What is cannabis withdrawal?

Cannabis withdrawal is a constellation of psychological and physical symptoms that typically begin within days of stopping heavy, prolonged cannabis use and resolve over 1–3 weeks. Symptoms can include irritability, sleep disturbance, decreased appetite, anxiety and craving, and can contribute to relapse.

Typical timeline

• Onset: 24–72 hours after last use (sometimes earlier or up to a week).
• Peak severity: Days 2–6 after cessation.
• Duration: Most symptoms improve within 1–2 weeks; sleep disturbance and low mood can persist longer in some individuals.

Common symptoms

• Irritability, anger or aggression.
• Sleep problems: insomnia, vivid or disturbing dreams.
• Decreased appetite or weight loss.
• Restlessness, anxiety, depressed mood.
• Craving for cannabis and difficulty concentrating.
• Physical symptoms: stomach pain, tremor, sweating, feverishness or headache (less common).

Risk factors for severe withdrawal

• High‑frequency daily use and high‑potency products.
• Long duration of use (months to years).
• Concurrent use of other substances (alcohol, benzodiazepines, stimulants).
• Underlying psychiatric disorders (anxiety, depression, bipolar disorder).

Assessment

1. Obtain a detailed substance history: quantity, frequency, product type (edibles/vape/flower), duration, last use and prior withdrawal experiences.
2. Assess severity using clinical interview and consider using structured tools (withdrawal symptom checklists, craving scales).
3. Screen for comorbid psychiatric conditions and suicide risk — withdrawal can unmask or worsen mood disorders.
4. Evaluate social supports, housing, employment and readiness to change; identify triggers for relapse.

Management principles

• Most withdrawal is mild-to-moderate and managed in outpatient settings with supportive care and psychoeducation.
• Provide clear information about expected timeline, normalising symptoms and emphasising relapse prevention strategies.
• Use behavioural interventions: CBT for substance use, motivational interviewing, sleep hygiene and relaxation techniques.
• Offer psychosocial supports: peer groups, contingency management, vocational or educational support where available.

Pharmacological options (evidence and cautions)

• No medication is universally approved for cannabis withdrawal; pharmacotherapy is considered symptomatic or experimental.
• Sleep disturbance: melatonin or short-term hypnotics can be considered with caution and clear exit plan.
• For severe anxiety or agitation: short-term benzodiazepines may help but carry dependence risk—use only briefly and monitor closely.
• Emerging/limited evidence: gabapentin, nabilone (synthetic cannabinoid) and certain antidepressants have shown promise in trials but require specialist oversight and risk–benefit discussion.

When to consider higher level care

• Severe psychiatric symptoms (suicidality, psychosis) or inability to function—consider psychiatric admission.
• Polysubstance withdrawal or medical instability—consider inpatient detoxification or medical monitoring.
• Repeated relapse despite outpatient support—refer to specialist addiction services for structured programs.

Key takeaways

• Cannabis withdrawal is common after heavy use and is an important reason for relapse; expect onset within days and resolution over 1–3 weeks for most people.
• Primary management is supportive and psychosocial — CBT, sleep hygiene, motivational strategies and peer support.
• Use pharmacotherapy selectively and with caution; refer complex or severe cases to specialist addiction or psychiatric services.