Liz Benton recently quit weed after smoking it at least once a day for seven years — and the first week was especially brutal. Within two days of quitting, she experienced a panic attack. She struggled to fall asleep, and when she did, she’d have horrifying nightmares, or wake up in the middle of the night, drenched in sweat.
“My anxiety was through the roof,” Benton — a 33-year-old Oakland resident — recalls of her experience five years ago. Her head throbbed with a dull, persistent ache, and her stomach felt queasy. She couldn’t bring herself to eat. Her symptoms finally subsided roughly three weeks later, but it took a full month for her to feel like her normal self again.
Benton may have been experiencing cannabis withdrawal syndrome, which medical professionals are only beginning to understand. In fact, it didn’t appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM) — the psychiatry “bible,” used to diagnose mental health issues — until the release of the most recent edition of the DSM in 2013. According to this edition, the DSM-5, signs of cannabis withdrawal can include anxiety, depressed mood, irritability, lowered appetite, difficulty sleeping, restlessness, and various uncomfortable physical symptoms.
“Typically this happens in chronic or heavy cannabis users” — those who imbibe every day, says Yu-Fung Lin, an associate professor at the University of California, Davis who teaches a course on the physiology of cannabis.
Cannabis withdrawal syndrome can be triggered by not only quitting weed altogether, but also significantly decreasing your use of it.
Unlike alcohol withdrawal, which can be deadly, cannabis withdrawal isn’t life-threatening, says Timothy Fong, a professor of psychiatry who helps lead the UCLA Cannabis Research Initiative. Nonetheless, “it can be debilitating, and can create a lot of physical and emotional suffering.”
Cannabis withdrawal syndrome can be triggered by not only quitting weed altogether, but also significantly decreasing your use of it. The minimum reduction needed to cause withdrawal varies from person to person, though, reflecting our individual biological differences, Fong says.
When you heavily use cannabis, you drastically increase the levels of the high-inducing compound tetrahydrocannabinol (THC) in your bloodstream. To restore balance, your body alters its natural levels of THC receptors, as well as neurochemicals like serotonin and adrenaline. Removing cannabis (or drastically reducing your intake of it) throws off this balance, which your body has to restore by once again altering THC receptor and neurochemical levels.
“When you’re in a state of withdrawal… your body is working hard to get to normal function,” Fong tells Mic. “It’s such a stress on the body” — which explains why it feels like death. Abnormal serotonin levels can lead to nausea, for example.
If you’re a heavy, chronic cannabis user, you might begin to notice withdrawal symptoms roughly a day after you last used weed, Lin says (although Fong has seen symptoms emerge as early as a few hours later). They usually peak one to four days after the last use and gradually dissipate in a few weeks’ time. Benton’s experience fit this description. “By day three or four is when I really started to feel it,” she recalls.
But this timeline, as well as particulars about the onset and duration of certain symptoms, again, differs from one person to the next. Basically, “this is a really individual and unique experience,” Fong says. For instance, just because your friend’s muscles began aching within four days of quitting doesn’t necessarily mean that’ll be the case for you. And not everyone who quits cannabis, or drastically reduces their consumption of it, experiences withdrawal. One recent study of heavy cannabis users found that about 12% did so.
Frequency seems to be more important than potency; Lin notes that consuming weed every day, even at low doses of THC, can result in the biochemical changes that might, in turn, lead to withdrawal.
More about the risk factors for withdrawal: While this is an area where we definitely need a lot more science, Fong says, we can surmise is that “if you do high potency [that is, high-THC] products several times per day, that’s probably going to set you up for a higher likelihood of withdrawal.”
But frequency seems to be more important than potency; Lin notes that consuming weed every day, even at low doses of THC, can result in the biochemical changes that might, in turn, lead to withdrawal. Health issues like a lack of sleep, dehydration, and poor nutrition can render you even more vulnerable to the stress of restoring normal body function, Fong notes.
Fong says he isn’t aware of any risk factors associated with specific types of cannabis products. Your risk might increase if you smoke high-potency concentrates like wax or shatter, but again, only if you do so every day. The same goes for edibles, although most of the patients he and his colleagues see at the UCLA Addiction Medicine Clinic aren’t pounding edibles on the daily.
If you think you’re experiencing cannabis withdrawal syndrome, Fong suggests asking your doctor to connect you to an addiction professional, who can give you anxiety medications and other interventions to help alleviate your symptoms. If you don’t have insurance, or your plan doesn’t cover addiction treatment, look for no-cost, publicly-funded or nonprofit treatment programs, or medical clinics.
Benton didn’t receive addiction treatment, but she found relief in anxiety-reducing strategies, like listening to a meditation app, and taking a cold shower, which helped still her racing mind and ground her in the present.
Quitting weed has its upsides, though. The moment you stop using it on a regular basis, your body starts reverting back to what it used be before you started smoking weed, Fong says. And if you struggle with cannabis addiction, or you want to quit for other reasons, getting through withdrawal is the first step to foregoing cannabis for good.
The moment you stop using it on a regular basis, your body starts reverting back to what it used be before you started smoking weed
While it might seem intuitive that quitting smoking weed would restore your lung function, it may actually result in little, if any, respiratory benefits. Tobacco and nicotine are clearly terrible for your lungs, but whether the same holds true for cannabis is still up for debate, Fong says. (Vaping cannabis can lead to lung injury, but because of other stuff in e-juice, not THC.)
After her withdrawal symptoms faded, Benton found that she had more energy for exercise and other activities than she did when she was still smoking weed. She ate and slept more consistently, too.
The biggest benefits of quitting, though, were mental and emotional. Her mind felt clearer, and she renewed her commitment to therapy. She realized how heavily she had relied on weed to self-medicate her anxiety. “I was forced to address other things in my mental health because I couldn’t use it as a crutch anymore,” she says. Cannabis withdrawal sucks, but you can survive it, and you may even gain a few powerful insights about yourself along the way.
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