Cannabidiol (CBD) for the management of cannabis withdrawal: a phase II proof of concept open label study
This is a feasibility study to test the effectiveness of cannabidiol (CBD) for alleviating cannabis withdrawal symptoms in a 6 night inpatient detoxification program.
Dr Nghi Phung
Western Sydney Local Health District
Prof Martin Weltman
To assess the effectiveness of CBD in reducing cannabis withdrawal symptoms.
This is a single subject repeated measures design, whereby one subject is assessed at baseline/time 1, given the intervention (CBD) and assessed again at time 2 (Day 3 of detox) and time 3 (day 7 of detox) and time 4 (28 days post admission follow-up) in addition to daily Cannabis Withdrawal Scale completion. This process is then repeated with 7 additional participants in order to replicate the findings. The intervention consists of 300mg of CBD on day 1, 300mg of CBD morning and night on days 2-5 and 300mg of CBD on day 6 for n=5 and 600mg BD for a further 3 participants. The aim of the assessment is to measure the safety and acceptability of the medication in reducing self-reported withdrawal symptoms.
The study has been completed.
The medication was found to be acceptable and free of adverse events even at the dose of 1200mg/day.
Presentation at national and international conferences. The findings are currently being prepared for peer reviewed journal publication.
These data provide support for funding submissions for a double blind randomised controlled trial.
Coping with cannabis withdrawal symptoms
If you use cannabis (weed) regularly you may get withdrawal symptoms when you cut down or stop.
Withdrawal symptoms are a positive sign that your body is recovering. They usually stop within a few weeks.
Here’s some advice to help you get through them.
Signs of cannabis withdrawal
It’s normal to experience low mood and cravings when you cut down or stop any drug.
If you cut down or stop cannabis, you may also experience:
- sleep problems
- strange dreams
- anxiety and restlessness
- irritability and anger
- sweats and chills
- changes in your appetite
- nicotine withdrawal (if you smoke cannabis with tobacco)
Cannabis withdrawal symptoms usually peak about four days after you stop or cut down.
They will probably be more intense if:
- you stop completely rather than cutting down
- you smoke cannabis every day or most days
Most symptoms stop by 10 days but some people carry on getting them for up to four weeks.
This is because the active ingredients in cannabis are stored in fat cells in your body. It takes up to four weeks for your fat cells to release them all.
How to handle cannabis withdrawal symptoms
Cannabis withdrawal symptoms can be difficult to deal with but they don’t last forever.
Be kind and patient with yourself as your body recovers.
You can expect a few sleepless nights when you give up cannabis, especially if you use it to help you sleep.
To help you sleep better:
- Get up and go to bed at the same times each day – having a regular sleep routine helps to train your body to fall asleep at the same time each night.
- Have a calming bedtime routine – having the same routine each night tells your body it’s time to sleep. Include calming things like a warm bath, reading or watching TV in your routine – whatever helps you feel relaxed and sleepy.
- Avoid going on your phone just before bed – the light from the screen makes it harder for your brain to switch off and go to sleep.
- Get out and about during the day – even a short walk in daylight hours will improve your mood and your sleep, and help with stress and anxiety too.
You'll find 10 tips to beat insomnia on the NHS website.
Some people start having strange or disturbing dreams when they stop using cannabis. These should start to fade after about a week.
Follow the sleep tips above till they pass.
Anxiety and restlessness
It’s quite common to feel anxious when you stop using cannabis. This is more likely if you use cannabis to manage anxiety.
The trick is to find new ways to handle your anxiety.
Writing your worries down can help. So can using simple breathing exercises to calm your breath.
Avoid coffee and other caffeinated drinks as well.
Without the sedating effects of cannabis, caffeine can make you feel more jittery and anxious than usual.
Irritability and anger
Some people say they feel irritable and angry when they stop using cannabis.
These feelings are normal and they will pass.
Try to cut down stress in your life and build in more things that you find relaxing, such as playing games or listening to music.
Telling a close friend or family member how you are feeling can be a great source of support.
If you don’t want to tell them you're irritable because you’ve stopped using cannabis, you could just say you’re feeling under the weather.
Sweats and chills
You may get flu-like symptoms like sweats, chills, headaches and muscle pains when you give up cannabis.
If this happens, look after yourself as though you had a cold or flu.
Wrap up and take it easy. Make sure you’re drinking plenty of fluids and take paracetamol or ibuprofen to ease any aches and pains.
Changes in your appetite
Food may taste different when you’re withdrawing from cannabis, and your appetite may change.
If you don’t feel like eating, try to eat little and often or have smoothies instead. Getting some exercise and fresh air may help to build your appetite too.
Some people get nausea and stomach pains. These should go away in a week or two.
If you smoke cannabis with tobacco
If you usually smoke cannabis mixed with tobacco, be aware that you’ll also get nicotine withdrawal symptoms if you stop.
Nicotine withdrawal symptoms are similar to those for cannabis. You may feel irritable, restless and like you can’t concentrate on anything.
To avoid withdrawing from nicotine at the same time as cannabis, you can use nicotine replacement treatments like patches or gum.
It’s best to avoid things like vaping or e-cigarettes. Anything that reminds you of smoking could be a trigger to use cannabis again.
Need help now?
For support with giving up cannabis and coping with withdrawal symptoms talk to us online or get in touch with one of our local services.