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Alan J. Budney, PhD; John R. Hughes, MD; Brent A. Moore, PhD; Pam L. Novy, PhD

Arch Gen Psychiatry. 2001;58:917-924.

Background  Although withdrawal symptoms are commonly reported by persons seeking treatment for marijuana dependence, the validity and clinical significance of a marijuana withdrawal syndrome has not been established. This controlled outpatient study examined the reliability and specificity of the abstinence effects that occur when daily marijuana users abruptly stop smoking marijuana.

Methods  Twelve daily marijuana smokers were assessed on 16 consecutive days during which they smoked marijuana as usual (days 1-5), abstained from smoking marijuana (days 6-8), returned to smoking marijuana (days 9-13), and again abstained from smoking marijuana (days 14-16).

Results  An overall measure of withdrawal discomfort increased significantly during the abstinence phases and returned to baseline when marijuana smoking resumed. Craving for marijuana, decreased appetite, sleep difficulty, and weight loss reliably changed across the smoking and abstinence phases. Aggression, anger, irritability, restlessness, and strange dreams increased significantly during one abstinence phase, but not the other. Collateral observers confirmed participant reports of these symptoms.

Conclusions  This study validated several specific effects of marijuana abstinence in heavy marijuana users, and showed they were reliable and clinically significant. These withdrawal effects appear similar in type and magnitude to those observed in studies of nicotine withdrawal.

From the Departments of Psychiatry (Drs Budney, Hughes, and Moore) and Psychology (Drs Budney and Hughes), The University of Vermont, Burlington; and the US Air Force, Biomedical Science Corps, Minot, ND (Dr Novy).

Corresponding author and reprints: Alan J. Budney, PhD, Department of Psychiatry, The University of Vermont, 54 W Twin Oaks Terr, Suite 9, S Burlington, VT 05403 (e-mail: abudney{at}zoo.uvm.edu).

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