As medical director for Medical Cannabis of Southern California I often evaluate patients who had used cannabis extensively for a long period of time prior to using it as a medication.   Many of these patients do in fact discuss similar withdrawal symptoms if they abruptly stop medicating.    Common complaints are irritability, anxiety, insomnia and difficulty focusing. Although cannabis as a medication is generally very safe I think these withdrawal symptoms warrant discussion.

Cannabinoids (the medically active ingredients in the plant) work by entering our body and bind to receptors on individual cells in the nervous and immune system.    Once the medicine binds to the receptor it causes changes to occur in the cell.   What can happen over time is that when receptors are constantly being bombarded(stimulated) by cannabis they can become less responsive to the cannabinoids (almost like “oh its you again… what do you want this time).  We see this in patients who develop diabetes.  High blood sugars lead to an increase and continuous release of insulin (which binds to cells and tells the cell to eat up the sugar) which bombard insulin receptors.  Over time these receptors are less responsive to the insulin and patients have hhigh blood sugar levels.

Although much more research needs to be done it makes sense that a similar situation occurs with cannabis.  The receptors most likely get fatigued and become less responsive to the cannabinoids.   The question becomes what happens if you stop using cannabis.  What makes sense is that these receptors are so used to becoming stimulated daily that the body reacts on a cellular level causing the symptoms people describe.    This is very similar to SSRI’s that patients take for depression.  Abruptly stoping them causes A LOT of issues.  THis is why patients are told to taper off slowly over time.

What I recommend for patients who regularly use cannabis is to give their bodies a break pretty frequently is possible.   Once a month go 3-5 days without it and let you body adjust naturally.   If you find that you are still having symptoms of withdrawal then maybe take breaks more frequently.

Whenever you use a medication you always have to weigh the benefits and risks.  If you are using cannabis for pain and your symptoms improve but you have to deal with mind withdrawal symptoms if you stop for a few days then it is probably worth it to continue.  You ultimately have to determine if the benefits outweigh the risks.

Be blessed,

Dr. Breeen