Since you are starting with the assumption that marijuana is an
addictive drug, I am not including material which discusses this
thesis pro and con. I've divided my answer into three sections to
correspond with your three-pronged question.
-----= WITHDRAWAL SYMPTOMS =-----
Since the addictivity of marijuana is primarily psychological, rather
than physiological, the symptoms of withdrawal are less dramatic than
is the case with cessation of opiate or tobacco use. Here are a few
accounts of symptoms which may be expected:
"On the day that you give up, and for a week or more after, some
people can feel out of sorts. There are a number of "withdrawal
symptoms" caused by stopping regular use of cannabis. These are some
of the things you might experience:
- Anxiety
- Moodiness
- Irritability
- Tremors
- Perspiration
- Nausea
- Sleep disturbances."
Northeast Valley Division of General Practice: MARIJUANA - A Guide to
Quitting
http://www.nevdgp.org.au/geninf/std_misc/MarijuanaQuit.html
-------------------------
"Heavy users of marijuana who suddenly go cold turkey have aggressive
impulses as powerful as those felt by people taking anabolic steroids.
The reaction is far less intense than the withdrawal symptoms of
alcoholics or people addicted to cocaine or heroin, and may reflect a
psychological dependence on the drug, rather than a genuine
physiological addiction."
New Scientist: Reefer Madness
http://www.newscientist.com/hottopics/marijuana/reefer.jsp
-------------------------
"While marijuana withdrawal symptoms aren't nearly as intense as those
associated with alcohol, nicotine cigarettes or harder drugs, recent
research indicates they're quite real. Aggression, anxiety,
irritability and hypersensitivity to pain are all possible... However,
these symptoms should fade within a month."
Third Age: Overcoming Marijuana Addiction
http://www.thirdage.com/news/archive/010604-02.html
-------------------------
"Since marijuana is an addictive substance, it is possible to
experience some withdrawal symptoms, especially with persons who use
high doses repeatedly. Some of these symptoms are restlessness,
nervousness, irritability, insomnia, and a decreased appetite.
Overall, these symptoms are relatively mild and last only a few days.
Of course, it can take several weeks before the body rids itself of
the chemicals in marijuana."
Listen Magazine: Ask Gary
http://www.listenmagazine.org/listwinner/listen/ask_gary.asp
-------------------------
"Abrupt termination of cannabis use can produce a mild withdrawal
syndrome. Symptoms include sleep disturbance, irritability, loss of
appetite and consequent weight loss, nervousness, anxiety, sweating
and upset stomach. Sometimes chills, increased body temperature and
tremors occur. The withdrawal syndrome usually lasts for less than a
week, although the sleep disturbances may persist for a longer
period."
Australian Drug Foundation: Cannabis
http://www.adf.org.au/drughit/facts/hdayca.html#withdrawal
-------------------------
"A distinctive marijuana withdrawal syndrome has been identified, but
it is mild and short lived. The syndrome includes restlessness,
irritability, mild agitation, insomnia, sleep disturbance, nausea, and
cramping."
National Academies Press: Marijuana and Medicine
http://www.nap.edu/html/marimed/es.html
-------------------------
"New research in nonhuman animals and humans is showing that marijuana
withdrawal can produce symptoms such as irritability, anxiety and
depressed appetite... In a 1999 study, Haney and colleagues at
Columbia University gave chronic marijuana smokers alternating courses
of marijuana or a placebo for 21 days, each for several days at a
time. While abstinent during placebo phases of the experiment,
participants experienced anxiety, irritability, stomach pain and
decreased appetite. Most withdrawal symptoms peaked on the third or
fourth day and abated when participants again received marijuana."
American Psychological Association: The changing face of marijuana
research
http://www.apa.org/monitor/jun01/marijuana.html
-----= OUTPATIENT TREATMENT OF WITHDRAWAL =-----
Although there is currently no specific medication for treating
marijuana dependence, this may soon change:
"A drug might soon be available that stops you getting high when you
smoke dope. Marijuana's psychoactive effect is thought to come about
when its key ingredient, tetrahydrocannabinol or THC, binds to CB1
cannabinoid receptors in the brain. A Paris-based company,
Sanofi-Synthelabo, has now developed a compound dubbed SR141716, which
prevents chemicals from binding to these CB1 sites...They found that a
single dose of SR141716 could make regular pot-smokers feel about half
as stoned as usual after smoking one joint. The participants' heart
rates also increased only half as much as normal. Whether marijuana is
truly addictive is still being debated... there is evidence that
quitting marijuana is a problem for some people. SR141716 might
help... but its effects after repeated doses will first have to be
explored."
New Scientist: Is this the answer for hopeless dopeheads?
http://www.newscientist.com/hottopics/marijuana/isthistheanswer.jsp
-------------------------
TREATMENT WITH PSYCHOTHERAPY:
"In the first controlled study of marijuana treatment, published in
1994, Stephens and colleague Roger A. Roffman, DSW, of the University
of Washington, compared the effectiveness of two treatment approaches,
both of which took place in group therapy sessions. One approach
applied cognitive-behavioral treatment principles to help people
identify and prevent situations in which they are most likely to use
marijuana. The second approach simply provided social support to
people who wanted to quit. In the study, about 60 percent of the 212
participants in both treatment groups successfully quit smoking
marijuana. One year later, about 25 percent remained abstinent.
In a follow-up study involving 291 participants, Stephens's group
compared a 14-session cognitive-behavioral treatment approach with a
two-session 'motivational enhancement' intervention... The results,
published last year, showed that participants in both treatment
conditions were more successful at quitting marijuana than were
participants in a control group--and equally so. As in the first
study, one year after treatment ended about 25 percent of participants
were abstinent.
Although that study suggested that a brief treatment works as well as
longer treatment, a recent large, multisite study funded by the
federal Center for Substance Abuse Treatment (CSAT) has indicated
otherwise. That study compared 450 chronic marijuana users who were
randomly assigned to a two-session motivational enhancement program or
to a nine-session program that involved both cognitive-behavioral
therapy and motivational enhancement. Participants who received more
treatment reduced marijuana consumption by about 60 percent on
average, the results showed, compared with 30 percent for those in the
brief-intervention condition... the CSAT study suggests that
treatments for marijuana dependence are effective, even for people who
are long-time, chronic marijuana users."
American Psychological Association: The changing face of marijuana
research
www.apa.org/monitor/jun01/marijuana.html
-------------------------
"The National Treatment Improvement Evaluation Study (NTIES) is a
Congressionally-mandated five-year study of the effectiveness of drug
and alcohol treatment programs that received public support in fiscal
year 1990-1991 from the Substance Abuse and Mental Health Services
Administration’s Center for Substance Abuse Treatment (CSAT).
For those clients receiving treatment for marijuana, NTIES found:
A sustained 45-percent reduction in use by those who chronically used
marijuana but not other illicit drugs approximately one year after
treatment.
A sustained 50-percent reduction in use by those who used marijuana
with other drugs approximately one year after treatment.
Every type of treatment (non-methadone outpatient, short-term
residential, long-term residential, correctional) produced large and
statistically significant reductions in marijuana use."
National Criminal Justice Reference Service: The National Treatment
Improvement Evaluation Study Fact Sheet
http://www.ncjrs.org/nties97/nties97f.htm
-----= ALTERNATIVES TO GROUP THERAPY PROGRAMS =-----
Although most outpatient marijuana treatment involves group therapy,
there is evidence that one-on-one intervention can be equally
effective. However, it should be kept in mind that the discomfort or
embarrassment that many people feel initially in group therapy tends
to abate over time.
"A marijuana treatment group is typically an abstinence-based group of
10 to 12 persons trying to end their dependence on marijuana In one
recent study, 14 groups were started; they met once a week for 14
weeks and were led by two co-therapists... Another model for treatment
involves one-on-one intervention, followed by an assessment session
that provides an overview to the patient, an in-depth discussion about
the patient's use of marijuana and reasons for favoring or opposing
quitting and answers to questions the client has about quitting or
modifying use.... During this session, patients who decided to quit
smoking marijuana were advised how to prepare for stopping and how to
deal with relapse risks. A 30-day plan was developed as an opportunity
to try out the behavior change (reducing or stopping use). A review
session was conducted with the patient after 30 days had passed.
These two counseling approaches were found to be equally successful.
The researchers concluded that a brief, three-session intervention
that focuses on helping patients resolve their mixed feelings about
change, identifies short-term goals that can be worked on over a
30-day period, provides advice about initiating change and reviews
progress after 30 days may be an effective counseling approach for
many chronic marijuana smokers."
Psych Central: Treatment for Marijuana Abuse
http://psychcentral.com/library/sa_txm.htm
-----= OTHER SOURCES OF HELP =-----
I have a friend who is fighting his cannabis habit. He highly
recommends a book called "The 2002 Official Patient's Sourcebook on
Marijuana Dependence: A Revised and Updated Directory for the Internet
Age." This is not the typical pep talk self-help book, but is a
collection of down-to-earth and practical articles, with many
references and URLs that will assist in finding more data on specific
topics.
Amazon.com: The 2002 Official Patient's Sourcebook on Marijuana
Dependence
http://www.amazon.com/exec/obidos/tg/detail/-/0597832439/qid=1042579236/sr=8-1/ref=sr_8_1/002-7314008-4609634?v=glance&s=books&n=507846
This is also available for purchase as an E-book, in the form of Adobe
PDF files (the link below displays the book's table of contents, as an
overview of the kinds of subjects that are discussed):
Amazon.com: The 2002 Official Patient's Sourcebook on Marijuana
Dependence, E-book
http://s1.amazon.com/exec/varzea/ts/exchange-glance/Y04Y5863086Y2399804/qid=1042579236/sr=1-1/002-7314008-4609634
---------------------------------
Addiction Help Line: Marijuana
http://www.addiction-help-line.com/marijuana.html
Addiction Help Line: Assessment Form
http://www.addiction-help-line.com/assessment_form.html
---------------------------------
Marijuana Anonymous
http://www.marijuana-anonymous.org/
---------------------------------
Narcotics Anonymous
http://www.na.org/
---------------------------------
Substance Abuse & Mental Health Services Administration: Substance
Abuse Treatment Facility Locator
http://findtreatment.samhsa.gov/facilitylocatordoc.htm
---------------------------------
Here you'll find a large collection of links related to substance
abuse treatment options:
Family Intervention Services: Alcohol & Drug Addiction Organizations
http://www.familyinterventionservices.com/RecommendedReadings.htm#Alcohol%20&%20Drug%20Addiction%20Organizations:
---------------------------------
The National Substance Abuse Web Index (NSAWI) is a search engine
which indexes 26 public interest and U.S. government sites:
National Substance Abuse Web Index
http://nsawi.health.org/
---------------------------------
These search terms were used, in varying combinations, in compiling my
research:
marijuana
cannabis
pot
abuse
addiction
withdrawal
cessation
symptoms
"cold turkey"
treatment
psychotherapy
"group therapy"
therapy
rehabilitation
intervention
rehab
I hope this information will be useful. It's always a pleasure to be
able to assist one of my fellow Researchers. In preparing my answer,
I've tried to give a general overview of the three topics mentioned in
your question; if you'd like me to focus more intensely on any
particular area of study, please let me know. I'll be glad to offer
further assistance.
Best wishes,
pinkfreud |
