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Withdrawal Symptoms Common for Patients Using Cannabis for Pain Management

A study based out of the University of Michigan Addiction Center found that more than half of those who use cannabis as a tool in pain management experience multiple withdrawal symptoms between uses. Their paper was published in the journal Addiction.

Led by Lara Coughlin, Ph.D., an addiction psychologist at the University of Michigan, the researchers examined how withdrawal symptoms evolved over time, surveying the study’s 527 participants one and two years after their initial survey. Symptoms of withdrawal included: aggression, anger, anxiety, cravings for cannabis, decreased appetite, depressed mood, headache, irritability, nausea, restlessness, shakiness, sleep difficulties, stomach pain, strange dreams, and sweating. At baseline, 41% of participants had mild symptoms, 34% had moderate symptoms (i.e. multiple withdrawal symptoms), and 25% qualified as having severe symptoms. Sleep problems were more common than other symptoms across all three classes, while nearly all participants in the severe group also reported anxiety and irritability, as well as sleep problems.

Though approximately 10% of those who took part in the study claimed that their energy levels, appetite, mood, mental state, and quality of sleep diminished over the two years that they used cannabis, the study found that symptom severity tended to trend downward or to remain static. Over the course of two years, those with mild symptoms were likely to continue to experience mild symptoms, those with moderate symptoms were likely to transition into the mild category, and the percentage of participants with severe symptoms had dropped to 17%.

The paper helps to identify the risks associated with using cannabis to treat conditions like chronic pain and should serve as a reminder to clinicians to inform patients that these symptoms could be an indication of cannabis use disorder. “Some people report experiencing significant benefits from medical cannabis,” said Dr. Coughlin, “But our findings suggest a real need to increase awareness about the signs of withdrawal symptoms developing to decrease the potential downsides of cannabis use, especially among those who experience severe or worsening symptoms over time.”

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