The cannabis withdrawal timeline is a rough estimate of how long a person going through cannabis withdrawal will experience symptoms. This estimate is subject to change based on the admission route and several biological factors. However, experts agree that most people will experience CWS symptoms within 24 to 48 hours of cessation. These symptoms generally peak at days two through six, though it isn’t unheard of for heavy cannabis users to experience symptoms lasting up to three weeks.

What is the Cannabis Elimination Half-Life?

An elimination half-life is the time it takes a substance to be reduced in the body by half.[11] It takes approximately four to five times a substance’s elimination half-life to fully leave the system.[11] For THC, the elimination half-life is between one and 13 days.[12] However, it can be detected in urine weeks to months after last use.

Does Cannabis Withdrawal Signal Addiction?

Cannabis withdrawal is a set of symptoms experienced by individuals with cannabis use disorder (CUD). When someone with CUD abstains from cannabis use, they will experience cannabis withdrawal symptoms hours or even days later. However, cannabis use disorder is not a full-blown addiction.

Cannabis use disorder belongs to a group of conditions called substance use disorders. The most severe form of a substance use disorder is addiction.[13] Someone with a cannabis addiction may display several signs that overlap with those of a cannabis use disorder.

They include:[14]

• Changes in physical appearance (such as weight loss or gain)
• Appearing drowsy or under the influence more often than not
• Needing to use more cannabis than before to feel its effects
• Lying to family or friends about cannabis use
• Frequently using cannabis products
• Frequent Mood swings or outbursts
• Losing interest in favorite hobbies

A person with a cannabis addiction may find it challenging to quit on their own due to persistent drug cravings and other uncomfortable withdrawal symptoms. Fortunately, there are evidence-based programs available, such as medical detox, to assist them in overcoming addiction and behavioral therapy to help identify the triggers that lead to their use. In fact, most CUD programs follow a comprehensive approach to treatment involving monitored detoxification, behavioral therapy, and peer support groups.

Besides the programs mentioned above, facilities like Southeast Detox GA provide dual diagnosis services aimed at addressing cannabis addiction alongside any co-occurring mental health conditions. This approach is vital because untreated or unrecognized mental health disorders often exacerbate substance use.

For more information on the programs available at Southeast Detox GA and how they can assist you or a loved one in overcoming drug use and abuse, reach out to us today.