Tuesday, February 5, 2008

Marijuana Withdrawal Revisited


Is cannabis addictive?

See also Marijuana Withdrawal


Until recently, there was very little evidence in animal models for marijuana tolerance and withdrawal, the classic symptoms of addiction. For at least four decades, million of Americans have used marijuana without clear evidence of a withdrawal syndrome. Most recreational marijuana users find that too much pot in one day makes them lethargic and uncomfortable. Self-proclaimed marijuana addicts, on the other hand, report that pot energizes them, calms them down when they are nervous, or otherwise allows them to function normally. They feel lethargic and uncomfortable without it. Heavy marijuana users claim that tolerance does build. And when they withdraw from use, they report strong cravings.

While the scientific evidence weighed in against the contention that marijuana is addictive, there were a few researchers who were willing to concede the possibility. “Probably not, for most people,” a researcher at the University of Minnesota’s Chemical Dependency Program told me in the late 1990s. “But there may be some small percentage of people who are on the same wavelength with it chemically, and who end up in some way hooked to it physically. It’s a complicated molecule.”

The difference between animal models and humans may be the difference between pure THC and naturally grown marijuana. Despite the fact that rats and monkeys find whopping doses of synthesized THC aversive in the lab, psychopharmacologist Ronald Siegel, in his book Intoxication, has documented numerous instances of rodents feeding happily on wild marijuana plants in the field. There are apparently other components in the psychoactive mix that makes marijuana what it is. When the lab version of THC is hundreds of times more potent that the genuine article, it is hard to know exactly what the research is telling us.

Some of the mystery of cannabis was resolved after researchers demonstrated that marijuana definitely increased dopamine activity in the ventral tegmental area of the brain. Some of the effects of pot are produced the old-fashioned way—by means of neurotransmitter alterations along the limbic system’s reward pathway.

A report prepared for Australia’s National Task Force on Cannabis put the matter straightforwardly:

There is good experimental evidence that chronic heavy cannabis users can develop tolerance to its subjective and cardiovascular effects, and there is suggestive evidence that some users may experience a withdrawal syndrome on the abrupt cessation of cannabis use. There is clinical and epidemiological evidence that some heavy cannabis users experience problems in controlling their cannabis use, and continue to use the drug despite experiencing adverse personal consequences of use.

The U.S. government’s essentially unchanged opposition to marijuana research has meant that, until quite recently, precious few dollars were available for pot research. This official recalcitrance is one of the reasons for the belated recognition and characterization of marijuana’s distinct withdrawal syndrome.

To pluck one statistic out of many, representing estimates made in the late 1990s, more than 11 million Americans smoked marijuana regularly in the NIDA-sponsored “National Household Survey on Drug Abuse.” What NIDA has learned about cannabis addiction, according to the principal investigator of a recent NIDA study, was that “we had no difficulty recruiting dozens of people between the ages of 30 and 55 who have smoked marijuana at least 5,000 times. A simple ad in the paper generated hundreds of phone calls from such people” (This would be roughly equivalent to 14 years of daily pot smoking).

There now exists a nice body of clinical trials showing that mice and dogs show evidence of cannabis withdrawal. (For THC-addicted dogs, it is the abnormal number of wet-dog shakes that give them away.) Today, scientists have a much better picture of the jobs performed by anandamide, the body’s own form of THC. This knowledge helps explain a wide range of THC withdrawal symptoms. Among the endogenous tasks performed by anandamide are pain control, memory blocking, appetite enhancement, the suckling reflex, lowering of blood pressure during shock, and the regulation of certain immune responses.

These functions shed light on common hallmarks of cannabis withdrawal, such as anxiety, chills, sweats, flu-like physical symptoms, and decreased appetite. At Columbia University’s National Center on Addiction and Substance Abuse, where a great deal of NIDA-funded research takes place, researchers have found that abrupt marijuana withdrawal leads to symptoms similar to depression and nicotine withdrawal.

In a 2003 research report entitled “Nefazodone Decreases Anxiety During Marijuana Withdrawal in Humans,” published in Psychopharmacology, researchers at the New York State Psychiatric Institute used Serzone (nefazodone) to decrease some symptoms of marijuana withdrawal in human subjects who had been regularly smoking six joints of pot per day. Anxiety and muscular discomfort were reduced, but Serzone had no effect on other symptoms, like irritability and sleep problems. The drug did not alter the perceived effects of marijuana intoxication (the SSRIs didn’t, either). Serzone is another antidepressant, a modest inhibitor of serotonin and norepinephrine, but its mechanism of action is ill defined. It is not in the SSRI or tricyclic families.

To date, there is no effective anti-craving medication approved for use against the marijuana withdrawal syndrome, for addiction-prone individuals unlucky enough to suffer from it.

For more, see earlier posts:

Marijuana Withdrawal

Is Marijuana Addictive?

Photo credit: 2nd International Cannabis and Mental Health Conference Programme

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43 comments:

daksya said...

Better than an anti-craving agent would be one that attentuated withdrawal. In rats, lithium did the trick, as did oxytocin. In humans, it worked in 4 or 5 out of 9 subjects despite lower plasma levels relative to the rat study.

Dirk Hanson said...

daksya:

Thanks for the citations on lithium for marijuana withdrawal.

Question: Even if you had medical help for withdrawal, isn't continued craving after withdrawal a problem that could cause relapse?

daksya said...

That depends on what one thinks are the reasons for addicts to keep using drugs. This review makes a good case for negative reinforcement, especially for the potency of craving. So, an agent that prevented withdrawal, would, at the very least, strongly reduce the severity of dependence.

Ultimately it comes down to political inclinations. If one's position is that any drug use is inimical, then, yes, what's required is an anti-craving agent that does its work within limited administrations (else you're replacing one drug with another). But if, as I think, it's certain patterns of drug use behavior that are malignant, then successfully tackling withdrawal and tolerance will help get rid of such patterns of drug use.

BTW, if you haven't already, you should check out DrugWarRant.com

Dirk Hanson said...

Nice site you have there--keep up the good work.

I do disagree with the contention that negative reinforcement sufficiently accounts for all withdrawal symptoms and craving. People with strong addictive propensities take drugs because their bodies are telling them something is wrong--often well before any exposure to drugs of abuse. Some people are, so to speak, "born to smoke," although the negative reinforcement of abstinence certainly contributes to the problem.

daksya said...

I do disagree with the contention that negative reinforcement sufficiently accounts for all withdrawal symptoms and craving.

Negative reinforcement doesn't account for any of the withdrawal symptoms; it accounts, I believe, for most of the craving within a drug-addicted individual.

People with strong addictive propensities take drugs because their bodies are telling them something is wrong

That's negative reinforcement

often well before any exposure to drugs of abuse.

Now, you're talking about drug initiation, and there are a variety of motives for drug use, including stress and depression.

Some people are, so to speak, "born to smoke,"

If the endogenous biochemistry of these people drives them to use drugs, then there can't be, in fact, an anti-craving agent unless it suitably alters that biochemistry with a few doses. Otherwise, you are simply replacing one drug with another. So, something that tackles withdrawal and tolerance will enable these individuals to control their drug use much better, whereas an anti-craving agent won't really be much help.

P.S. Drug WarRant isn't my site.

Dirk Hanson said...

If the endogenous biochemistry of these people drives them to use drugs, then there can't be, in fact, an anti-craving agent unless it suitably alters that biochemistry with a few doses. Otherwise, you are simply replacing one drug with another.

-------
Yes: You are replacing the use of an addictive drug with a preventative, non-addictive maintenance medication. Sort of like pills for high blood pressure or diabetes. Seems like an improvement to me.

Drugs for drug addicton--fighting fire with fire--is the future of addiction treatment, in my opinion.

You seem to be discounting the fact that, regardless of set, setting, mood, class, race or poverty, certain people will become addicted to addictive drugs, and certain people won't. The sociological approach to sorting out those two groups is being largely abandoned, in part because of sophisticated twins studies showing how little effect these outside influences have on the onset and course of addiction.

daksya said...

You are replacing the use of an addictive drug with a preventative, non-addictive maintenance medication.

Are you using "addictive" to mean 'mind-altering'?

If not, then it's a distinction without any real difference.

And if so, then that's a political preference, over which we disagree.

Dirk Hanson said...

daksya asks:

"Are you using "addictive" to mean 'mind-altering'?

If not, then it's a distinction without any real difference."
----------------

No, I'm using "addictive" to mean "addictive." Or is addiction to any mind-altering drug a concept with which you disagree?

Addictive mind-altering drugs: cocaine, heroin, speed, alcohol, etc.

Non-addictive mind-altering drugs: LSD, psilocybin mushrooms, Prozac, MDMA, etc.

daksya said...

Then I don't see how your anti-craving agent (ACA) is non-addictive.

As I understand it, per your scenario, when a person who is "born to smoke" takes up pot & then gets addicted to it. Decides to quit, and so takes up ACA on a maintenance basis as you envision. Then what happens if said person wants to quit ACA? If they do, their internal chemistry resumes and they are again left with the craving for something to alleviate that internal chemistry. That's the same pattern that the original drug produced.

If the ACA doesn't permanently alter their brain so as to reduce the need for any substance, then the ACA will simply substitute for whatever it's replacing. Then why object to the original addiction in the first place, unless it's for reasons other than its addictive nature per se, like health effects or social acceptance? It's also likely that any ACA suitable as a maintenance substitute will mimic the original drug's pharmacology to a considerable extent.

Dirk Hanson said...

"It's also likely that any ACA suitable as a maintenance substitute will mimic the original drug's pharmacology to a considerable extent."
------------------

That's a very real problem in the design of anti-craving drugs, no doubt about it. The methadone trap.

What comes to the rescue and disrupts your overall scenario is neural plasticity. Just as the brain had to adjust in the first place to the artificial flood of "feel-good" neurotransmission, so an effective anti-craving drug will help create the time away from the drug that allows the brain to retrain itself to function effectively without the addictive substance. And here, of course, a bunch of cognitive and social factors do come into play, even though relapse itself is primarily a biological imperative triggered by deep survival structures in the brain.

Anyway, does all this mean we end up merely back on square one? Abstinent but ready to resume use due to negative reinforcement? Sometimes. But in other cases, such as Zyban/Wellbutrin for nicotine craving, the outcomes have been quite good: a bunch of former smokers, and nobody addicted to Zyban in its place.

daksya said...

so an effective anti-craving drug will help create the time away from the drug that allows the brain to retrain itself to function effectively without the addictive substance.

Yeah, but your brain is adapting itself to function with the ACA present in its stead. It still has exogenous interference.

As for Zyban (bupropion), this trial shows continuous year long abstinence at 14.6% in the Zyban group v.s. 10.3% in the placebo group, so a very moderate rate of success. Even with the best treatment in that comparison trial, 76% don't achieve long abstinence, and 10% of that could be attributed to the placebo effect.

Chris Jones said...

Thank you for your article on marijuana withdrawal. It is very timely and helpful. I do experience the anxiety noted. The first 7 days are almost unbearable but I find that Tramacet helps. I can get through the day okay but the evening is roughest. 1 Tramacet at 6 pm helps with the worst cravings and allows for a decent night of sleep.

Morte Cerebrale said...

Hmm, informative site, its nice to read a fact-based scientific and critical page that overestimates my intelligence rather than just giving vague advice..
However, that being said, I notice theres a bit of non-pragmatic stuff on this and other sites on how to treat THC withdrawals. Some people doubt the very fact of pot addiction, and imply that its a symptom of some kind of lack of moral fiber. Some of those assertions on this excellent site are centered around as yet not fully complete biochemical knowledge, some based on more psychological or sociological reasoning.
As a health professional on my 7th day of abstaining, I am reminded of what I was taught "the best qualified expert on a patient's pain level IS that patient."
That so many people should have identical psychosomatic symptoms seems a little unlikely.
It also seems a little silly to me to question the mental "strength" of people who have had symptoms for many days and are prepared to keep on kicking the s**t..

Dirk Hanson said...

"That so many people should have identical psychosomatic symptoms seems a little unlikely."

It certainly seems unlikely to me--and to almost everybody who has ever posted here.

Dirk Hanson said...

"its nice to read a fact-based scientific and critical page that overestimates my intelligence"
-----
Yeah, well, nobody ever went broke OVERestimating the intelligence of the American.... no, wait, I got that wrong, how does that go....

Morte Cerebrale said...

Thanks for the cool responses Dirk!
I am now in day 15, and Einstein's
time-distortion when travelling at light speed is NOTHING compared to my throwing out my bong. Was it really 10 days ago I posted that comment?!?!? I really am completly blown away by that, it FEELS like a couple of months ago!! Its funny how those 10 days would have just flown by if I was still gurgling and coughing ALL my cash and a lot of life-experiences away.

Now I feel cocky enough to offer some sage advice!! It has been tough, but this time I'd only smoked for months, before I managed to live life instead.
Usually it been years, but I guess it must be a little like herion or something, 'cause it seemed like latent long-term abuse-effects reared its ugly head anyway. I still had(!) the sweat soaked bed, and beads of sweat on my forhead if I even thought about walking. And it felt like I was over-dosing on bad speed. What REALLY helped me personally, were those old-fashioned drowsiness-inducing anti-histamines, which my doctor put me on because they are far less addictive than benzo's. I am not saying that they are a cure for the sleepnessless, but that they HELPED, some. And I still have to treat them with respect, 'cause I can get addicted to anything..
ALSO, knowing that its the addiction talking, when the WHOLE WORLD SCREAMS at me that it demands that I toke up.
Because, I mean, JUST LOOK AT THE INHUMAN; IMPOSSIBLE-TO-DEAL-WITH-S**T I am expected to put up with!!
Sound familliar? Its horrible, that feeling. But it does ease off with time.
Cutting back on the coffee.
Oh, and exercise.. An incredibly boring and quite depressingly daunting concept when sitting in my chair, but it really works for a LOT of people. I dare say everyone actually.
Anyway, the fun of not handling any sort of problem without almost collapsing into self-pity and utter irritation is waiting for me outside. Along with the good, intense feeling of actually being in the here and now!

Anonymous said...

Great article. I am on day 3 of not smoking weed, and i must say i am completly misserable (as is my spelling). I am experincing head aches, stomach aches, i am much more "snappy" at people for things that shouldnt make me mad. The biggest thing for me though is the lack of sleep and the lack of desire to eat. I must admit i have smoked very heavily for the last 5 years. ( about 2 ounces a week). the cravings really hit me hard on day 2 and today(day 3), although i just went for a walk to calm myself down. I do not seem to have any desire to eat at all though. Havent consumed food in 30 hours now, but when i try to eat it just taste plain and i get full off very little. As for the sleeping, its 2 am so that tells you how thats going. i have slept a total of 2 hours the last 3 days, and thats when i crave the most, trying to fall asleep. Any suggestion or helpfull tips? Im more than open to them.

Morte Cerebrale said...

Mate, to be honest I'm pretty much in the same boat again, having relapsed after a house-fire and working too much...and I guess for no good reason at all, too. So, sitting in detox now ( I tend to eventually get to drinking a lot too ) and been here for 5 days. Climbing the walls, but at least I feel like I'm not as tempted to relapse, because here they expect me to be snappy and shitty.. 60 g's a week? You must be suffering man... Anyway, as stoopid as it might sound, the only thing that really helps me is two hours of exercise a day. It helps calm me and act more rational to people who dare look at me on the bus, lol. It helps get me knackered enough for a couple of hours of sweat-filled sleep, and it REALLY helps me eat ( aleiviates the "help, this bite of sandwich is expanding in my mouth" syndrome ). I tend to get out on my snowboard or mountainbike, because then the aggression can be directed at the mountain and not at innocent bystanders to the tragi-comedy of my day. Also, the old drowsiness-inducing anti-histamines ( taken by the mouthful, unfortunatly )
Anyway, thanks for the kind words, we gotta hang tough (aaaaarrrrggghhh!!!) because its going to get worse before it gets better. Day 10-14 is commenly accepted as the worst.. Maybe try to get to get some therapy? Thinking of you, and the holiday and things I can afford again soon..

Dirk Hanson said...

Anonymous and Morte pretty much lay out the usual suspects, withdrawal-wise. I don't have a brilliant idea for combatting the irritation and snappish behavior that is part of the deal--exercise, like Morte says, is probably as good a defense against anger/irritability as anything. And yes, food can taste like cardboard for awhile--an opportunity for some weight loss, if needed? Sleep is tough--the less sleep, the more irritable. Benydryl and other OTC allergy medicines make some people drowsy enough to bag it in for the night. If not, you might ask a doctor for a prescription for Desyrel, aka trazadone, an old, rarely used antidepressant that didn't work so well because it made people extremely sleepy. Its safety track record is good; it's been around for like forever.

Morte Cerebrale said...

Thank you, thank you kind sir. For both the reply and the suggestion. I will ask the nurse here about those (a rather dry lol) if the sleepy times still elude me.
The staff at this detox-center are really recommending a ADHD appraisal for me, something that quite a few people have mentioned to me. And I'm getting to think maybe theyve got a point. Just because its an over-diagnosed thing doesnt mean that it doesnt pertain to me, I guess... And I've noticed that a LOT of people who are constant tokers are pretty hyper, and/or "sensation seekers". Any thoughts on that, Dirk, or anyone?

Dirk Hanson said...

I don't know about a connection between ADHD and pot smoking, but it's possible that weed functions a little like ritalin for such people--it helps them focus. The "sensation seeker" part fits directly into some earlier research indicating that addicted people have high risk/low arousal metabolisms. Meaning that the ordinary mood lifters of the day that ordinary people respond to just don't pack enough punch for low serotonin/low dopamine addicts. A normal person walks into a busy, smoke filled gambling casino at 2 o'clock in the morning, let's say, and their reaction is often "ugh, I'm going to bed." Whereas an addict is likely to walk into the same casino setting and smile and say,"my kinda people." Addicts skydive, drive fast, injure themselves more often, etc.

Anonymous said...

Help! I need help diagnosing my symptoms. I am a daily smoker for many years and quit cold turkey a week ago for a job. I have chills, nausea, vommitting, muscle aches, feel lathargic, anxiety, moody and just plain like crap. I have quit once before during my pregnancy and NEVER had any symptoms. What gives? What worries me is the muscle aching.

I am tempted to go to the doctor because I am convinced there is no way withdrawls can be this bad from marijuana.

Please help ...

Anonymous said...

Oh yeah, one more thing, I was the last post ....

I spent a hundred bucks on some detox pills that you take for a week. I am wondering if I take those and get all this crap out of me if I will feel better?

Anonymous said...

My boyfriend is currently experiencing extremly bad withdrawl symptoms. I've read all the information you have posted and have taken all the advice you have given(he's loving the exercise lol). I've been giving him gravol(dimenhydrinate) to help him sleep and combat the nausea. I was wondering how long these symptoms will last? He's been smoking 5 years approx 1/4 oz per week. Any advice yo could offer would be much appreciated.

Dirk Hanson said...

I wish there was a totally reliable and consistent answer to that question. Based on posts here and at other pot withdrawal sites on my blog, I would say that 90 per cent of people appear to fall in the 3 weeks to 3 months range when it comes to withdrawal symptoms. An unlucky few report having significant withdrawal effects for 6 months or more.

Come to think of it, that's not so different from the time line for most people when they quit smoking cigarettes.

Andrew said...

This is all completely brilliant, and rational. Thanks to everyone and esp. to the blogger, for *telling the truth*.

Anonymous said...

That was a good exchange at the top of this comment section with daksya and Dirk. This blog is fantastic, the best I have found on the web. I smoked daily for 20 years. I am 40 now. I began when I was 15. I quit March 3rd, 2009 so I am about 80 days in. I had tried many times before. Always unsucessful except 3 years ago and 10 years ago I went for 6 months each time.

I can confirm all of the withdrawl symptoms reported and add one that I have yet to find on this site. Confirming irritability, insomnia, excessive phlegm, cravings, sweating, restlessness, mild anxiety, boredom, depression, and so on. The vivid and intense dreaming/nightmares (not widely reported) seem to be the main concern I have now at this stage of my withdrawl (80 days). As I understand it, pot keeps you from entering the REM stage of sleeping (the deepest level of sleep) and/or keeps you from remembering any dreaming you have done. It is because your body/mind is not used to this stage that it comes roaring back with a vengence. I am sure it does not help that I live a stressful life. Although a very "functional addict", my business causes me great stress. The dreaming is so intense, I can wake up with nervous shakes and even palpitations from the adrenaline. I also go back to sleep and right back to the same dream, many times to replay it or to find a variance of the same topics. In the dreams, I am many times aware that I am dreaming but can't wake up out of them. Very vivid, very intense, even after I wake up it takes me a little while to reconcile that they were dreams and not reality. Please comment if anybody else is experiencing this.

Most of the other symptoms have subsided entirely and did within the first 30 days. I believe the intense dreaming can last 6 months+. Exercise absolutely helps me. Fast walking daily for 45 minutes or so. This gives me some joy to go into the outdoors, makes me tired, makes me hungry, (after a good cool off period) and gives me a nice injection of natural high from the dopamine and other chemicals produed from exercise. It seems to make any depression ease and feel good about myself and life.

tim part 1

Anonymous said...

tim part 2:

As an all day pot smoker I was the most apathetic (other than my biz) person you could find. I never wanted to do anything or go anywhere unless it involved and permitted me to smoke every hour. My life revolved around it. If I traveled, I had to smuggle it and enough to get through. I spent $1000 or more a month on it. 2+ ounces of the high end stuff. Although I was motivated in business, everything else was a complete waste of time unless I could be smoking. What a sad exisitence.

I have read that your attention span is permanaently ruined after chronic smoking. Dirk, have you found this to be true? I still find it hard but less so, to want to concentrate on one thing for a long period of time. It was much worse when I was still smoking.

After the first time I quit for six months, 10 years or so ago, I just miseed it so much, life wasnt fun, I started again. The same thing happened 3 years ago or so. I was overdoing my business and neglecting everything else. I missed it, I started. Always with the "only on the weekend", or "only in the evenings" intention but us OCD-obsessive-compulsive personalities don't stand a chance. I do know people who can moderate, I can't.

So why did I quit? Health, family, try to live a "here and now" life. I was wheezing, and coughing up phlegm all the time, surely lung disease was next. My kids are 17 and 14 and I hope to find the patience and desire to spend time with them, my marriage has held on , but things are not very good. Perhaps it's too late? Either way I am on the edge, even though most of the withdrwal symtoms are gone, I still miss it, still crave it at times, especially on the weekends when I have time to kill. I am not sure if I will make it. I like saying that when I am 60, I will go back to it once I can afford to die from it and my life is played out at that point. How awful.

How do I get over the 6 month hump?

I hope what I have written here is helpful to others. I hope others can comment and give me some help.

Tim

Dirk Hanson said...

Thanks for the detailed post. And thanks for the kind words about the blog.

Surely there is some sort of rebound effect involved in the intense dreaming. On the other hand, I have found myself wondering whether an ordinary person's relatively normal cycle of dreams and nightmares might be experienced more intensely by a chronically dream-suppressed pot smoker. Just thinking out loud.

As for permanently ruining one's attention span through overuse: To me, the brain seems so plastic in its ability to change and compensate and heal that I'm wary of calling ANY kind of change permanent.

Anonymous said...

Yes, I think you are correct that after being dream supressed for so long, I (x-pot smokers) have to get used to the new found cognition of dreaming. Many of the dreams include usage and posession of pot which always cause me to feel guilty and upset with myself within the dream, evidence that I really want to quit and stay off.

On the attention deficit situation, I also agree. Quite bad for me as a chronic user, less now that I quit. The brain is powerful and plastic and can adapt with time. I am glad you see this and it relieves me to hear it from somebody of knowledge as yourself.

Are you still drug free? (assuming you were a user) That site drugwarrant.com seems toa advocate cannabis usage and it's legalization. How do you feel about that? If moderated use is achievable for some, do you think it is as acceptable?

Tim

Dirk Hanson said...

As someone who has been an AA member, I prefer to stay short on the personal specifics. And hey, I post here under my own name! :-)

I am in favor of some form of legalization as an alternative to the current legal clusterfuck over cannabis. After all, we know that at least 10% of drinkers become alcoholics, but this does not stop us from making it legally available.

I believe in harm reduction strategies and an end to the drug war, so called.

Anonymous said...

yes, understandable on the personal stuff. Just wanted to know if the blogster can personally relate.

I assume then your books don't go there either.

From your answers, now that I have read the main blog 400+ responses I can see you relate well either way.

What % of cannabis users become chronic users or past the socially acceptable point? Here and in places where it is legal?

If it becomes legal, it would still be bad for me, I would be in that x% of abusers. In fact selfishly, I hope it does not, as it would tempt me greatly. To really make a neutral opinion, I would have to learn more about the movement and it's implications.

Can you elaborate a little more on what you mean by harm reduction strategies?

Tim

Dirk Hanson said...

Not to worry; the blogster can personally relate.

Re Harm Reduction--the short answer is, Drug wars never work. No amount of Viet Nam-style escalation or sheer military firepower is capable of preventing people from getting their hands on illegal drugs. Moreover, current youth programs treat all young people as if they are at equal risk. Harm Reduction strategies involve the view of drug use as a social and medical issue, not a legal and moral one.

Anonymous said...

I have been an off and on user for about 5 years now. just recently i had went back to smoking weed after a year of quitting. then one particular day i smoked a unusually large amount of weed and i was using blunts. i shared 2 blunts with a group of friends and then i smoked again when i got home with my lady. then one of my peoples came over and we smoked another blunt. unknowing to me at the time, he brought over some purple haze and i loaded the blunt like it was regular weed. so immediately after getting high with him my heart rate skyrocketed to the point where i thought i was having a heart attack. i vomited up everything that was in my stomach and i could barely breathe. its been a little over 2 weeks and i have had so much trouble breathing and sometimes when i go to sleep i wake up all shocked and scared like i was one of those mummies returning from the dead....this morning, my heart rate skyrocketed two times shortly after one of my sleeping episodes and i was worried that it had something to do with my heart itself and not withdrawal. but i went to the doctor last weak and had an ekg and they told me hy heart was fine. so right now i am trying to find answers because i keep having the urge to use the bathroom 10 to 25 min. apart. what the boss is goin on?!?!?!

Dirk Hanson said...

I don't know if this is what happened to you, but one of the strangest and little-discussed pot effects is really an odd one: Sometimes, after smoking regularly for years, a smoker will get really high and for some unknown reason, he or she has a full-blown anxiety attack as a result. And from that point on, they stop smoking, because a reliable recreational drug now induces nasty panic attacks. I've never seen this particular toking phenomenon addressed, let alone explained. But I personally know three people to whom this has happened.

Anonymous said...

That is EXACTLY what is goin on. i have tried to get to sleep and its like every time i do try to go to sleep that my mind and body jumps out of sleep. i was thinkin that maybe it was a stressed induced panic attack, but i wasnt too sure....is there any way that i can fix the problem so i can go to sleep, of do i have to deal with this until the weed gets out of my system?

Dirk Hanson said...

I'm no doctor, but if you have panic attacks and serious trouble sleeping, you might consider talking to a physician about possible short-term treatment options.

Anonymous said...

First of great site.

I've been a moderate marijuana smoker for 7 years. On regards to panic attacks and smoking marijuana, I've had them and they suck. This was at a very stressful time for me and marijuana made things much worse. I had Depersonalization/Derealization brought on during an episode of opiate withdrawals. But, I think it has a lot to do with your mental state, setting and type of marijuana. I would recommend indica over sativa, as these to have significantly different effects.

Dirk Hanson said...

" I would recommend indica over sativa, as these have significantly different effects."

And about half of smokers would recommend sativa over indica. ;-)

Anonymous said...

Really, I think if you go on some of the boards focused only on marijuana, you'd find that at least 90% of them agree with me. People post question related to marijuana panic attacks daily there, i know because I was one of them.
50-50? Where'd you get that pertaining to anxiety?

Dirk Hanson said...

I was just pointing out that arguments about indica vs. sativa are sort of like red vs. white wine. Everybody has their favorite. A lot of the top strains are mixtures of both as you are no doubt aware. I wasn't aware that most smokers feel sativa is more prone to causing anxiety. Do other posters agree?

Anonymous said...

I have enjoyed this blog, I appreciate the intelligence of some of the posters, and identify with almost every entry in this list. I think we are all looking for encouragement and answers to make it easy, just like smoking a joint will make it easier to deal with your stress... hmm.

Other than daily moderate marijuana use for the past 4 years, I am an exceptionally healthy female, aged 26. I exercise regularly, practice relaxation techniques like Yoga, and lead a rewarding career as an Entrepreneur. I have little emotional stress in my life that would lead me to resort to marijuana use to 'escape', but tend to use it in social situations. About a month ago, I decided to quit cold turkey. It was simply a positive, definite choice. I have absolutely experienced all of the possible withdrawal symptoms mentioned in previous posts, but only for the first week or so. I am now still feeling a bit 'blah' if you will, or mild depression/lethargy/demotivation. I have not resorted to any kind of OTC option to control my symptoms, but simply accepted that my body must rid itself of the toxins I have flooded into it over the past few years.

Like any addiction, however extreme or benign, it all comes down to mental commitment and a positive reason for quitting! Like anything in life, if you think you can do it, and you want to do it, you will. If you doubt yourself, you are accepting the possibility that an external substance has more power over your body than your mind does - which is not true. If you want to quit, do it. Yes, you may experience some discomfort, but absolutely no growth can ever be achieved without moving past your comfort zones. You can do it!

Joe said...

I have been smoking pot for 7 to 8 years and have tried to quit numerous times. Now I am quitting againthis is day 6 of no pot and I am experiencing all the withdrawls mentioned here I used to smoke about 2oz of pot a week. It has seriously affected my life such as losing jobs, my gf/fiancee dumping me because I would take money and blow it that crap and then lie to her about it so we would not fight. I could not think straight or anything. This is a little note for people using pot please stop it affects way more than just a good feeling it mess's up your home life work life because everything revolves around you just trying to get that high and to me now being at rock bottom it is not worth the feeling you get out of it. thank you for letting me vent on your site