The symptoms of marijuana withdrawal can vary significantly from person to person, and are influenced by how much you use, how often you use, and a host of other personal factors. Even so, knowing what to anticipate may help further reduce any added stress that may accompany the dread of withdrawal. Importantly, it should also raise alarm bells if some symptoms lasting longer than expected, or if they are not showing signs of improvement.
Nervousness, Anxiety, and Hostility
Early on in the withdrawal process, mood symptoms can start to manifest, and range from irritability to depression to anxiety. Within just 24 hours of stopping marijuana, you may feel that your thoughts are trapped in a loop, or that you can’t stop worrying about issues that normally wouldn’t bother you. For others, nervousness may manifest as being more on edge: you may find that you are more easily irritated, or that you respond to situations with out-of-character anger, which may entail verbal or physical aggression. As many as 3 in 4 people who use marijuana regularly will feel anxious and on edge within 24 to 72 hours of abruptly stopping. Feelings of anxiety typically persist and peak within the first week of quitting but will gradually resolve and eventually disappear within two weeks (Budney, J Abnorm Psychol, 2003). In some people, however, symptoms can continue, or even worsen, over the first month of abstinence.
There are several reasons you may be experiencing all of these symptoms. First, irritability and anxiety are common across all substance use disorders and reflect the shared neural mechanism of removing a potent positive stimulus. Much of the anxiety you are experiencing therefore has to do with recalibration of the neurotransmitter balances in your brain. Second, you may have used cannabis as a tool to mitigate the negative feelings of stress or sadness in your everyday life. Maybe you smoked to dull your feelings of nervousness, or to take the edge off for a little while. Once the marijuana wore off, though, that anxiety returned, and restarted a vicious cycle of dependence.
With cessation of marijuana, everyday stressors can seem heightened, and withdrawal related anxiety can be a major source of temptation to self-medicate with marijuana. In fact, the anxiolytic effects of marijuana may be a huge factor in which you began using in the first place. Now, while you in the midst of anxiety, is the time to hold firm, and break the cycle. Remember that self-medicating with marijuana isn’t addressing the underlying problem, and that using only serves to delay your anxiety further down the line.
Try and find alternative ways to cope with the negative feelings caused by withdrawal. Consider ways of relaxing your body or mind when you feel anxiety creeping in, or perhaps find comfort and support in your family and friends. No matter what, don’t fall for the trick of self-medicating your withdrawal induced anxiety—you will thank yourself later for saying no in the moment.
If you are like most individuals abstaining from marijuana use, you have probably had difficulty falling asleep. Maybe you have had vivid, disturbing dreams since stopping cannabis, or worse yet, you haven’t been able to sleep at all. Sleep disturbance is the hallmark of marijuana withdrawal and occurs in about 70% of regular users (Livine, Drug Alc Depend, 2019). Because sleep is a vital physiologic function and time for the brain to recover from the events of the day, disruptions in sleep from marijuana withdrawal can be a source of major distress for people who are on already fatigued, on edge, or feeling down.
The biological and psychosocial factors that drive sleep changes in marijuana withdrawal are complex. Many individuals smoke before bed, and even infrequent users report subjective improvements in sleep quality after smoking, likening marijuana to a sleep aid. Chronic cannabis use, however, is actually disruptive to sleep, by interrupting normal sleep architecture, in part through its actions at the CB1 receptor (Kesner, Front Mol Neurosci, 2020). In fact, sleep studies of people in the first week of cannabis withdrawal have shown changes in almost every phase of sleep, including longer time to fall asleep, decreased total sleep time, and poorer sleep efficiency. What’s more, increased time in REM sleep likely contributes to vivid and disturbing dreams (Gates, Subst Abus, 2016; Garcia, Am J Addict, 2015). This again creates a vicious cycle: cannabis disrupts sleep and contributes to feelings of tiredness, which motivates users to smoke more due to the perception that they achieve better sleep.
Finding strategies to compensate for sleep disruptions during withdrawal and improving the routines you have when it’s time for bed can be a major predictor of how likely you are to relapse (Angarita, Addiction Science & Clinical Practice, 2016). Ensuring that you have a healthy routine surrounding sleep, or “sleep hygiene”, is vital to minimizing the sleep disturbances that may be exacerbated by marijuana withdrawal. First, avoiding caffeine, large meals, or screen time immediately before bed can eliminate confusing signals to your body that it should stay awake. Regular exercise can also produce a healthy physical fatigue that helps promote sleep. Keep your bedroom environment reserved only for sleep and sex and ensure that lighting is low, and sound is minimized. Instituting a sleep-promoting routine—a warm bath, stretching, meditation, or reading—can help as well.
Other tips to practice excellent sleep hygiene: if you find yourself lying in bed for more than 20 minutes, get up and do something else until you feel sleepy again. Restricting the amount of time you spend in bed to only those moments when you feel sleepy helps your body associate your bed with tiredness, rather than the angst of not being able to fall asleep.
Finally, if you find yourself still struggling with poor quality sleep weeks to months after cannabis, just find comfort in the fact that this is still normal, and part of the process.
GI upset is the most common physical symptom of marijuana withdrawal, affecting over 50% of users attempting to abstain, and can manifest itself in a multitude of ways. It might be nausea, food aversion, or loss of appetite. Others may have upset stomach, or stomach pains. Less frequently, people may suffer from transient episodes of vomiting or diarrhea, and fortunately, these symptoms occur in less than 10% of users. While up to 29% of people will experience an acute decrease in appetite, both mild weight gain and weight loss are seen, and are the direct result of changes in amount of food intake (Levin, Drug Alcohol Depend, 2010).
Eating is one of the many joys that makes us human, and enhancement of the subjective experience of eating may have been one of the primary pleasures you derived from using marijuana. Feeling unable to eat, turned off by the plate before you, or physically uncomfortable during acute marijuana withdrawal can be incredibly vexing and disappointing. The good news is that, even though GI upset is the commonest physical symptom of marijuana withdrawal, it tends to be of quicker onset, quick peak intensity, and shorter duration than other marijuana withdrawal symptoms.
Though it may be difficult, the best way to get through this phase is to try and adhere to a normal meal schedule, and not by absence of hunger signals coming from your brain. If you don’t feel hungry, try to eat smaller portions, or otherwise consume healthy snacks throughout the day. Your body food in order to recover and function—even if your brain isn’t passing along the message appropriately. Make sure you give your body the fuel it needs to tackle these hurdles, and rest assured that your appetite will eventually return.
If you have been feeling down or depressed since stopping marijuana, just know you are not alone. Depression is a real and serious symptom of marijuana withdrawal affecting over half of regular marijuana users. The lack of energy and inability to enjoy the things around you may feel dreary—even scary. Some people describe a longing for who they used to be or worry that they may not ever experience the thrills of life again. It can be hard to even think about tomorrow when you are struggling with the emotions of today.
If these are thoughts you are having right now, know this: weed does not make you who you are.
This is your brain, fighting to regain control of the circuits that control happiness, pleasure, and reward. With chronic or heavy marijuana use, CB1 receptors located in areas of the brain that regulate reward become dulled over time. During withdrawal, the removal of the exogenous stimulus (THC) pushes those receptors and their pleasure-producing pathways into a state of hypoactivity. Hence your perceptions that the world is bleak, uninviting, and empty. Hence why you can’t muster the energy to do even the simplest of tasks.
It may sound impossible now, but depression, as with all other symptoms of withdrawal, will eventually go away. Instead of seeing the world through a window blurred by marijuana, imagine being able to take in the beauty of the world with no filters, and no disguises. Take some time to think about what you were really like when you smoked. What was the thing about your life with marijuana that you wanted to change in the first place? Hold on to that—that’s what you have to look forward to with the new day.
Headaches are a common marijuana withdrawal symptom. Headaches are not experienced by everyone who quits using, but for some, they can be intense and even debilitating. The headaches can be localized to any part of the head and usually present in more than one location.
In affected individuals, headaches typically start 1-3 days after quitting and may become more severe within the first week. In most cases, after about two weeks, the symptoms generally subside. However, some former-marijuana users report persistent headaches for weeks or months after quitting.
Research shows that marijuana withdrawal headaches can be common in younger marijuana users. In a 2006 study of 72 marijuana users aged 14 to 19, 25% reported moderate or severe headaches during withdrawal (Vandrey, Drug and alcohol depend, 2005). A separate 2012 study found that the earlier age of first marijuana use was correlated with higher incidence of headache – interestingly, this correlation was not observed in other commonly abused substances (Beckmann, Clinical neurology and neurosurg, 2012).
More recent research is beginning to shed light on the cause of headaches during marijuana withdrawal. THC has been shown to have direct action on many areas of the brain related to pain regulation. THC binds to CB1 receptors in the brain but also interacts with other receptors including serotonin, NMDA, and dopamine receptors. When the brain is no longer flooded by THC and other cannabinoids, the system must readjust, which is believed to cause to headaches in some (Elsohly, Life Sci, 2005; EP Baron, Headache Currents, 2018).
People who report headaches as a long-term side effect of quitting marijuana may find it hard to cope. However, if you suffer from these types of headaches, do not despair. There are things you can do to fight back.
First contact your doctor. They may discover that your headaches are caused another, non-marijuana related condition or they may be able to treat your headaches with medications. Additionally, certain lifestyle modifications could help ease your withdrawal-related headaches including meditation, regular exercise, eating a balanced diet, and good sleep hygiene.
The experience of brain fog is in the name itself: it’s like a haze that drifts over your mind, affecting your ability to think, reason, remember, or concentrate. According to the Merriam-Webster dictionary, brain for is “a usually temporary state of diminished mental capacity marked by inability to concentrate or to think or reason clearly.”
With cessation of marijuana, you might feel as though your brain just doesn’t seem to work as fast as you want it to. Some people describe feeling as through their brain and body are out of sync with each other. Other people experience more difficulty with concentrating on tasks, or difficulty with memory. As with other withdrawal symptoms, the cognitive difficulties you may encounter will be unique to you, and represent your brain recalibrating its neural circuity from extended marijuana use.
Again, there’s biology to explain why you’re feeling slow. More importantly, there’s also biology to explain why brain fog is not permanent. Acute marijuana intoxication is akin to putting your brain through a mental meat-grinder. In scientific studies, that translates to measurable impairments in verbal memory, attention, and basic motor coordination (Crean, J Addict Med, 2011; Broyd, Biol Psychiatry, 2016). There is further evidence to suggest that acute intoxication interferes with higher-level brain functions like planning, organizing, problem solving, decision-making and risk-taking, which are collectively referred to as executive functions.
Impairments in executive function will continue in the hours to days after stopping marijuana use and may last up to a month (Crean, J Addict Med, 2011). You will notice that some things, like your coordination, attention span, and short-term memory recover faster than others. That’s normal. Depending on how long you’ve smoked for, and how much you smoke, it may take longer for your brain to recover. By approximately 1 month, however, the differences in executive function in former heavy users and non-users approaches zero (Pope Jr, J Clin Pharmacol, 2002).
To summarize, the ultimate cure for brain fog is time. In the meantime, though you can optimize your actions and routines for your daily functioning. Eating healthy, exercising, and maximizing your sleep can help boost your brain processing while it’s on the mend from chronic marijuana use. If you’re having difficulty remembering tasks or items, make reminders for yourself with lists or alarms on your smartphone or devices. Be patient with yourself—we believe in you.
Changes in Libido
Talking about sex and sex drive can be awkward. Many people think that talking about sex is taboo—after all, what marijuana withdrawal have to do with libido? Because of these taboos and misconceptions, people often feel a sense of shame when it comes to talking about changes in sex drive. The truth is, though, that changes in libido are actually quite common in those that quit. Some studies indicate that nearly one third of users experience this withdrawal symptom during the cessation period (Levin, Drug Alcohol Depend, 2010). For some people, marijuana withdrawal causes decreases in sex drive, while for others, it actually increases sex drive. While 1 in 3 people may already seem like a lot, this likely still a vast underestimate of the true prevalence, since people are hesitant to report symptoms relating to sex.
Now that we’ve broken the silence, let’s take an even deeper dive.
Your libido, or sex drive, is influenced by both biologic and psychologic factors. From a the standpoint of the brain, sex drive is modulated by the interactions of several brain territories, the most important of these being the dopamine-driven reward center; CB1 activation by THC and natural cannabinoids therefore controls the release of many neurotransmitters that are key to sex physiology, including sexual arousal and sex drive (Klein, J Sex Med, 2012). This shouldn’t be too much of a surprise, as surveys indicate that acute marijuana use is associated with increased subjective sexual enjoyment (Dawley, J Clin Psychol, 1979). Not only are cannabinoid receptors found in the brain, though, they are also found in other sex hormone-producing organs like the adrenal glands and ovaries. After prolonged marijuana use, signaling through both these systems becomes altered. During withdrawal, dampened signals in the reward center, in particular, can make it difficult to achieve the same amount of sexual pleasure or even want to engage in sex at all.
There’s more to this story. Interestingly, studies of circulating cannabinoid levels in both animals and humans have shown that higher levels may actually be related to decreased sexual functioning (Lopez, Pharmacol Biochem Behav, 2009; Klein, J Sex Med, 2012). This may sound counterintuitive, but if you give it further thought, it provides a rationale for why many people actually report increased sex drive following cessation of marijuana.
Whether you end up feeling more or less excited about sex after you quit is going to depend on which of these opposing mechanisms has larger effect. Keep in mind that, in addition to the changing physiology that is happening in your brain and body, sex is intimately linked to your emotional state, your relationship dynamics, and a host of other extrinsic variables. The key to getting through what can seem like a physical and emotional rollercoaster is to be non-judgmental of yourself, and to communicate openly with your partner(s) about what you’re experiencing.
There you have it! Either way, rest easy knowing that your confusing, fluctuating libido is totally normal.
Cravings can be particularly strong during the early withdrawal period, and peak within the first week of quitting. In fact, in studies of people with cannabis withdrawal, cravings are frequently rated as being the strongest or most intense withdrawal symptom and occur in anywhere from 50-75% of users (Bonnet, Subst Abuse Rehabil, 2017). Unlike other withdrawal symptoms, which can be more continuous, and smoldering, the unpredictable timing and intensity of cravings can represent the biggest challenge for people who are trying to quit marijuana. If you’ve been there before, you know what we’re talking about.
That visceral feeling, or that voice in your head, telling you to smoke—that’s the impaired cannabinoid signaling in your brain, trying to propel your addiction at the same time that it’s trying to restore its normal neural connections. While the first few days are when cravings strike often, and hard, over time, your brain has the capacity to rewire and rebuild itself—the neuroscience term for this is synaptic plasticity. Again, the timing and severity of cravings depends on how long your brain has been exposed to marijuana, pre-disposing genetic factors, and your overall mood state (Parsons, Nat Rev Neurosci, 2015). As your endocannabinoid signaling systems establishes its new baseline, cravings will become less frequent, and you will find consistent and reliable strategies for suppressing them.
What brings on a craving is entirely person and situation dependent. Usually, you will be prone to cravings in physical environments or social contexts in which you formerly used marijuana. This might mean at bedtime, while watching a movie, or while hanging out with friend groups—especially if those friends are high. Other times, an intense craving sets in when your other withdrawal symptoms—insomnia, anxiety—are especially bad, as your body has become habituated to viewing marijuana as an alleviator of these unpleasant parallel effects.
These scenarios will pop up frequently during your first week of abstinence, as you adjust to a new routine of life without marijuana. Beyond avoiding these situations altogether (which represents a different strategy we will touch on later), the best way to avoid relapse when a craving arises is to redirect your attention. In other words, keep yourself busy. Don’t let yourself sit idly, and dwell on how much better you’d feel if you used again. You may get temporary relief, true, but if you’re on this journey, you have loftier goals.
So, what can you do to stay busy? Think of hobbies or projects you can pick up at home or find an outdoor activity if you are looking for a change of scenery. Maybe it’s finally time to tackle that house project that was pushed to the side by weed. Maybe it’s as simple as picking up a new book, playing music, or cooking more. Channel your cravings into physical exercise, which has been proven to enhance the body’s natural production of compounds that produce feelings of reward. Whatever you choose to occupy yourself with, remember that staying busy equals staying clean.
If you were a frequent user, a large portion of your day may have been spent smoking weed. Now that you aren’t doing that, your days may feel empty. You may work efficiently throughout the day without a giving a single thought to marijuana, but the second your free time hits, the angst sets in, and you feel the itch to use. Many people cite boredom as one of the hardest things to combat during the early cessation period, with 50% of people endorsing feeling bored, and 33% endorsing feeling restless (Levin, Drug Alcohol Depend, 2010).
What’s worse, boredom opens the door to cravings, depression, and anxiety. To be frank, boredom is oftentimes the common denominator underlying many of those symptoms. Boredom may be the real reason why you’re experiencing sadness, anxiety, or cravings. At its core, though boredom stems from a lack of fulfillment. Just remember: marijuana addiction was not, and is not, an activity, and therefore not a solution to boredom, even if it consumed large amounts of your time.
It’s not uncommon to have a hard time coming up with ways to meaningfully fill your time. Or maybe you already had hobbies you know you love but are having a hard time picking up where you left off. Being high all the time was likely obscuring what was truly fulfilling to you. Use this time now, to find something that gives you joy—that gives you energy, makes you ask questions, that gives your pride. If you’re new to this, know variety can be good, especially in the beginning. In the long run, active minds and bodies translate into better physical and mental health and can add years to your life. For now, though, if you can find something from which can derive internal pleasure—whether it’s a solitary activity or spending time with friends—it will go a long way in keeping you away from weed.
Weed withdrawal is cited by many chronic users as a cause of reduced productivity. Withdrawal-related losses in productivity are especially frustrating because many users decide to quit in part to improve productivity and job performance! The good news is that research suggests symptoms generally improve a few weeks after quitting.
Like many other marijuana withdrawal symptoms, those taking a break after periods of heavy use may experience varying degrees of decreased productivity and tiredness. A 2014 study which assessed marijuana symptoms 2-30 days after quitting found that most participants reported substantially increased tiredness and fatigue (Lee et al., American Journal of Addiction, 2014).
Decreased productivity may be related to deficits in sleep quality related to marijuana withdrawal. Sleep disturbance is a hallmark of marijuana withdrawal and occurs in about 70% of regular users (Livine, Drug Alc Depend, 2019). Because sleep is a vital physiologic function and time for the brain to recover from the events of the day, disruptions in sleep from marijuana withdrawal can be a source of major distress for people who are on already struggling to keep up.
Researchers do not completely understand the underlying causes of withdrawal-related productivity losses. However, studies have shown that marijuana has numerous effects on the brain’s cognitive decision-making abilities. One animal study in rats who were administered THC showed that long-term marijuana use ‘rewired’ parts of the brain responsible for attempting difficult or demanding tasks, resulting in decreased productivity after cessation of use (Silveira et al., Journal of Psychiatry Neuroscience, 2017).
Body Temperature Regulation
Regulation of body temperature is a critical and complicated process for human health. Deep, highly connected regions of the brain play essential roles in maintaining body temperature within a narrow range around 98° F (37° C). While many chronic marijuana users may be aware of withdrawal symptoms such as irritability or sleep difficulty, you may be surprised to learn that sudden changes in body temperature – feeling hot or cold – are reported by many individuals who have stopped using marijuana after periods of heavy use.
A 2011 study in chronic marijuana users observed increases in body temperature within 48 hours after stopping. These symptoms were reduced after 96 hours (Gorelick et al., Journal of clinical psychopharmacology, 2011). Other research shows that body temperature changes typically start after 1-2 days, reach peak incidence within six days, and can last anywhere from a few days to several months (Babson et al., Current psychiatry reports, 2017).
While the mechanism behind marijuana withdrawal-related body temperature dysregulation is not completely understood, THC has been shown to bind to many regions of the brain responsible for temperature regulation such as the hypothalamus and pituitary (Cservenka et al., Frontiers Psychiatry, 2018). It is believed that sudden absence of external THC and cannabinoids may disrupt this balance of pathways and hormones in the brain.
Changes in body temperature have also been reported in individuals suffering from cannabinoid hyperemesis syndrome (CHS), a cyclical vomiting illness that presents in some heavy marijuana users. In one study, patients admitted for CHS were shown to exhibit changes in body temperature, in addition to changes in blood pressure, heart rate, skin flushing, and perspiration (Allen et al., Gut, 2004). Interestingly, many CHS patients have reported that hot showers can provide symptomatic relief. The effect appears temperature dependent – e.g. hotter showers provided more relief from CHS.
Timeline of Marijuana Withdrawal
The first days and weeks after quitting marijuana can be a rollercoaster of thoughts, physical symptoms, and emotions. Though we provide a general timeline of typical withdrawal symptoms, everyone is different. Your experience with withdrawal is influenced by how much and how long you’ve used as well as a host of biological and psychosocial factors that make your experience wholly unique. So, use this as a general outline to mentally prepare yourself for what’s to come, but don’t be alarmed if your experience is a little different.