DSM-5 cannabis withdrawal syndrome: Demographic and clinical correlates in U.S. adults.
Level 4 - case-series / case-control
Cross-sectional analysis of national epidemiological survey data (NESARC-III).
PubMed 30361043 · doi:10.1016/j.drugalcdep.2018.09.005
What was done
Researchers analyzed data from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a nationally representative survey of U.S. adults aged 18 and older. The analysis focused on a subsample of 1,527 frequent cannabis users (defined as using cannabis ≥3 times per week in the prior 12 months) to evaluate the prevalence, symptom profile, and sociodemographic and clinical correlates of DSM-5 cannabis withdrawal syndrome (CWS).
What was found
Among frequent cannabis users, the prevalence of DSM-5 CWS was 12.1%. The most common withdrawal symptoms among individuals with CWS were nervousness/anxiety (76.3%), hostility (71.9%), sleep difficulty (68.2%), and depressed mood (58.9%). CWS was significantly associated with functional disability (p < 0.001), mood disorders (adjusted odds ratios [aOR] = 1.9–2.6), anxiety disorders (aOR = 2.4–2.5), personality disorders (aOR = 1.7–2.2), and a family history of depression (aOR = 2.5). CWS was not significantly associated with a personal history of other substance use disorders or a family history of substance use problems.
Why it matters
This study provides nationally representative estimates of DSM-5 cannabis withdrawal syndrome, establishing that withdrawal affects over one in eight frequent users and is strongly comorbid with psychiatric disorders.
Limits
The study is cross-sectional and relies on retrospective self-report, precluding causal inference. Findings are restricted to frequent cannabis users (≥3 times weekly), limiting generalizability to occasional users.
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