Introduction

Cannabis is commonly used among individuals today, and overuse of the drug can lead to withdrawal, which is a growing issue in society. Common symptoms of cannabis withdrawal include anger, sleep disturbances, a decline in overall physical health, which can eventually lead to difficulty functioning in daily life. Cannabis withdrawal has both social and occupational effects, and there is a range of strategies to help mitigate the side effects. For example, antidepressants have been used to support individuals with mental health conditions as well as cognitive behavioural therapy.¹ Although cannabis dependence is not considered as severe as that of tobacco or alcohol, the withdrawal symptoms can be difficult to manage, especially for individuals predisposed to mental health issues and anxiety.² This article is going to delve into the issues associated with cannabis dependence and withdrawal and will explore the different strategies that can be used to manage these symptoms. Strategies to avoid addiction relapse with also be explored.

Understanding cannabis withdrawal

Withdrawal symptoms mainly occur due to tetrahydrocannabinol (THC) and the endocannabinoid system (ECS) not working properly. THC affects how the ECS works, which regulates nerve activity, and also greatly impacts human psychology. This is due to the two cannabinoid receptors, called cannabinoid type-1 and type-2 (CB1R and CB2R), binding to THC. When THC binds to these receptors, which are involved in mood changes, they become less active when cannabis is consumed for a long time. 

CB1R becomes much less active after THC exposure, so these receptors are not activated as much when people stop using cannabis, which can lead to major psychological changes such as depression and anxiety.³ The effects on the CB1 receptor have led to the use of agonist and antagonist drugs to try and overcome withdrawal. However, there are other, less experimental strategies to help manage cannabis withdrawal.⁴

Cannabis withdrawal symptoms usually follow a very common timeline. Typically, symptoms begin after two days and include anger, sleep disturbances and a decrease in appetite. These symptoms become more severe between days 2-6, then gradually level out over the next fourteen to twenty-one days. Depending on how long cannabis use lasted before quitting, the length of symptoms differs and is highly individual.⁵

General principles for coping with withdrawal

There are many ways to deal with cannabis withdrawal. It is very important for those around people recovering from withdrawal, such as close family and friends, to provide support during the recovery process. It is integral that compassion and understanding are shown to people recovering from cannabis addiction, and that self-compassion helps those in recovery to stop cannabis consumption effectively. 

It still needs to be clarified through scientific evidence whether gradual cessation is helpful for withdrawal or if abrupt cessation is a better method to quit cannabis use.⁶ In order to establish the best methods to cope with withdrawal, healthcare professionals and regular monitoring and consultations are required to find a suitable strategy for managing withdrawal symptoms and effects.

Effective coping strategies

Coping strategies for withdrawal can be characterised into three different types: physical, psychological, and social, along with alternative therapy methods. 

Physical strategies

Exercise is a very important coping mechanism. Physical activities such as jogging, swimming and even yoga have been strongly linked to better mental health outcomes, with studies demonstrating that people with anxiety benefit from higher physical activity levels.⁷ Diet is another very important physical factor, with studies showing that diets rich in fibrous foods such as vegetables can lower fatigue. Omega-3 fatty acids are anti-inflammatory, and the reduction in inflammation due to a controlled diet lowers the likelihood of fatigue during withdrawal.⁸ Diets containing foods that are high in gluten and histamines, such as processed foods and alcohol, should also be avoided, as these foods typically lead to an increased risk of headaches, which is a major withdrawal symptom.⁹ Cannabis leads to sleeping disorders, and this is also common during withdrawal; therefore, proper management of sleep and addressing symptoms such as insomnia is necessary to mitigate these risks. Encouraging regular sleeping patterns will also reduce fatigue.¹⁰ Meditation has also been linked to a lower likelihood of substance abuse and relapse, and meditation is known to make withdrawal easier for those affected by this phenomenon.¹¹

Psychological strategies

Psychological strategies are also widely utilised by those suffering from withdrawal. As aforementioned, meditation has the potential to reduce anxiety in those experiencing withdrawal, and this can be administered in a multitude of ways, including special applications on phones as well as in-person classes.⁹ Cognitive behavioural techniques (CBT) are also very popular. This type of psychological therapy is used to identify cognitive changes and use this to elucidate what causes negative thoughts and alter the mood associated with these triggers to eliminate these outcomes. CBT is also utilised to lower the chance of relapse, helping to prevent cannabis use from resurfacing in the future.¹² Another effective method involves writing down progress on symptom management and personal thoughts in a journal, allowing individuals to monitor their recovery over time. Reflecting on past experiences is important during this stage as it can reinforce the positive effects of quitting cannabis.¹³

Social support and emotional wellbeing

Emotional support and availability are also paramount in ensuring a safe recovery. For example, support groups are a great way for those affected to share experiences and lower the social anxiety associated with addiction. The families and friends of those withdrawing from cannabis use are a very important support network, and psychiatric therapy and counselling also help to identify the reasons behind addiction and triggers.¹⁴ Professional help can allow people to delve into why they started taking cannabis in the first place; therefore, by pinpointing this, the chance of a relapse lowers.

Alternative and complementary therapies

Less common therapies involving herbal medicines such as valerian and chamomile are utilised for depression, anxiety and sleeping disorders; however, the mechanisms behind positive outcomes are less well documented and need to be researched further.¹⁵ Polyunsaturated fatty acids such as omega-3 are useful in treating depression.¹⁶ Aromatherapy using inhalers with aromas such as lavender has been shown in some studies to decrease stress and anxiety levels; however, more research needs to be conducted before the prevalence of this strategy increases for those coping with withdrawal symptoms.¹⁷

Avoiding relapse

There are several ways to avoid a relapse. Certain triggers for relapse are well known, such as stressful situations or anything that reminds the individual of past traumatic experiences.¹⁸ Identifying these triggers is crucial in such cases. 

The time previously spent on substance use can be redirected towards a new hobby or activity. This can improve mental health and help distract individuals from cravings in many instances.¹⁹ Support networks are available for those who need advice on managing cravings and urges. Distraction is an effective strategy for supporting recovery.

Seeking professional help

It is important to seek professional help when the cannabis withdrawal symptoms occurring become very severe, such as tremors and hallucinations. Severe withdrawal is characterised by more than six symptoms, compared to mild and moderate withdrawal, where individuals typically present with two, three, or four to five symptoms, respectively.⁵ People with mental health conditions are also more likely to experience more severe withdrawal, as they have a higher chance of developing additional anxiety or depression. Thus, individuals with these conditions may be more likely to require professional intervention. 

Rehabilitation programmes are available. For example, some therapeutic communities involve individuals in recovery living together and learning skills to prevent relapse. Drug rehabilitation programmes are generally successful.²⁰ There are also web and telephone-based resources and counselling for those struggling with withdrawal. These resources are important, as some individuals in recovery may not feel comfortable interacting with others in person initially.²¹

Summary

Overall, cannabis withdrawal symptoms typically do not last for an extended time and can be managed effectively through various strategies. Physical approaches such as exercise and nutrition, are very important, alongside physiological interventions like CBT. 

There are also less commonly used methods, such as aromatherapy, available. However, a support network should not be underestimated. Emotional support for individuals experiencing withdrawal symptoms is vital and can significantly improve outcomes. 

It is crucial that individuals recovering from withdrawal symptoms feel confident seeking professional help when needed and know where to find support. There are various initiatives available for individuals experiencing these issues, and a broader community effort to help individuals struggling with addiction will lead to fewer cannabis users and addicts in the future. 

Encouraging individuals to take up new hobbies and addressing broader mental health issues that lead to cannabis use will help reduce the number of people recovering from withdrawal. Further initiatives and research into why individuals use cannabis and how to treat withdrawal symptoms will help reduce relapses. Improved coping strategies will enhance the lives of many for years to come.