Comparing Cannabis and Nicotine Withdrawal

April 29, 2008

For some reason many people are in denial about cannabis dependence and wish to assert that there is no such thing, or if there is, it is somehow of lesser importance than is dependence on other substances of abuse. There are many ways to assess importance of course. What gets me going, however, are the assertions about cannabis abuse and dependence that are informed by anecdote and personal experience with a handful of users instead of an understanding of the available evidence.
To provide a little context for todays’ post, I took MarkH of denialism blog to task for his expression of what I viewed as standard cannabis science denialism a fair while ago. In a comment following his post, MarkH specifically identified nicotine withdrawal as being worse than cannabis withdrawal. This is the perfect setup since there are two recent papers which set out explicitly to test this hypothesis. Let us see what they found, shall we?


First off, what does cannabis withdrawal look like? As I’ve mentioned before the Diagnostic and Statistical Manual of Mental Disorders (DSM; current major version DSM-IV) employs generic substance abuse and dependence criteria for cannabis dependence. One of the ways the DSM gets revised over time is that researchers provide data and studies in-between revisions to attempt to refine and clarify diagnoses. The individual I most associate with the effort to describe the nature of cannabis dependence, and specifically withdrawal, is Alan J. Budney. He has a 2006 review of his (and others’) work in this area and anyone who wishes to grapple with the consistency of findings and the subtleties of the subject samples under investigation should track back through the reviewed articles. For today, the important issue is that Budney proposes that a symptom list for cannabis withdrawal should be included in the next revision of the DSM as follows (from Table 1):
Common symptoms

  • Anger or aggression
  • Decreased appetite or weight loss
  • Irritability
  • Nervousness/anxiety
  • Restlessness
  • Sleep difficulties including strange dreaming

Less common symptoms/equivocal

  • Chills
  • Depressed mood
  • Stomach pain
  • Shakiness
  • Sweating

Hmm. Very broadly consistent with symptoms established for other drugs of abuse, including nicotine. This brings us to the two papers comparing nicotine and cannabis withdrawal which have recently appeared; perhaps unsurprisingly, Budney is an author on each of these.

Vandrey RG, Budney AJ, Hughes JR, Liguori A. A within-subject comparison of withdrawal symptoms during abstinence from cannabis, tobacco, and both substances.
Drug Alcohol Depend. 2008 Jan 1;92(1-3):48-54. Epub 2007 Jul 23.
Budney AJ, Vandrey RG, Hughes JR, Thostenson JD, Bursac Z. Comparison of cannabis and tobacco withdrawal: Severity and contribution to relapse. J Subst Abuse Treat. 2008 Mar 12; [Epub ahead of print]

The first study, Vandrey et al, 2008, includes a relatively small sample (N=12) of cannabis/tobacco users (>6mo of 25 days/mo cannabis smoking, 10 tobacco cigarettes or more per day; all the usual exclusions of other issues). Importantly these individuals were not seeking treatment for either tobacco or cannabis use. The design was a series of blocks of Smoking As Usual (SAU) and the abstaining from cigarettes, cannabis or both for a 5 day interval. SAU for 9 days was interleaved between any of the abstinence intervals. Okay, so what did they find?

Vandrey08-WithdrawalFigure.jpg

Fig. 2. Mean ratings for WSC items for which significant condition by day interactions were observed. Filled symbols indicate values significantly different from SAU. Subscripts designate differences by condition on a given study day (a = dual > cannabis and tobacco; b = dual and tobacco > cannabis; c = dual > cannabis;
d = dual > tobacco). Squares indicate abstinence from cannabis only, circles indicate abstinence from tobacco only, and triangles indicate abstinence from cannabis and tobacco.

Discontinuation of both substances seemed to cause the greatest degree of withdrawal, particularly in terms of anger, irritability and aggression on day 2. Cannabis discontinuation (alone) seemed to cause sleep disturbances for longer than did nicotine discontinuation (alone). Perhaps most strikingly, the discontinuation of cannabis (alone) or nicotine (alone) seemed to produce approximately equivalently severe withdrawal symptoms as rated by these dual-users.
The next study, Budney et al, 2008, included a larger samples of individuals who had recently attempted to quit tobacco (N= 54) or cannabis (N= 67). This was a retrospective method (unlike the above prospective method) to survey symptoms experienced during the subjects’ prior attempts to quit substance use. Nevertheless the outcome was strikingly similar.

Budney08-SymptomSeverity.jpg

Fig. 1. Group mean severity scores for the WDS (refer to Y-axis scale on left side of figure) and individual symptoms on the Withdrawal Symptom Checklist
(refer to Y-axis scale on right side of figure). Asterisk indicates a significant difference between groups after controlling for age, gender, race, and Global Symptom Index score from the Brief Symptom Inventory in the linear regression models.

With the exception of appetite, craving and sweating symptoms, the severity of withdrawal symptoms was approximately equivalent across substances. This study also included the frequency of symptoms, i.e., the proportion of the sample which experienced each symptom.

Budney08-SymptomFreq.jpg

Fig. 2. Percentage of participants from each group that reported each withdrawal symptom, i.e., scoring greater or equal to 1 on the 0-3 point Withdrawal
Checklist Scale. Asterisk indicates significant differences between groups on chi square analysis (p b .05).

As with symptom severity, the frequencies were similar. Except that cannabis withdrawal resulted in more individuals with irritability and decreased appetite while nicotine discontinuation resulted in more individuals with increased appetite and craving.
In total, these studies paint a picture in which the discontinuation of nicotine and cannabis produce withdrawal symptoms of relatively similar severity and in similar proportion.

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127 Responses to “Comparing Cannabis and Nicotine Withdrawal”

  1. Gray Gaffer Says:

    I find the repeated use of the phrase “seemed to produce” rather telling here. There is also much missing information. First of all, I would only consider studies of withdrawal effect from cannabis made on subjects whose _only_ potentially addictive drug was cannabis, and who were using it at a similar dosage level to a distinct group of nicotine users, i.e constantly high (5 or more complete un-shared joints/day) vs 20 or more cigarettes per day. I would place both at high abuse levels, arrived at through early uninformed peer-pressure that overdose is the only way to use. But testing on subjects who used both, even if only one of the substances was to be stopped, cannot separate the otherwise well known effects of nicotine withdrawal from withdrawal problems per se. Perhaps the presence of nicotine causes withdrawal problems from any other drug? Has this been tested? It is not clear if the second study cited contained single-drug users.
    I know you do not consider “anecdotal” experience to be “evidence”, but I submit that over the last 40 years I have observed a far larger sample of people struggling with addictions than the sizes of the samples in those two studies. Plus I myself spent nearly 20 years trying to release myself from 45 (total) years of nicotine dependence (succeeded 3+ years ago, discovered it was much more of a behavioral problem than chemical). I have had friends who had to deal with alcohol, cocaine, crack, heroin, and various prescription drug issues. I watched from inside the 60’s counter-culture and its aftermath. I met or knew nobody – I repeat nobody – who experienced any problems from pot alone, and all of those who did have problems used other drugs that were more obviously the problem even if they did also use pot. Yes, pot + exacerbates the problems of other addictive drugs, typically by apparently removing the thoughts that something might be wrong with the behavior, thus enabling even deeper excursions with the other drug(s). But pot on its own? Even with periodic barren periods? Never an issue. Indeed, with some friends who had other medical problems, especially with epilepsy, pot was a positive influence. Much better than the zombie-fying prescription solution. As long as _only_ pot was in the picture.
    Pot is known to enhance appetite. So obviously ceasing its use will decrease appetite. And craving was associated with nicotine cessation, not pot cessation. I thought cravings were the signature of withdrawal – so pot cessation symptoms could more likely be a sign of habit changing more than chemical dependence. And irritability – again, the pot haze is ‘laid-back’, maybe that is the contrast. I have to say I think the root cause of the symptoms observed with pot cessation are not the same cause as chemical withdrawal symptoms seen from all the other drugs, from nicotine and alcohol on up the chain. Or, these studies should seek to identify and compensate for behavioral habit change symptoms before ascribing causal effects to the chemical withdrawal. Habit changes cause issues whatever the habit that has to change. Try having to drop the ‘married’ habits. Irritability, loss of appetite, loss of attention to personal hygiene, sleep problems, etc. Clearly not chemical withdrawal, but can be very intense.

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  2. DrugMonkey Says:

    I find the repeated use of the phrase “seemed to produce” rather telling here. There is also much missing information.
    quoth the denialist. I use the phrase “seemed to produce” because I think this leads to less sloppy thinking in science than to act as if any given result is definitive proof. yes of course you can pick holes in any particular study because this is the way science works. It is exceptionally rare that any one paper is going to effectively nail down every possible objection. This post of mine addresses a fairly specific issue, namely the comparison between two smoked recreational drugs. The fact that I am talking about two specific papers does not alter the fact that there are many other papers that are relevant to this issue!
    First of all, I would only consider studies of withdrawal effect from cannabis made on subjects whose _only_ potentially addictive drug was cannabis, and who were using it at a similar dosage level to a distinct group of nicotine users, i.e constantly high (5 or more complete un-shared joints/day) vs 20 or more cigarettes per day.
    You are welcome to go through the literature. I suspect if you take a good faith effort you will find the appropriately restricted samples in one study or another. start with the Budney review and/or the PubMed search link under his name. Beware of the standard denialist tactic of defining “what would convince you” so narrowly that it cannot possibly be satisfied experimentally, however. Also feel free to explore why if all the supposedly flawed studies are flawed in different ways and yet all point toward the same conclusions there is any hope that your perfect pie-in-sky study will prove something else.
    I met or knew nobody – I repeat nobody – who experienced any problems from pot alone, and all of those who did have problems used other drugs that were more obviously the problem even if they did also use pot.
    First, as I have covered elsewhere and likely will again, it is only a small minority of people who “smoke pot” who will meet criteria for dependence. Perhaps 10% although one can argue about the appropriate denominator and/or population to refer to as sufficiently “smoking pot”. (the 25 days + per month is just one way to operationalize matters) As to what fraction of those that meet diagnostic criteria comport with your subjective opinion about what “a problem” might be, well, that’s a different issue.
    The bottom line for me is that there are significant number of people seeking to cut back their pot use and having difficulty. People who are seeking treatment. As I remarked to MarkH in that prior discussion the colleague I know who does this type of research says after a single solicitation for treatment-seekers in the newspaper, the project is overwhelmed with potential subjects- a phenomenon that is NOT common with other drugs of abuse including alcohol from what I understand from colleagues.
    To suggest that you don’t know any treatment seekers (and really, how many of these people have you followed though the substantial number of years or decades that it typically takes for a recreational drug user to go full distance with a dependence problem?) so therefore these existing treatment seekers mustn’t actually exist is arrogant in the extreme. If you think at all about the way that the many researchers doing this work sample their available populations it should be obvious that this is far more likely as a whole to be representative than the number of people you have personally known to be pot smokers.
    And craving was associated with nicotine cessation, not pot cessation.
    This is an incorrect reading of the data. The point was that nicotine craving was greater than pot craving. Pot craving, however, was measurable and non-zero. Again, you can delve into the prior literature to see how the withdrawal measures have been validated.
    so pot cessation symptoms could more likely be a sign of habit changing more than chemical dependence….Clearly not chemical withdrawal, but can be very intense.
    and this is precisely where I got so exercised at MarkH for his apparent closet dualism. In his phrasing it was “psychological” vs. “physical” dependence but it sounds as though you are trying to strike a similar distinction. Please explain, very clearly, what you mean by “habit” and “chemical dependence” and how these things are likely to differ in categorical root cause.

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  3. Abbie Says:

    I tend to smoke weed in bursts- multiple times a day day for a few weeks or months, then not at all for much longer than that. When I stop, nothing happens. The only withdrawal I go through is a brief “damnit I really wish I had some more weed” phase that lasts maybe a couple days. Then I forget about it.
    Absolutely no other effects, whatsoever. I suffer horrible withdrawal if I come off Paxil cold-turkey… I know what physical withdrawal feels like… I really don’t think weed causes it at all.

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  4. bill Says:

    it is only a small minority of people who “smoke pot” who will meet criteria for dependence
    Of those who smoke tobacco, what proportion qualify as dependent? You mention that studies seeking subjects who want to cut back on pot are overwhelmed, whereas this doesn’t happen so much with alcohol — what about nicotine?
    And of course, there are established methods and programs for cutting back alcohol and nicotine. Just the fact that these programs exist will likely cut into the number of subjects responding to treatment study ads — in contrast, an academic study is probably the only quit-pot program around.
    I have no problem with the idea that pot is just as addictive as nicotine or alcohol. What I wonder about is whether the consequences of its use and abuse are so different from the consequences of alcohol or tobacco abuse that it ought to be regulated so very differently.
    Full disclosure: I like a drink, me, but I’ve never smoked tobacco *or* pot (on anything remotely resembling a regular basis).

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  5. DrugMonkey Says:

    I suffer horrible withdrawal if I come off Paxil cold-turkey… I know what physical withdrawal feels like… I really don’t think weed causes it at all.
    aaaaannnd we have goal post moving. Gracias, Abbie!
    Just because there are recreational and other drugs that cause more severe or qualitatively different signs and symptoms of withdrawal does not mean that cannabis does not cause so called physical withdrawal at all.
    When I stop, nothing happens. The only withdrawal I go through is a brief “damnit I really wish I had some more weed” phase that lasts maybe a couple days.
    yeah well that sure sounds like “something happens” to me. And the bottom line is that despite what you might think you are not always the best and most detached analyzer of things that are happening to you. Especially if they are relatively subtle or have occurred frequently enough that you simply think of it within the normal range of your behavior.
    This is why proper studies use well-validated measures that go beyond “did you go into withdrawal? oh, you don’t think so, good enough for me”.
    and then finally, read my comments above. it is possible you are in the probable majority of pot smokers that indeed won’t become dependent. Lucky you. This does not mean that others won’t become dependent nor does it mean that such dependence isn’t a direct effect of cannabis smoking in those individuals.

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  6. DrugMonkey Says:

    bill, the post where I discussed trying to determine conditional probability of dependence was this one:
    http://scienceblogs.com/drugmonkey/2008/04/recreational_drug_use_in_the_y_1.php
    I also had a prior post which may underline the issue of nicotine dependence as a less obligatory phenomenon then we may think.
    https://drugmonkey.wordpress.com/2007/04/26/drugs-are-bad-mkay/
    I haven’t had any conversations on the topic of human volunteers with anyone who does nicotine research yet. I’ll ask next time I see one of them.
    from what I can tell, the treatment market is spooling up to meet cannabis treatment demand but it isn’t really my area of knowledge.

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  7. Green Eagle Says:

    It is a strange thing to me to be taking the opposite side from seemingly scientific research, but this is a gigantic load of crap.
    I have had MASSIVE personal experience with drugs. I have known hundreds of drug users. None of us ever felt any withdrawal symptoms from weed. I knew many people with heavy heroin habits ($200/day plus). without exception, they said that it was easier to kick heroin than it was to stop smoking.
    I don’t know what your agenda is, but the truth is that marijuana consumption is virtually totally benign compared to the consequences of tobacco smoking. Anyone who denies that is living in some sort of mysterious dream world.

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  8. Rowan Says:

    In regards to Eagle: I don’t quite see why so many people are raising so many objections. As DrugMonkey aptly put, it is entirely misguided to look comparisons between withdrawal experiences (especially when all you proffer is anecdotes). In fact, I’ll go so far as to say it’s infantile.
    And then you go and make the statement that consumption of marijuana is totally benign? The very process of bringing smoke into the lungs is not without consequence.
    You, and the other posters here, are conflating issues. This is not a discussion about politics, which is essentially what you guys are reacting to given that every post here has been party line responses to the misrepresentation of cannabis as being extremely harmful.

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  9. Becca Says:

    DM- an interesting set of articles. I agree with your bottom line- there are people out there trying to quit pot and having trouble. I don’t think it behooves anyone to minimize the struggles people go through, including those with quiting pot.
    One technical question- in the second study, how recently had these folks quit? Do we have any info on the timeline that these symptoms might be expected?
    Although I can’t imagine what it would take to actually design the study, it would be kind of cool to see what *external* signs occured during cessation of various drugs. Is it harder to be around someone who quits pot or tobacco? I think this is a valid (and, as far as I know [although it’s not my field] understudied) aspect of consequences of dependence/addiction. And how should we factor in health risks of when there is increased weight gain post-tobacco cessation?
    (tounge-in-cheek: maybe we shouldn’t legalize pot afterall- imagine what the munchies would do to the Fast Food Nation)

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  10. Lindsay Says:

    Both dad and I smoke. He is definitely dependent (3-5 unshared joints per day) and I am not (

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  11. Wisaakah Says:

    Forgive me if I’m misinterpreting here –
    It seems that a relatively low proportion of people who smoke pot smoke enough to be considered dependent, and of those, a small proportion develop withdrawal symptoms (not so sure about this one – I might be reading into something here), but that those withdrawal symptoms can be as severe and frequent as those caused by nicotine. The question is, what is it that seems to make pot smokers less likely to consume enough regularly to lead to dependence? That may be why a lot of people A) know a lot of pot smokers, and B) don’t know any that had any trouble stopping. I myself have a hard time believing that cannabis dependence can be as much a problem as nicotine, even though I can see the data right in front of me. Interesting how we can put up barriers to things we don’t want to hear.
    That being said, I’ve had a similar experience to Abbie’s. Although n=2 means a whole lot of nothing.
    I’m curious about a comparison with other drugs that cause a similar level/type of high, as opposed to nicotine.

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  12. bill Says:


    http://scienceblogs.com/drugmonkey/2008/04/recreational_drug_use_in_the_y_1.php

    This study completely ignored nicotine, which — given the mode of delivery — seems an obvious comparison for MJ. The comparisons with alcohol don’t show what I would call a striking difference.
    https://drugmonkey.wordpress.com/2007/04/26/drugs-are-bad-mkay/
    This study strikes me as odd: 40% of long-term daily smokers are “not dependent”? Insert all the usual arguments against DSM-IV as a research tool, plus the usual complaints about self-reported rather than revealed preferences/information. That figure just seems way too low to me: why the fuck would you smoke 10/day for 10 years if you didn’t have a jones? I’d like to know how many of the “not dependent” population could quit and stay quit — in other words, I wish that first study had included nicotine.
    (In case anyone’s wondering, my “agenda” is that the War on Some Drugs seems like an unconscionable waste of time and money to me — particularly those battalions whose target is maryjane. Is anyone safer on the street because they put Tommy fucking Chong in jail?)

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  13. bill Says:

    what is it that seems to make pot smokers less likely to consume enough regularly to lead to dependence?
    For one thing, you can drive a car (function on the job) while you smoke tobacco, or if you smoked a couple of cigarettes at lunch.
    (Also, note to self: next time strip the http:// so the damn spamfilter won’t recognize the links as links and send me to Moderation Limbo.)

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  14. CanadianChick Says:

    FWIW, I have known people who did go through withdrawal when quitting pot – 2 of them. And both were definitely of the “dependent” variety.
    I’ve also seen what I always thought were “withdrawal” symptoms in casual users, who like Abbie, binged on pot for a short period, then stopped. I had dismissed them as being “merely psychological” not physiological, but was never really comfortable with that.
    On the other hand, I also know several ‘casual’ users of tobacco. A few that only smoke when they are drinking in a bar (not anymore, of course, you can’t drink in bars where I live). Another that will smoke once a month, with a particular group of colleagues.
    Never having used either tobacco or pot, I can’t speak from any personal knowledge, only observation.
    all of which only goes to prove two things – we all know some exception to the rule and the plural of anecdote still isn’t data.

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  15. pmont Says:

    “I tend to smoke weed in bursts-multiple times a day for a few weeks or months, then not at all for much longer than that. When I stop, nothing happens. The only withdrawal I go through is a brief “damnit I really wish I had some more weed” phase that lasts maybe a couple days. Then I forget about it. Absolutely no other effects, whatsoever…I really don’t think weed causes it at all.”
    This is exactly my experience. I’ve been smoking pot for 35 years, and I do not smoke tobacco. I smoke, fine; I don’t smoke…no withdrawal. I am among the lucky 90%, then. Thank ghod. After watching numerous people drop dead after a lifetime of smoking tobacco while all us pot smokers keep on ticking (except those who also smoked tobacco, poor bastards), I feel very fortunate, indeed, that I never got addicted to the true devil’s weed, which would be tobacco.
    Really, the study that ought to be done to assess the harmful effects of tobacco vs. marijuana is this:
    Bake two batches of brownies. In one batch, add 15 grams of powdered marijuana; in the other, add 15 grams of powdered tobacco. Divide test subjects into 2 groups: one that will eat the marijuana brownies, and one that will eat the tobacco brownies. Wait a couple of hours to determine the results. I speculate what the outcomes would be: Oops! All the marijuana-brownie eaters are knocking on the door asking for more brownies, while all the tobacco-brownie-eaters are DEAD! That’s right, marijuana is a relatively benign substance (and in all probability, a beneficial substance) while tobacco is a deadly poison.

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  16. Onkel Bob Says:

    I wonder if the persons suffering from “withdrawal” also exhibited addictive personalities. The study seems to ignore other factors in determining whether marijuana is addictive.
    Seems odd to compare the two substances. How many “social” cigarette smokers are there? Among the people I know, you either smoke cigarettes or you do not smoke cigarettes. I do not know anyone that smokes a cigarette or two on the weekend or when they go to a concert. Conversely, I know a number of people that smoke a joint on the weekend or at a concert. The conflation of the substances seems to be a crusade rather than an investigation.

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  17. PhysioProf Says:

    Smoking weed kicks fucking ass!

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  18. electronic janitor Says:

    I guess I’m in the other 10% then. I can’t really stop smoking weed once I start and I definitely jones for it when I don’t have any. It’s not so much physical withdrawal like from alcohol or heroin but anxiety and craving. I’m sure I’m more irritable, too. But staying off weed is far easier than quitting smoking cigarettes. THC is just a different drug than nicotine.
    I’ve heard that THC isn’t terribly physically addictive (i.e. you don’t have to increase the dose to get high) but it is HIGHLY psychologically addictive. Like one’s threshold for feeling adequately stoned increases over time. An ex-roommate told me I could put away a blunt and a few bowls by myself and still act perfectly lucid. Which is scary.
    This is different from alcoholics who can drink 3-4 drinks and still not feel buzzed, blow below a 0.08% BAC, etc. because they are physically addicted. It takes more and more alcohol to get baseline drunk, unlike weed. Every pothead will feel the effects of THC after one hit, it’s just a matter of when you’re high enough.

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  19. Muse142 Says:

    I would like to say, for my own sanity (and so drugmonkey doesn’t think all of his commenters are idiots):
    The plural of anecdote is not ‘data’. This is why we do experiments. Don’t like the results of this experiment? Explain why the methods / analysis / any aspect was flawed. Find other, better-done studies that contradict it.
    I can dig that the ‘psychological’ withdrawal symptoms are caused by some physiological process. I can also dig that mild symptoms that relate primarily to mental state (cravings, irritability) could be categorized as a different type of withdrawal effect than effects detectable as a disturbance in the totality of bodily systems (DT’s, nausea/vomiting).
    Interesting stuff all around. (Except for pmont’s proposed ‘experiment’ and related mary-jane glorification and tobacco demonization. That would just be stupid.)

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  20. BlindSquirrel Says:

    personal experience with a handful of users instead of an understanding of the available evidence.

    And then you present us with two studies involving a whopping 12 and 67 individuals? LOL I have known a hell of a lot of pot smokers and tobacco smokers in my long life. Most of the pot smokers have quit or cut back to the occasional party, while the tobacco smokers are pretty much still addicted even though they know it is killing them. I will grant that there are pot addicts, whatever the word means, but there are addictive personalities out there who will become “addicted” to whatever they can get their hands on. I understand there was a rash of ether addicts when it was first discovered.A lot of these pot addicts in treatment centers are diverted there to escape the draconian drug laws. Hell yes, I would cop to a pot addiction if it meant I could avoid a prison sentence. Then the “alarming rise” in pot addicts in treatment is used to justify further draconian laws. Sweet system, huh? Wish I owed stock.

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  21. Dunc Says:

    Well, another long-term pot and tobacco smoker here to throw my anecdata into the ring…
    These results don’t seem particularly surprising to me. In fact, not surprising at all. In my experience, the major differences I notice between withdrawal from the two drugs are that nicotine withdrawal hits faster, and is harder to ignore by keeping busy. I have no trouble getting through the day at work without smoking dope, but if I tried to not smoke tobacco, I’d be tearing my hair out by lunchtime. However, put me in a study situation with somebody asking me about how I felt about not smoking dope, and it might be a different matter.

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  22. PhysioProf Says:

    Yeah, I’m gonna call shenanigans on this bullshit. Jacking off is fucking “addictive” and if you stop dudes from jacking off they will go through “withdrawal” symptoms. The idea that tobacco and marijuana are similarly “addictive” is just an absolute crock of shit.

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  23. Sven DiMilo Says:

    I had dismissed them as being “merely psychological” not physiological

    False dichotomy?
    I’m with PhysioProf on this one (as with so much else it seems)…I’d offer my own anecdote in support but who cares? I’m not arguing with the data presented–data are data–but I guess I don’t see that all of those variables are components of meaningful “withdrawal.” Flood your cannabanoid receptors for 10 years and then stop abruptly, and of course there are going to be symptoms of de-flooding…but is that necessarily “withdrawal” in any meaningful clinical sense? Any different from jacking off or Twinkies?

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  24. Twi Says:

    What an appropriate article for me this morning. Some background:
    I have been a near daily pot smoker for 12+ years. Up until 15 weeks and three days ago, I smoked 1 1/2 – 2 packs of cigs a day for about that same amount of time. Three weeks ago, I stopped drinking as well (I typically got drunk 4-6 times a week, but was still able to hold a job, get A/B’s in school, etc. – essentially I was a functional alcoholic – I’ve been that way for about 5 years) So I quit that too. (This has been my ‘year of self improvement’)
    And despite what I want to say, I am having the hardest time with pot. I think it’s because I used it to quit the others (when I wanted a smoke the first week, I’d just go get high. Eventually that’s how I quit smoking cigs. Same thing with booze – when I wanted a drink, I’d get high.) I was substituting one substance for another. And now I’ve been reduced to coffee. Which is a poor substitute for weed. I’ve been ‘clean’ for 2 days now. Hence, I’ve been depressed as hell, bitchy, grumpy, and yeah, I’ve barely eaten the last few days.
    I 100% think pot should be legal, as long as cigs and booze are. It is, from everything I can tell, much safer than either. But I agree that it is addictive and certainly not harmless – just less harmful. In which sense, I’m not sure – perhaps humans just enjoy pleasure? What a novel idea! But it does differ than the chemical dependency that cigs and booze cause, IMHO. Anyways, great blog and it is synchronistically appropriate for me today. Thank you.

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  25. bsci Says:

    Granted this is all anecdote, but it seems like 80-90% of the posters here say that marijuana wasn’t addictive to them and 10-20% say it was. This seems to match some of the data presented in past posts.
    Are the people saying it’s never “really” addictive willing to read the comments of those 10-20% here and accept that there really are serious addiction/withdrawal issues is a sizeable minority of users? The caveats that the symptoms aren’t as serious as nicotine/alcohol/heroin/Pan Galactic Gargle Blasters, are irrelevant to accepting that marijuana can cause dependence problems.

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  26. These comments remind me of Intro Psych lectures. Lots of freshman arguing against data with personal anecdotes.
    I thought the sleep disturbance result was most interesting though. I’ll quote so you don’t have to scroll up:
    Cannabis discontinuation (alone) seemed to cause sleep disturbances for longer than did nicotine discontinuation (alone).
    Maybe not unexpected when taken with other findings about the role of cannabinoids in controlling obstructive sleep apnea. Certainly cannabinoids have an effect on the body, and removing them after developing dependence would result in withdrawal. I don’t see why people are so resistant to that.
    AND if Gambling can be an addiction, then so too can twinkles and masturbation. Although I’ll admit that withdrawal from these ‘behavioral’ addictions might depend on your definition of ‘withdrawal.’

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  27. Roland Latour Says:

    The real question is: who funded this research?
    This guy Alan J. Budney works for U-Arkansas.
    Where did he get the cannabis? From the DEA?
    There’s no other legal source in the US.
    The DEA has a history of funding research on
    this with pre-determined outcomes. Sounds like
    the kind of politically-motivated BS that
    is passed off as science these days.

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  28. bsci Says:

    Roland,
    If you bothered to read the post you’d see that this study has nothing to do with giving people drugs. It was a withdrawal study, thus the DEA pot supply was not involved.
    From the 2008 paper that is referenced here:
    This research was supported by research grants from the National Institute on Drug Abuse: DA12471, T32DA07242, K02-00109, K05-00450, and in part by the Arkansas Biosciences Institute, the major research component of the Tobacco Settlement Proceeds Act of 2000. Parts of this study were conducted as a segment of the doctoral dissertation of Ryan G. Vandrey at the University of Vermont. Preliminary findings from this study were presented at the annual conference of the College of Problems on Drug Dependence, 2006.
    From his 2006 review paper: This work was supported in part by National Institute on Drug Abuse grants, DA12471, DA12157, DA55186 and T32-DA07242.
    Does NIDA also have a history of only funding research with predetermined outcomes? Is Drugmonkey biased because is probably also gets money from NIDA to study drug abuse?

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  29. @ Roland Latour:
    Easy enough to check. All it takes is a glance at the article. Vandrey was supported by grants R01-DA12471, T32-DA07242 from the National Institute on Drug Abuse. Budney was supported by research grants from the National Institute on Drug Abuse: DA12471, T32DA07242, K02-00109, K05-00450, and in part by the Arkansas Biosciences Institute, the major research component of the Tobacco Settlement Proceeds Act of 2000.
    In neither study were participants given marijuana.

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  30. Neil Says:

    Like a number of other posters, I am rather skeptical of the conclusions reached by these studies. Based on purely personal/anecdotal understanding of cannabis use, I hypothesize that symptoms/effects of introduction to cannabis use would include:
    reduction of irritability
    increase in appetite (‘the munchies’)
    reduction of nervousness
    sleepiness
    The measurement of the removal of these effects would, of course, appear to be similar to withdrawal symptoms, but without studying the entire cycle of substance use, it is surely impossible to distinguish between the measurement of a withdrawal symptom and the simple removal of an effect.

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  31. DrugMonkey Says:

    in the second study, how recently had these folks quit? Do we have any info on the timeline that these symptoms might be expected?
    18 or 19 days as an average for the two groups.
    to quick and dirty the subject table, first number is for cannabis group, second for nicotine. variance indicators in parenthesis are quartiles and +/- are standard deviation.

    # of past quit attempts 3 (2, 6) 5 (4, 10)
    Longest prior period of abstinence (days) 60 (10, 248) 75 (16, 365)
    % quitting another substance at same time 24% 13%
    # of days from quit date to interview 18.4 � 8.6 19.0 � 8.4
    # of days abstinent following quit attempt 9.7 � 8.4 8.0 � 7.1

    I wonder if the persons suffering from “withdrawal” also exhibited addictive personalities.
    ah yes, the old “addictive personality” dodge. As used by the advocate this is supposed to mean there can’t be any effect of the drug itself, it is just a person who will be addicted to anything that is the problem. [I’ll let you jackoff and Twinkie fans see where your favorite pleasures fit in…]. And you very quickly find some dismissive arguments that the problem is “psychological” in nature, as if it is some how less real.
    But this is an interesting point when looked at appropriately. Yes, from a neurobiological perspective, much of what I talk about on the epidemiological front does indeed ask the question about why some individuals are more at risk for developing dependence. I think this is overwhelmingly clear although, as I also mention at times, I think some approaches to animal models seem to assume that the issue is only about sufficient drug exposure. I happen to think we can investigate drug abuse in more complex terms of both drug exposure and existing individual liability.
    bsci at #25- BINGO! I love these threads that emerge for precisely this reason. blog comment anecdote recapitulates the published data…how fresh is that!?!?
    The DEA has a history of funding research on
    this with pre-determined outcomes. Sounds like
    the kind of politically-motivated BS that
    is passed off as science these days.

    please, do explain this history to us if you would? And while you are at it, perhaps a data based critique or at least a scientifically informed critique of these papers that allows you to conclude that they are “politically-motivated BS”? Other than the fact that you simply don’t like the outcome, because that is a good way to detect political motivations in dismissing scientific findings…”The outcome doesn’t align with my political position therefore the science must be flawed” sounds very bushrovian to me. just sayin’

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  32. Way late to this party but anyway—I can’t believe the number of “I have blah experience with blah drug and blah friends who do blah dope….and withdrawal is bullshit” arguments.
    What part of “….informed by anecdote and personal experience ……instead of an understanding of the available evidence…” —-in the first paragraph of this post—is so freaking hard to understand?

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  33. Mac Says:

    Re Green Eagle #7
    “marijuana consumption is virtually totally benign compared to the consequences of tobacco smoking”
    Where on earth is your data to support this? Is marijuana smoke somehow less carcinogenic than cigarette smoke? Your brand of anecdotal evidence is exactly what fuels so much denialism in society.

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  34. paul Says:

    Bottom Line is that both substances produce a mild self limiting withdrawal that probably can be greatly reduced by a slow taper, the physical withdrwal symptoms will go away within a month, this is nothing compared to the life threating withdrwals one can get from alcohol and benzos if they are stopped abruptly.

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  35. DrugMonkey Says:

    Flood your cannabanoid receptors for 10 years and then stop abruptly, and of course there are going to be symptoms of de-flooding…but is that necessarily “withdrawal” in any meaningful clinical sense?
    First, Sven, what on earth do you think withdrawal from any substance is other than “symptoms of de-flooding”!!??? Good gravy. But surely you are aware that the processes at work are usually considerably more involved, yes? That what happens is that the normal operation of the receptor systems (not just the primary or first-contact receptor but also other chemical signaling systems down-stream) gets altered by the continued ‘flooding’. a very simplistic model of drug tolerance, for example, might be a decrease in the number of cannabinoid receptors expressed on a given neuron due to continued exo-cannabinoid exposure. If you remove the exogenous drug, the system is in a deficit state, compared with pre-exposure.
    With respect to “clinical significance” I can again refer you to the Budney work but let us face it, it is difficult to agree on what a dependence “problem” really is. Ultimately it will be subjective. Does it matter that someone is “kinda snappish” if they haven’t had their toke? Well, perhaps not at the job place if the individual works alone at a computer all day…at home with wife and kids? big problem.
    some individual with independent wealth and no dependents or obligations wants to stay high all the time- no problem right? not so for others.
    As I’ve commented elsewhere, the fact that people are themselves seeking treatment is a very good sign that there is a significant clinical problem. Whether you happen to think you would be treatment seeking in their shoes or not.

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  36. Neil Says:

    I find it interesting that the sample group in the second study was based on subjects who had already identified themselves as being dependent on cannabis/nicotine. It would perhaps be revealing to discover the proportion of all daily users of each substance who would identify themselves as dependent, in order to contextualize the conclusions.

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  37. DrugMonkey Says:

    bill @ #12
    you have to track back to the original data source on that prior post but the nicotine data are there ( I think it was NeuroStudent who mentioned this in the comments)
    http://oas.samhsa.gov/NSDUH/2k6NSDUH/2k6results.cfm#Ch4
    That figure just seems way too low to me: why the fuck would you smoke 10/day for 10 years if you didn’t have a jones?
    The Donny and Dierker study was, if not gob-smacking, very salient to YHN as well. I’m assuming we’ll be hearing more on this topic. And as you can tell, it is a little bit of a hobby of mine to look at what I call the conditional probability of dependence. i.e., “given that you take this drug [in pattern X and amount Y] what are your chances of becoming dependent”. It is not an easy or obvious question to answer with hard data. This does not mean, however, that the available data aren’t informative.
    but yes, as I’ve mentioned in the comments above, the notion of meeting particular diagnostic criteria (DSM is not the only schema, btw) for “dependence” is not the be all / end all. It is necessary to have as operationalized and objective criteria as possible to generate scientific data that will be useful. These are, however, going to be population level analyses. Determining what is “a drug problem” for an individual user is in the realm of personalized clinical care.

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  38. Onkel Bob Says:

    My, you are a condescending asshole.
    Have a fucking shitty day.

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  39. Tim Says:

    Hey Author,
    Smoke cigarettes for a year straight and then quit. Then smoke cannabis for a year straight then quit. See which one is harder and you will have your answer. Quitting Tobacco is much harder than weed. Try it!!!!

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  40. DrugMonkey Says:

    It would perhaps be revealing to discover the proportion of all daily users of each substance who would identify themselves as dependent, in order to contextualize the conclusions.
    Are you asking whether people who are substance dependent know that they are? I am not really conversant with this literature but I’d be surprised if one couldn’t dig up a little something.
    Or are you suspecting for this particular study that those that have tried to quit cannabis are in some way further down the cannabis-addiction path than nicotine quitters are down the nicotine-addiction path? That is a very interesting point. It would bear some thinking on how to get at this question. Certainly a seat of the pants consideration, not to mention comments in this thread, would suggest that the population awareness that cigarettes are addicting is higher than the awareness that cannabis smoking is addicting. It would not be a great leap to think that there might be a higher threshold on the “this is causing problems, I need to quit” scale for cannabis smokers relative to cigarette smokers…

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  41. DrugMonkey Says:

    Quitting Tobacco is much harder than weed.
    Tim, these papers addressed acute withdrawal in the first several days following substance discontinuation. The acute withdrawal is only one of many influences on “quitting”. Is this not obvious?

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  42. Marion Delgado Says:

    You are a classic fraud, frankly, and a fit target for people fighting back against politicized science.
    Cherrypicking crank results is not going to establish anything scientifically, but it works wonders clouding the water politically and legally. You’re simply another shill providing cover for whatever pleases the right-wing corporate funders of the GOP War on Science.

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  43. PhysioProf Says:

    Does it matter that someone is “kinda snappish” if they haven’t had their toke?

    Just toke the fuck up! No more snappishness!

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  44. Neil Says:

    I contend that it is likely that the group of cannabis users that have identified themselves as dependent have done so because they experience withdrawal symptoms when they try to stop. The study is therefore measuring withdrawal symptoms in a group more likely to experience those symptoms than the population of daily cannabis users as a whole. This is of course the same for nicotine users. Therefore it will have a lot to say to determine the proportion of the daily users of each substance as a whole that consider themselves dependent, in order to draw any meaningful conclusion whatsoever.
    I would suspect that a random sampling of each group would identify nicotine users as being much more likely to admit to dependency than cannabis users.
    I hypothesize that nicotine, statistically, induces far greater degrees of withdrawal symptoms than cannabis. This hypothesis is not falsified by the second study, for the reasons above. The first study involved such a tiny number of subjects, that I do not think that it can demonstrate anything at all.

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  45. DrugMonkey Says:

    I contend that it is likely that the group of cannabis users that have identified themselves as dependent have done so because they experience withdrawal symptoms when they try to stop. … in order to draw any meaningful conclusion whatsoever….The first study involved such a tiny number of subjects, that I do not think that it can demonstrate anything at all.
    The first bit you have here is great. Alternative testable hypotheses. Exactly the way skeptical knowledge seeking should work.
    You then retreat to the denialist position- that the existing data are meaningless because the study wasn’t done exactly the way you wish. And this is the part that I find to be denialist.

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  46. Neil Says:

    “..Certainly a seat of the pants consideration, not to mention comments in this thread, would suggest that the population awareness that cigarettes are addicting is higher than the awareness that cannabis smoking is addicting. It would not be a great leap to think that there might be a higher threshold on the “this is causing problems, I need to quit” scale for cannabis smokers relative to cigarette smokers…”
    Surely the data collected in this study was, at least partially, based on the subjects’ awareness of their withdrawal symptoms. Are you contending that cannabis smokers who state that they are not dependent and do not suffer significant withdrawal symptoms do really, but are just not aware of them?

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  47. DrugMonkey Says:

    Are you contending that cannabis smokers who state that they are not dependent and do not suffer significant withdrawal symptoms do really, but are just not aware of them?
    I am contending that people who are drug dependent and do suffer significant and classic symptoms of withdrawal are frequently unaware of them.
    You aren’t seriously questioning this are you? Do you really think that every cannabis user is walking around thinking “Gee, I’m a little more aggressive with my email comments today, hm, how many hours ago did I last smoke out?”. or “Hmm, slept like crap last night…OMG! I’m precisely 48 hours out from my last bong hit!”. Do you think anyone walks around correlating fluctuations in mood state with their substance use…?
    Surely the data collected in this study was, at least partially, based on the subjects’ awareness of their withdrawal symptoms.
    I’m not sure we know this. The subject pool was gated on a prior attempt to quit. It is your hypothesis that withdrawal symptoms motivate attempts to quit. A good hypothesis but not proven by this study (unless I overlooked something in the methods, which is possible).

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  48. Neil Says:

    You then retreat to the denialist position- that the existing data are meaningless because the study wasn’t done exactly the way you wish. And this is the part that I find to be denialist.
    N=12 is tiny. Also, the measurements of increased anger, aggression, irritability (pretty much the same thing) were in relation to SAU. If it were the case that an effect of cannabis were to reduce these things, then it would appear likely that stopping consumption would revert the subjects back to a normal level of anger, aggression and irritability. i.e. an increase. I don’t believe that this is what most people understand as being a withdrawal symptom.
    The conclusion of the Budney report indicated that a dependency to cannabis was similar in nature to nicotine dependency – there was no inference concerning the probability of dependency occurring.
    I have two simple hypotheses: 1) Cannabis reduces irritability/anger etc. 2) Cannabis, in most cases, causes insignificant amounts of withdrawal symptoms compared to nicotine.
    These hypotheses are consistent with the results of both reports.

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  49. Neil Says:

    It is your hypothesis that withdrawal symptoms motivate attempts to quit.
    No, it is my hypothesis that withdrawal symptoms induce awareness of dependency.

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  50. Neil Says:

    Do you think anyone walks around correlating fluctuations in mood state with their substance use…?
    yes.

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  51. Becca Says:

    @ Neil +1.
    You mean, there are people who *don’t* correlate fluctuations in mood state with substance use??!
    When I get cranky, the first thing I think- “Have I eaten today?” and “How long ago was it?”
    Next thing I check is whether I’ve slept. Next is whether I might have had too much- or too little- caffeine (Caffeine is first if I notice myself jittery, hyper, excitable or shaky- which is quite common- I’m definitely dependent to some degree). In the past, when I’ve taken oral contraceptives, I consistantly used to wonder if my cuddle to sex drive ratio was being affected… even without it, I wonder how *unspecified endogenous female hormones* are affecting my mood- I try charting my cycle to get a hold of this one, as it can be *very* important in answering the “Why am I having a crummy day?” question.
    In the past, while I was on anti-depressants, I made a serious habit of trying to correlate those with my mood (otherwise, what would be the point of those check-in-with-your-prescriber meetings?!).
    When I drink, I wonder about my inhibitions and coordination.
    Does anyone seriously not do this? Am I some kind of hyper-analytic self-fixated-psychopharmacolgically obsessed weirdo?

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  52. Mike Says:

    Awesome post, DrugMonkey. You really brought out the deniers/conspiracy theorists/anti-everything types. And it is always fun when they get stirred up.

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  53. DrugMonkey Says:

    Becca @ #52: umm. wow. and do I take it you are not training in any sort of psychopharm discipline? geez.
    ( and i’m not touching your last question lest you smack me around like you have been poor Greggie lately. “stick to sheep”! w00t!)

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  54. Neil Says:

    I am contending that people who are drug dependent and do suffer significant and classic symptoms of withdrawal are frequently unaware of them.
    We are talking about cannabis, specifically, here. Report 1, based on a sample of 12 people – these 12 smoked cannabis 25 or more days per month. If, as I contend, cannabis is normally fairly benign as far as withdrawal symptoms are concerned, then most users would not be concerned about consuming it almost every day – these 12 are relatively heavy cannabis users. If someone does something every day that they enjoy and then they’re not allowed to do it, they will tend to be more irritable; you could probably plot similar graphs for internet gamers or gambler or reality TV addicts – by definition, the sample group are habitual users and withdrawal from the thing they do habitually will cause them irritation.
    By picking out a particular drug for this analysis immediately implies that there is some physiological cause for the symptoms.
    Report 2 is very guarded about inferring any such link:
    The differentiation between �physical�
    and �psychological� dependence is arbitrary and merely
    contributes to misconceptions about the nature and
    severity of substance dependence disorders.

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  55. Flood your cannabanoid receptors for 10 years and then stop abruptly, and of course there are going to be symptoms of de-flooding
    I’m not so sure. I’ve seen people smoke absolutely massive amounts for years (say 1/4 oz of top-of-the-line stuff a week), and then because of job or other requirements, stop cold turkey and have no problems whatsoever. Yeah, I know, and George Burns smoked cigars for nearly 100 years.
    The bigger point was made by another poster here: all of the “common symptoms” of marijuana withdrawel are the polar opposite of marijuana effects. It’s akin to listing dehydration as an effect of gatorade withdrawel, or headaches as a symptom of aspirin withdrawel. A a bare minimum I want to know why these particular traits were chosen as symptoms.
    I lack time to go through the details of the study at the moment, but plan to. I must say I am not optimistic, since I’ve never seen a study of this type that didn’t have severe methodological flaws. However, it is important that we do not dismiss a study merely because it MIGHT have flaws. That’s the surest way to make our mistakes permanent.

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  56. Neil Says:

    Mike
    Denier?
    I am not denying the results of the studies at all: the 1st study I don’t have access to and the 2nd study is of subjects who have already admitted a dependency. I am not proposing Noahs Ark here, I have a subjective opinion that is entirely consistent with both anecdotal and empirical sources.
    The 2nd report concludes only that there is a qualitative similarity between withdrawal symptoms for cannabis and nicotine in subjects who have recognized a dependency. There is no way that it can be implied from this study what the frequency of dependencies are for these substances or that they are comparable.
    Conspiracy Theory?
    These tend to be utterly infeasible – It is possible that DrugMonkey has some kind of political motivation – people often do when illegal drugs are the issue.
    Anti-everything?

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  57. DrugMonkey Says:

    I must say I am not optimistic, since I’ve never seen a study of this type that didn’t have severe methodological flaws
    Dude, just about every study of consequences of long-term exposure to “X” in humans is flawed by a lack of random assignment, numerous correlative variables of interest, interplay of environmental and genetic contributions, etc. From one way of looking at it all humans studies have “severe” flaws. The animal studies, OTOH, can have random assignment, controlled exposure to “X”, multiple control groups, etc. …and yet there is always the problem that they are not humans. Aha! Flawed!
    It is a science-denialist position to refuse to come to a reasonable synthesis of all the available evidence. It is a science-denialist position to assert that scientific findings on one particular topic are all irretrievably flawed just because the reasonable synthesis points away from your gut level or anecdote supported hypotheses.
    all of the “common symptoms” of marijuana withdrawel are the polar opposite of marijuana effects. It’s akin to listing dehydration as an effect of gatorade withdrawel, or headaches as a symptom of aspirin withdrawel. A a bare minimum I want to know why these particular traits were chosen as symptoms.
    If I have this right you are arguing that acute marijuana has lowered these supposed withdrawal signs below a “normal” baseline to which they return once abstinent? So the first place to start is Budney et al 2003 for a comparison of users withdrawn from cannabis with ex-users (similar prior profiles of use except one year of abstinence or more. to my mind the ex-user group is the control requiring the least hand waving but i’ll look around for study with a matched never-cannabis control group to sort of bracket this issue.

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  58. Grammar RWA Says:

    Tim, these papers addressed acute withdrawal in the first several days following substance discontinuation. The acute withdrawal is only one of many influences on “quitting”. Is this not obvious?

    I don’t think it’s obvious. Off the top of my head, I couldn’t name any other factors involved in quitting. Many of your readers have little or no scientific training, and fewer still are versed in the study of addiction. It helps me, and surely others, if you’re as thorough as you can be.
    I’m sure there are people who get mad at any suggestion that weed isn’t wonderful for the body. I’m not one of them, and I smoke weed. I’m not at all bothered by evidence that it can cause dependency; I already knew that.
    Here’s my issue. If you don’t add a specific political perspective to your discussion of this topic, your coverage will be used to uphold the status quo. You didn’t say “cannabis and tobacco have similar withdrawal effects, so perhaps cannabis should be treated similarly to tobacco: legalization, with treatment programs available for those who wish to quit.”
    I know, you probably wish you could just talk about the science and leave out the politics, but there is no such thing as a depoliticized discussion on this topic. If you don’t say anything political, you have effectively said “we must keep it illegal.” Hence the reactions. I’d be angry too if I didn’t think you had just casually overlooked this factor.

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  59. AtheistAcolyte Says:

    The Vandrey data you supply does seem to support a hypothesis of cannabis withdrawal being less severe or shorter in length. All the markers checked are either stable or decreasing in days 3-5. Cannabis also stays below all other groups for 3+ days out of the 5 total in 4 out of the 6 categories.
    Not that I am an apologist for cannabis-smoking, I have no interesting anecdotes like anyone else, except for my underwhelming first and only experience. It just seems to me that the data isn’t making as clear a case for equivalence as you are suggesting. Or perhaps I’m inferring you’re suggesting.

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  60. DrugMonkey Says:

    It is possible that DrugMonkey has some kind of political motivation – people often do when illegal drugs are the issue.
    Amongst the interested parties of cannabis users, politicians, morality-police members of the public and scientists…well, it sure ain’t the scientists who act as if they have an agenda that is resistant to data, logic and analysis. Just sayin’
    I will not protest to any great extent about what my ‘motivations’ and ‘agenda’ may be. You simply have to determine that through what I write. I will note, however, that someone who is willing to observe that the population of heroin dependent individuals has been reported to be only 24% as large as that of those who try IV heroin in a 12 month interval is not likely to be part of the right-wing anti-drug prohibitionist agenda as construed by a typical legalize-eet mon perspective.

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  61. DrugMonkey Says:

    I don’t think it’s obvious. Off the top of my head, I couldn’t name any other factors involved in quitting. Many of your readers have little or no scientific training, and fewer still are versed in the study of addiction.
    My total bad, Grammar, sorry. Thanks for pointing that out. A few factors include: Drug availability in terms of cost and access. Cues associated with drug use, such as the people, places and circumstances of prior or typical use. Social acceptability (think caffeine and alcohol versus nicotine versus cannabis versus IV heroin, quite different and context dependent) in workplace, social group, family, etc. Complex learning and associative phenomena (yeah, that thing about IV drug users injecting saline now and again is not just a myth; think of it like the pleasure of near beer and decaf coffee-both inherently unpleasant sensory experiences that you seek even without the primary reinforcer included!) beliefs about harm associated with use!!
    I’d be angry too if I didn’t think you had just casually overlooked this factor
    It is generally explicit, not a casual ignoring of policy implications. I am not in public policy. My opinions there are as amateurish as anyone else’s and I think some conspiracy theorists might be quite surprised.
    But to be clear, I am as intolerant of misusing drug-abuse science to promote restrictions on use as I am to promote relaxation of restrictions. My agenda on the policy front is to stand up for as accurate a reflection of the truth as we know it as possible.

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  62. Grammar RWA Says:

    I am not in public policy.

    We’re all in public policy! 🙂 Well, those of us who live in ostensible democracies. I hope you aren’t under the impression that your amateurish opinion isn’t important. You do vote?
    And I’d be shocked if you don’t have one friend, acquaintance or extended family member who has been unjustly harmed by the War On Some Drugs.
    Policy is currently: “pot’s bad for you, so it should be illegal.” It’s not much more sophisticated than that. You quote favorably from research that says “pot’s bad for you.” In lieu of other commentary from you, any professional policy maker who reads this blog will conclude, “so it should be illegal.”
    I think it’s unfortunate that you aren’t allowed to not have an opinion, but that’s where we are at this time.

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  63. DrugMonkey Says:

    I think it’s unfortunate that you aren’t allowed to not have an opinion, but that’s where we are at this time.
    Nice! Who said anything about me “not being allowed” to have an opinion? I stay away from public policy implications (particularly in the main post) because I want to, not because anyone else thinks I should do so.
    You quote favorably from research that says “pot’s bad for you.” In lieu of other commentary from you, any professional policy maker who reads this blog will conclude, “so it should be illegal.”
    And here you really would be dragging this discussion into territory covered by the great ID/Evilution/NewAtheist/Framer debates. I cannot help with the idea that a post that I write for one purpose will be picked to help the arguments on one side or the other. This is just not what I am interested in doing with the blog at this time. You might as well suggest that drug abuse scientists should only publish findings that cannot be “misused” by one political policy agenda or another. That notion is just completely at odds with my view of my real job which is to get at the closest approximation of what is true, not that which is convenient to one political agenda or another.

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  64. Mike Says:

    Who brought out all of these creationists. They way these commenters reject science reminds me of the way creationists do.

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  65. Grammar RWA Says:

    Nice! Who said anything about me “not being allowed” to have an opinion?

    I did, and I’m afraid it’s fact of life in these times. If you don’t like it, it doesn’t matter. Without further commentary on your part, your coverage will be used to promote criminalization. Sorry. Neither you nor I can do anything about that fact.

    You might as well suggest that drug abuse scientists should only publish findings that cannot be “misused” by one political policy agenda or another.

    Not fair. I did not say that. Drug abuse scientists should publish their research, whatever it is.
    But they should be aware of the political implications. If they personally support even a small level of decriminalization, they should say so. It’s naive to hope that our society can have a depoliticized conversation about this.
    On the other hand, if researchers support criminalization, then it’s not necessary to say anything. The research will be spun to support criminalization, because that’s the status quo.

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  66. Grammar RWA Says:

    Excuse me. I misread you a moment ago. I didn’t say that you’re not allowed to have an opinion. I said you’re not allowed to not have an opinion, and I also lamented this situation.

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  67. Becca Says:

    @DM- nope, I’m definitely not studying psychopharm. Well, my PhD will be in “molecular medicine”- so maybe it’s not completely shocking (though MM is such a gloriously vauge term I can justify everything as related).
    Oh well, chalk another one up for “I’m really quite a weirdo”
    (and I don’t think you have to worry about getting the same treatment as “poor Greggie”… you may be his equal in innate ability for condescesion, but you seem more judicious in your excecution thereof… and, at any rate I’m begining to think you have more legit authority [i.e. knowledge] in your left toenail than “poor Greggie” will ever muster)
    In any event, I do second Grammar RWA’s request for your actual thoughts on policy (though I would be interested in hearing regardless of whether they tend toward pro or anti status quo). The point about democracy was well said.

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  68. pmont Says:

    “Interesting stuff all around. (Except for pmont’s proposed ‘experiment’ and related mary-jane glorification and tobacco demonization. That would just be stupid.)”
    OK, I was being subjective and anecdotal. Yes, it would be a stupid experiment to do, but only because we know what the outcome would be: extreme sickness and maybe even death in a number of the tobacco-munching subjects, but likely not with the pot-eaters. I know drugmonkey’s report is about addiction, and I’m not arguing with the data, but here’s the point I would like to reiterate: if one is to be addicted to a substance, it might be “better” to be addicted to a substance that is probably benign than to get hooked on something that is a demonstrably deadly toxin. Yes, inhaling the smoke from any burning, carbon-based matter is going to fuck up your lungs and other organs (it’s smoke inhalation, after all); with tobacco, though, you also inhale that erstwhile insecticide, nicotine, which in a high-enough dose can kill on skin contact. No equivalent killing substance has been found in marijuana.
    Some people go though withdrawal from pot-smoking cessation. Granted. And so do some (many?) people who stop smokin’ terbacky. Big deal. I’m not denying it. But, as Grammar RWA suggests, politics might enter the picture here. Suspicions about political motivations are raised, for instance, when drugmonkey uses the characterization “legalize-eet mon” in one of his posts to derogatorily describe (possibly non-scientists’) anecdotally-contributed comments. That sounds defensive. And I suggest that defensiveness, in this case, might mask another sort of denialism, such as denying that there might be political motivations flavoring the origin of this post. Ya think? (Mmmm…flavoring…is that a chocolate brownie, or peanut butter?)

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  69. fullerenedream Says:

    @ Becca #52: I don’t think you’re a weirdo! You’re just keeping an eye on what substances might be affecting your mood. I do the same thing, and I think it’s a good habit.

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  70. DuWayne Says:

    First; Smoking weed kicks fucking ass! (Sorry, PP was looking kinda lonely)
    I have two minds with this that I think mesh well here. I have been mulling this over since your post on recreational drug use, trying to formulate a response. But first;
    Do you think anyone walks around correlating fluctuations in mood state with their substance use…?
    Yes. Because I do. If I get particularly cranky early in the day, I think about my coffee intake. Did I drink too much, not enough? If I am having trouble focusing, I wonder if it’s not time to switch my substance intake around a bit. If I am feeling down without a substantive reason (i.e. my mother or my dog just died), I really think about what I might have taken, eaten or otherwise been exposed to, as the only time I have ever dealt with regular, non-situational depression was when I quit using hallucinogens. If I am feeling excessively euphoric I really think about what might have caused it. While I am generally enthusiastic and happy, getting giddy to the point of irritating is not the norm. Although on the occasions when it happens, I tend to guess what might be lacking (I have been diagnosed bipolar).
    I also know a lot of people who are pretty much admitted substance abusers who also do this. People who use narcotics to sleep every night, lots of caffeine to wake up and various drugs of choice to manage through the day. These are people who pay exceptionally close attention to how they are feeling and it’s correlation with their substance intake.
    But in to the point…
    First, the issue of “psychological” addiction versus overt chemical dependence is kind of a silly one. Addiction starts long before overt dependency takes hold.
    The first time someone smokes crack for example, they are overwhelmed by an intense desire to smoke more. This is not an overt physical withdrawal, it has nothing to do with the body craving more of it. It is the intense desire to feel the way that drug makes you feel that lends itself to sustained, regular use that turns into dependency.
    This is also shown in the typical desire of clean addicts to use their drug of choice long after they have quit using. Every ex-tobacco user I know, whether they quit a week ago or several decades ago, still want a smoke. Their bodies have adjusted to the lack of nicotine just fine, it’s all in their heads.
    This lends me to believe that dependency is merely a side effect of addiction, having little to do with the cause. This is not to make light of the overt dependency and withdrawal, it’s a miserable place to be and depending on the chemical in question, can even be fatal. But the fact that it is the most palpable, definable aspect of addiction, does not mean that it is the sum of addiction, or even all that important an aspect of addiction.
    Going further into the notion of psychological addiction. Let’s please not make light of the understanding that this too is a physiological response, just one that is harder to see. This is important because this is the heart of addiction.
    Look at it from this perspective. ADHD is a psychological issue. Bipolar disorder is a psychological issue. Schizophrenia is a psychological issue. So lets not downplay “psychological” addiction. Indeed, my preference would be to see a larger distinction made between addiction and dependency. While they are inter-related they are separate problems – it just happens that when one is battling one, they are often battling both.
    All that said, I think that it is important to recognize that all addiction and dependency is not the same.
    In your last post on recreational drug use, you made the claim that marijuana is far more important from a public health perspective, than most of us who favor legalization (or in MarkH’s opinion, decriminalization – a separate topic that I strongly disagree with him on) like to believe. This based on the fact that more people are addicted to cannabis than drugs like heroin or cocaine. The implication being that cannabis addiction is a much larger problem in our society than heroin addiction or cocaine addiction.
    This is where you lose me. I’m sorry, but excepting the very heaviest users, most cannabis addicts I know are functional, contributing members of society and manage to stay that way in spite of (or as some of them would claim, because of) sustained, regular use. If compelled by circumstances, it isn’t a hard drug to quit – even for the most die-hard tokers. Yeah, they have the same desire that other addicts have, even months or years out, but it doesn’t work out as being nearly as difficult to manage as tobacco or alcohol. If after years, a cannabis addict has a few tokes, it isn’t nearly as likely to lead to a binge. Unlike ex-tobacco users, who almost always end up back into the swing of their addiction if they take one hit off a cigarette.
    I would love to see marijuana stripped of this special status in the pantheon of illicit/licit recreational drugs, as being some benign force that can do no wrong. Which I suspect is your goal in all this. But I am strongly averse to putting it into a category that makes it seem worse than it is.
    For full disclosure, as today and tomorrow are my weekend (I have a restaurant kitchen remodel starting friday, that will put my next day off in fifteen days) I am stoned as I type this. I smoke once or twice a month (on average) and I smoke really good shit. So to second PP (and myself now);
    Smoking weed kicks fucking ass!

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  71. anonymous Says:

    @59,63,66: I think it bogus to whine about “you must support us or you are against us”.

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  72. Grammar RWA Says:

    I agree, anonymous, and I didn’t say that.

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  73. “just about every study of consequences of long-term exposure to “X” in humans is flawed by a lack of random assignment, numerous correlative variables of interest, interplay of environmental and genetic contributions, etc.”
    Not to this extent. For Jeebus sake, every one of your metrics is subjective! What the heck does “irritable” mean exactly?
    Doing a good controlled study isn’t all that difficult, unless there is a particular outcome you want to see…
    It is a science-denialist position to refuse to come to a reasonable synthesis of all the available evidence. It is a science-denialist position to assert that scientific findings on one particular topic are all irretrievably flawed just because the reasonable synthesis points away from your gut level or anecdote supported hypotheses.
    It is a crank position to demand that shoddy, poorly performed experimental evidence should be accepted just because there is a lot of it, or because it tells you what you want to hear. It is a crank position to claim it is a denialist position to reject flawed studies, even if that means 100% of them.
    See, we can play this cute little loaded rhetoric game as long as you like, it won’t change the fact that you don’t have the evidenciary goods.

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  74. Grammar RWA Says:

    here’s the point I would like to reiterate: if one is to be addicted to a substance, it might be “better” to be addicted to a substance that is probably benign than to get hooked on something that is a demonstrably deadly toxin. Yes, inhaling the smoke from any burning, carbon-based matter is going to fuck up your lungs and other organs (it’s smoke inhalation, after all); with tobacco, though, you also inhale that erstwhile insecticide, nicotine, which in a high-enough dose can kill on skin contact. No equivalent killing substance has been found in marijuana.
    Some people go though withdrawal from pot-smoking cessation. Granted. And so do some (many?) people who stop smokin’ terbacky. Big deal. I’m not denying it. But, as Grammar RWA suggests, politics might enter the picture here. Suspicions about political motivations are raised, for instance, when drugmonkey uses the characterization “legalize-eet mon”

    I would agree that nicotine is probably worse, physiologically, than anything in cannabis, at the quantities that these substances are smoked or otherwise consumed.
    But please do not make my words suggest that the political persuasions of the researchers or their funders have impacted the results of this research, nor that DrugMonkey’s politics have influenced or colored the coverage here. I am proposing nothing of the sort.
    I have only said that when we do not explicitly share our own opinions on politically-loaded topics such as this, our words will be used to uphold the status quo. That is the nature of oppressive systems, and the War On Some Drugs is as oppressive as any of them.

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  75. Gibbon1 Says:

    “The plural of anecdote is not ‘data’. This is why we do experiments. Don’t like the results of this experiment? Explain why the methods / analysis / any aspect was flawed. Find other, better-done studies that contradict it.”
    I’m not sure why I hate that first line. It’s probably cause I spend a lot of time picking through anecdotes as part of my work. What is more anecdotal than a bug report? Put it this way if your data doesn’t explain the anecdotal observations you got a problem. In real life that usually means your data isn’t measuring what you think it does not that the anecdotes are crap.
    In this case the elephant in the room is the unspoken equating of withdrawal symptoms with addictive potential. That is looking at the problem from the wrong end. What causes people to have a hard time stopping, rather than what causes them to take it up (again and again) in the first place. A simple thought experiment will tell a lot, imagine a drug that causes no symptoms at all, until you stop taking it, then you puke for a week. That drug is going to have an addiction potential of zero. And then think to yourself how much the theory that withdrawal equals addiction rests on the idea that humans are pansies in the face of all sorts of observations to the contrary.

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  76. PalMD Says:

    Wow. First, great post, and great thread.
    Second, WOW, what an interesting thread.
    One theme running through is the whole, “Dude, I know what science says, but fuck it, that’s not how me/my bud/someonesomewhere felt.”
    The whole point of science is to systematically study these phenomena and try to get answers. Anecdotes in interesting, but…

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  77. DuWayne Says:

    Grammar RWA –
    I just noticed your comment about factors other than withdrawal that affect quitting.
    Quite honestly, the withdrawal is really a minor aspect of quitting most drugs. Obviously some withdrawal is worse than others. DTs or heroin withdrawal for example, can be fatal without medical intervention. But acute withdrawal is more or less a medical condition, something that can be treated. This doesn’t mean that it’s easy, even with treatment it is usually misery. But it has an end. Once it’s over, it’s over.
    Not so much with the addiction. Years after the chemical has been eliminated from a person’s body, the desire to use it is still there. This has nothing to do with physical dependency, that has been done and gone for years. But the addiction is still there. An alcoholic who has been clean for years, then goes on a one night binge, is not going to go through DTs because of it. It is however, quite possible that said alcoholic is going to drink steadily enough after that slip, that they will go through them eventually.
    Gibbon 1 –
    In real life that usually means your data isn’t measuring what you think it does not that the anecdotes are crap.
    Here’s the problem with that. I used to be really into altie “medicine” woo. One of the common threads in all of them is all the anecdotes you could possibly ask for. Centuries of anecdotes behind some of them. Guess what? When studies have been done on a lot of it, it turns out that the extensive history of anecdotes is a load of crap. Not just one study but in the case of homeopathy several. Even studies by homeopaths themselves show it to be bullshit, thus why they make claims that it just can’t be studied the same way that actual medicines are studied.
    OTOH, I do agree with you one hundred fifty percent on your second para.

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  78. DrugMonkey Says:

    What is more anecdotal than a bug report? Put it this way if your data doesn’t explain the anecdotal observations you got a problem. In real life that usually means your data isn’t measuring what you think it does not that the anecdotes are crap.
    Gibbon, do I take it “bug report” means computer programming? Do I really have to point out that biological systems have a great deal of variability while the point of the digital computer is that it does the exact same thing, each time, every time?
    To be specific about the data under discussion, the central tendencies of the samples were being described. The samples were not, however, homogeneous (see my comment #31). Does this “explain the anecdotal report”? well, sure it does. to the extent that this sample included individuals with very low or zero reported symptoms.
    DuWayne- nice outline of the distinction between acute withdrawal symptoms and lasting addiction. drug dependence is a multi-faceted beast, people.
    Not to this extent. For Jeebus sake, every one of your metrics is subjective! What the heck does “irritable” mean exactly?
    Doing a good controlled study isn’t all that difficult, unless there is a particular outcome you want to see…
    okay Avenger, we’re making a little headway although I’ll note that these are not “my” metrics. Seems as though you have no respect for measures that derive in one way or another from asking people how they feel? Since I have no information on the degree to which you understand how these metrics are created, validated and employed to get at human subjective states of affect, it is hard to know where to go with the argument. Certainly your question suggests you didn’t so much as bother to find out what “irritability” meant in this particular study. For those that are actually interested in learning a bit more about the process you might start with Budney et al, 1999 Addiction, 94(9)1311-1322.
    If you do reject, out of hand, the notion that any informative and scientifically reliable measures can be employed then you are denying the validity of a very broad swath of science. If you do so from a perspective of ignorance of the way these measures are created and validated, well…
    It is a crank position to demand that shoddy, poorly performed experimental evidence should be accepted just because there is a lot of it, or because it tells you what you want to hear. It is a crank position to claim it is a denialist position to reject flawed studies, even if that means 100% of them.
    So by all means tell us why the entire body of scientific work on withdrawal from cannabis is “shoddy, poorly performed experimental evidence”? You should probably include your critique of the experimental animal literature in which withdrawal symptoms were characterized after chronic delta9-THC exposure as well. Just so we know that you have a scientifically informed point and are not just making sheist up.

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  79. DrugMonkey Says:

    I said you’re not allowed to not have an opinion, and I also lamented this situation.
    ok, gotcha. I misread what you wrote, my bad.
    I have only said that when we do not explicitly share our own opinions on politically-loaded topics such as this, our words will be used to uphold the status quo.
    I just disagree with your entire premise that scientist’s should communicate their personal policy positions along with each scientific finding. Once one starts to pursue one’s political policy agenda through one’s science, that science is going to be compromised. Or so I would argue.
    I’ll also point out that I am always amazed that advocates for de-criminalization of currently illegal drugs seem to think that policy is going to be changed by arguing “the facts” about relative dangers of psychoactive drugs when this is so clearly beside the point for political decision making.

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  80. DuWayne Says:

    DM –
    I’ll also point out that I am always amazed that advocates for de-criminalization of currently illegal drugs seem to think that policy is going to be changed by arguing “the facts” about relative dangers of psychoactive drugs when this is so clearly beside the point for political decision making.
    This gets me too. I believe that this is so entirely besides the point. But then I am neither a fan of the notion of decriminalization or the notion of restricting legalization and regulation to cannabis alone.
    It really doesn’t matter how good or bad a drug is for someone. What matters is that they are making an informed, conscious decision to take that drug. At that point, the individual should be allowed to make that decision without interference from the state. I don’t care if a drug is discovered that foments serious, terminal addiction from the first dose – i.e. if you use it once, you will have to use it until you die. If people want to make that choice, it is their body to make it with.
    I think that of far more importance than trying to obfuscate the reality of cannabis or any other drug, so as to make it not so illegal, is making sure people understand what they are getting into or possibly getting into of they use it. The key to (relatively) safe and responsible, legal drug use, is to ensure that potential users are able to make a reasonably informed decision about it.

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  81. DuWayne Says:

    Oh, and;
    Smoking weed kicks fucking ass!
    I’m missing PP about now.

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  82. Sven DiMilo Says:

    what on earth do you think withdrawal from any substance is other than “symptoms of de-flooding”!!???

    uh…the rest of your paragraph? You know, the part that starts “But surely you are aware that the processes at work are usually considerably more involved”? I was questioning the relative extent of receptor-density adaptation etc. in the cases of the two drugs. Classical physiologiical dependency vs. psychological, if they differ qualitatively.
    But I don’t really know what I’m talking about.

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  83. Seems as though you have no respect for measures that derive in one way or another from asking people how they feel? … it is hard to know where to go with the argument.
    Simple. Find a study that doesn’t rely on such subjective metrics, especially when they are what one would expect even if there wasn’t a problem. That’s about as loaded as a study could be. Show me something objective and unexpected. Telling me that marijuana smokers had a reduced appetite when abstaining is like telling me that your bank balance declined when you spent more money. That leaps way beyond imperfect into the realm of horribly flawed.
    If you do reject, out of hand, the notion that any informative and scientifically reliable measures can be employed then you are denying the validity of a very broad swath of science.
    I didnt’ do it out of hand, I listed my reasons, and I’ve not seen single refutation of them that wasn’t a blatant dodge. Misrepresenting me that way doesn’t do much for your credibility.
    So by all means tell us why the entire body of scientific work on withdrawal from cannabis is “shoddy, poorly performed experimental evidence”?
    Nice attempt at of misrepresenting me once again. I said all of the experiments I had seen were shoddy work, not that all of the ones in existence were. Simply show me one that I can’t pick apart in 30 seconds and I’ll stand corrected. Whining about all the work that went into having shoddy metrics doesn’t impress me.
    And not to shock you or anything, but I’m quite willing to grant that heavy marijuana use can lead to a nonzero level of physical withdrawels, and that marijuana use carries with it some health risks. It is pie-in-the-sky to think otherwise. But withdrawels akin to cigarettes? Sorry, a lifetime spent around smokers of both and witnessing the dramatic difference in difficulty involved in quitting, along with the symptoms of withdrawel, is not an anecdote, and is good cause for skepticism of the methods of experiments that proport to show otherwise.
    But you are right about one thing. Nothing should be rejected out of hand, and I’ve been surprised before. So, going through these studies you list here in gory detail has just jumped to the top of my weekend priority list, and I will blog on my findings, pro or con. If my objections are considered and refuted by the study, I’ll stand corrected. See you in a few days.

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  84. jamie Says:

    “But withdrawels akin to cigarettes? Sorry, a lifetime spent around smokers of both and witnessing the dramatic difference in difficulty involved in quitting, along with the symptoms of withdrawel, is not an anecdote, and is good cause for skepticism of the methods of experiments that proport to show otherwise.”
    Withdrawal is not the same thing as addiction! There’s a lot of people here commenting without the knowledge of pharmacology necessary to really discuss it in an intelligent manner. Withdrawal/dependence are widely known to be comparatively minor factors in difficulty of abstinence compared to learning behaviours. Withdrawal can be comparatively severe and yet not majorly impact the difficulty of quitting if the learning mechanisms are not the same.

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  85. jamie Says:

    “…heroin withdrawal for example, can be fatal without medical intervention.”
    Source? I’m fairly well read on the opioid field, and I’ve never heard of a single case of opioid withdrawal causing death outside of previous poor health of the addict. Nor can I think of a single plausible mechanism by which it would do so. Alcohol and benzo’s are the only drugs in which withdrawal symptoms can cause death, as far as I’m aware.

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  86. DrugMonkey Says:

    Okay, Science Avenger, I’ll continue for a bit to err on the side of assuming you are arguing in good faith.
    Simple. Find a study that doesn’t rely on such subjective metrics, especially when they are what one would expect even if there wasn’t a problem. That’s about as loaded as a study could be.
    This is complete and utter bullshit and as I proposed in a previous comment it reflects a viewpoint that rejects a broad swath of scientific endeavor. Namely the effort to grapple with human subjective states. Affect. You may be doing so out of ignorance, which is fine. But when someone points out to you your lack of familiarity, the onus shifts onto you to do at least a modicum of due diligence to understand how subjective metrics are designed, validated and employed. You’ve done little except to bleat on about how a subjective measure must be inherently flawed. Sorry, but to me this is exactly the same as claiming that any other well-validated scientific measure is inherently flawed.
    Show me something objective and unexpected. Telling me that marijuana smokers had a reduced appetite when abstaining is like telling me that your bank balance declined when you spent more money. That leaps way beyond imperfect into the realm of horribly flawed.
    Providing evidence for a commonly expected hypothesis is not more flawed than providing evidence for a “surprising” hypothesis. This betrays a very fundamental misunderstanding of science. At the very least you might view confirming an “expected” finding as a positive control for the study, a generally good feature of experimental design.
    If you do reject, out of hand, the notion that any informative and scientifically reliable measures can be employed then you are denying the validity of a very broad swath of science.
    I didnt’ do it out of hand, I listed my reasons, and I’ve not seen single refutation of them that wasn’t a blatant dodge. Misrepresenting me that way doesn’t do much for your credibility.
    No, you didn’t. At #56 you asserted your hypothesis about these symptoms being “opposite” of acute marijuana effects but admitted you essentially had no knowledge of how or why these things were selected. the answer is for you to read through the literature describing the creation and validation of these metrics (see comment #79 for a starter). This is also the comment where you started with your apparently uninformed skepticism of all “these studies” but failed to provide specifics.
    In comment #74 we got the first inkling that you were on about “subjective” measures which you reiterate here. It is not a dodge to get to the heart of your problem with such measures before we can possibly move on to the specifics of this case. Your failure to respond on the issue of whether you understand how these measures are created, validated and employed is, in fact, the dodge that is preventing us from moving forward here. You also continued your accusations of “shoddy” and “flawed” design, once again without providing specifics.
    So far, you have failed to communicate your objections in any specific way. Hence my only available response is to make some assumptions about what you might conceivably be objecting to and respond to that. The more specific you can make your objections, the more headway we can make in the discussion. Unfortunately, if your core objections boil down to an ignorance of a broad type of experimental technique I’m not going to do your work for you on that.
    So by all means tell us why the entire body of scientific work on withdrawal from cannabis is “shoddy, poorly performed experimental evidence”?
    Nice attempt at of misrepresenting me once again. I said all of the experiments I had seen were shoddy work, not that all of the ones in existence were. Simply show me one that I can’t pick apart in 30 seconds and I’ll stand corrected. Whining about all the work that went into having shoddy metrics doesn’t impress me.
    Here you at the same time confess your ignorance of the specific literature and assert your proud rejection of scientific measures you don’t understand. I’m not here to force you to drink my man, a blog can lead one to water, at best. You can either engage in a good faith effort to understand the science or you can persist in your opinions that are resistant to information.
    However, since you reiterate a classic anti-science statement that is a common theme of mine, I will respond to one thing. Scientific understanding only exceptionally rarely advances through one perfect “unflawed” paper. It rather advances by a series of incremental observations which in isolation, have limitations. “Flaws” if you will. Legitimate scientists understand this and act accordingly. Demonstrations which are replicated, directly or indirectly, come to have greater valence and be accepted as a closer approximation of the truth- at all times subject to revision based on subsequent data. In short, anyone with half a brain can “pick apart” just about any study. The trick is to synthesize an ongoing literature so as to understand a subject more comprehensively.
    a lifetime spent around smokers of both and witnessing the dramatic difference in difficulty involved in quitting, along with the symptoms of withdrawel, is not an anecdote, and is good cause for skepticism of the methods of experiments that proport to show otherwise.
    Personal experiences are always good cause for skepticism. Gut feelings that some body of work or a specific paper is BS can often motivate a lot of good science. But what you demonstrate here is a failure to appreciate that these are just two papers derived from limited studies. I’m not even sure you appreciate the degree to which the subject pools have been selected and what this means for bringing your anecdotes to bear. One of the very first and obvious caveats should be “for this type of user population”. Good faith effort, however, requires that you also be at least a bit familiar with other user types that have been evaluated before you reject an entire literature out of hand based on your anecdotes.
    But you are right about one thing. Nothing should be rejected out of hand, and I’ve been surprised before. So, going through these studies you list here in gory detail has just jumped to the top of my weekend priority list, and I will blog on my findings, pro or con. If my objections are considered and refuted by the study, I’ll stand corrected. See you in a few days.
    And this is all that I’m getting at. Track back through the literature, come to a legitimate understanding of what it does and does not support. Really and truly grapple with the idea that if these are minority responses, your personal anecdotes need to be screened accordingly. Be honest about the quality and accuracy of your own anecdotal evidence. etc.
    Then, if you have specific and informed objections we can resume the discussion.

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  87. I can see you are going to continue to either misrepresent what I say, or ignore it, depending apparently on whichever suits you at the moment, so I’m not even going to bother with the rhetoric above. I expected better.
    The bottom line is the science, not rhetoric. Unfortunately, when I got good and comfy and ready to make good my promise and peruse the articles you cited here, I was denied access (one site demanded money, and on the other apparently my brief registration didn’t earn me access to the article).
    So, if you would be so kind as to link me to a paper supporting similar conclusions to the ones above, and that I can access without dipping into my pocket, or going through the 8 basic ballet steps, I will be true to my word, give it a detailed read and review, hopefully in detail even you will find gory.
    Oh, and BTW, I went through this with Zuska on discrimination against females in science. I began as a skeptic, challenged her to prove me wrong, and she pummelled me with some high quality studies that changed my views pronto.
    Here’s your chance to get a convert with attitude.

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  88. AtheistAcolyte Says:

    DrugMonkey-
    Re: The Vandrey study, did they ensure the populations did not increase their uptake of their other drug? For a small-scale paper like this, it seems like it could be a big problem. For instance, the users who quit smoking cigarettes could smoke more pot and vice-versa. Just wondering if data had been collected on the possibility.

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  89. bill Says:

    link me to a paper supporting similar conclusions to the ones above, and that I can access without dipping into my pocket

    Urge to proselytize… rising… where’s my farting porker?

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  90. DrugMonkey Says:

    we don’t accept your Wayfarer’s Letter of Credit, neither!
    But yes, OpenAccess would be good here…
    I do note the MAPS database (see sidebar) has the Budney et al 1999 .

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  91. Gibbon1 Says:

    DuWayne
    Gibbon 1 –
    In real life that usually means your data isn’t measuring what you think it does not that the anecdotes are crap.
    Here’s the problem with that. I used to be really into altie “medicine” woo. One of the common threads in all of them is all the anecdotes you could possibly ask for. Centuries of anecdotes behind some of them. Guess what? When studies have been done on a lot of it, it turns out that the extensive history of anecdotes is a load of crap.

    One thing I’ve found troubling is a seeming lack of concern for observability as the metric for judging whether a study or anecdote says what it purports to say. Anecdotes are all over the map as to their significance. Cherry picked fuzzy headed anecdotes based on information recollected by biased observers are pretty much the definition of worthless.
    But one account by a reliable person with good observability is gold. Whereas a poorly designed study that isn’t actually measuring what the biased proponents say it does is pure sewage.
    So from my perspective the canard “The Plural of Anecdote is not data” appears to me to be an appeal to lazy arrogance.
    Not just one study but in the case of homeopathy several. Even studies by homeopaths themselves show it to be bullshit, thus why they make claims that it just can’t be studied the same way that actual medicines are studied.
    The problem with Homepathy is that it’s dam near impossible to convince a man that what he’s doing for a living is crap.

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  92. Klem Says:

    I’ll also point out that I am always amazed that advocates for de-criminalization of currently illegal drugs seem to think that policy is going to be changed by arguing “the facts” about relative dangers of psychoactive drugs when this is so clearly beside the point for political decision making.
    DrugMonkey, could you please elaborate on this? As an impartial informed observer, could you offer some tips towards a drug war armistice?
    In my experience, a lot of policy makers and other people don’t realize that alcohol is so dangerous compared to other drugs, and this has an impact on how they evaluate drug policy. They look in the street or campus on a Saturday night and see drunk people passing out, fighting, and doing wildly irresponsible stuff, and they think that it would be probably be worse if those people were “messed up on drugs”.
    The ACLU of Washington’s campaign “Marijuana: It’s Time for a Conversation” is a good example of presenting facts in a calm manner. As you advise, they don’t overly dwell on making comparisons to other drugs.

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  93. DrugMonkey Says:

    DrugMonkey, could you please elaborate on this? As an impartial informed observer, could you offer some tips towards a drug war armistice?
    What I meant by this is the evidence that alcohol and tobacco are legal for adults and certain other drugs are not is evidence a-plenty that a rational and objective discussion of “risk” is beside the point. There are too many historical and economic factors tied up in this. You all know this already, right?
    This is why the action is in making an economic argument on the legal side (as in “it is too expensive to prosecute and incarcerate dope smokers”) and various medical trojans.

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  94. DuWayne Says:

    DM –
    This is why the action is in making an economic argument on the legal side (as in “it is too expensive to prosecute and incarcerate dope smokers”) and various medical trojans.
    To me the cost benefit ratio for the war on drugs is an incidental. My argument is mostly liberty based, not any different than my arguments for legalizing prostitution, assisted suicide and getting rid of the state monopoly on gambling. But then, unlike most marijuana activists, I am not interested in giving weed any special status. I am just as voracious in my advocacy for legalizing and regulating the sale and use of crack cocaine, as I am weed. It’s all the same violation of liberty to me.
    The billions spent each year prosecuting all of those and the billions in potential tax revenue lost each year, are just icing on the cake.

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  95. DrugMonkey Says:

    DuWayne, I think “liberty” is just as much of a nonstarter as “relative harm”. I mean, when’s the last time real return of liberty came other than at the hands of the Supreme Court? I mean sure, one state or two may fight the good fight.
    But seriously. Once Marlboro “Green” is on the table it is a done deal. Right? Economics makes things happen…

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  96. Patrick Says:

    Ok. I have been smoking on and off since I was 14 (I am now 24, nearly 25). On and off means for years at a time and maybe a month or a year here or there that I didnt. Since I turned around 20, I’ve been smoking almost daily. I “quit” a few months back. Alot of this is very true.
    I had INCREDIBLY bizarre dreams for starters. Incredibly. Imagine a badger shaped like a bowling pin that is screeching at you so you twist it’s head off and this clear thick goo starts pouring out.
    I think that is primarily because I tend to fall asleep high. So maybe not everyone will deal with that.
    Furthermore, Headaches, anxiety (haha, BIG TIME), anger/irritability (ask my coworkers and bandmates). And guess what, the whole time I didnt even SORT OF crave it. I didn’t want it at all. My mental symptoms are unrelated to “wanting but not having”. That is a sign of physiological addiction.
    Stop living in denial, and furthermore everyone is affected by chemicals (dependance and effect) differently.

    Like

  97. leigh Says:

    ahh, the cannabinoid debate. thanks for sending along this link in another comment thread, DM. like any other receptor/signaling system, cb1 desensitizes in response to constant agonist presence. basic principle of pharmacology. systems respond in a way that promotes homeostasis rather than continuous activation of the signaling pathway. what happens when this adapted system no longer has the presence of the exogenous drug? what the hell do you think? but here’s something to consider of a pharmacokinetic nature: since thc is so lipophilic, would we expect a higher level of circulating thc to remain in the system of people who have more body fat? is this a contributing factor in easing withdrawal, possibly related to the individual differences argument? individual differences in usage also complicate things- after all, have you seen the doses they’re giving in animal models?
    there are lots of other things i could address. i just don’t have the time or energy.

    Like

  98. stumpy Says:

    read a lot of these comments some are good some are not so good ,been smoking weed for twenty years and have now given it up and it is causing me severe problems i.e. severe anxiety attacks and a definate depression and paranoia which i got but stoned over it when actively smoking ,one thing that i do notice about drug users of whatever drug wether it be alcohol,marajuana,cocaine ,heroin or whatever else they will never admit that its a problem when using ,i hasten to add here that the l0 weeks b4 xmas 2007 i stopped smoking tobaco , so i’m not talking about dual withdrawl here as i stopped the weed exactly a year later as a long term plan to quit drugs , anyone who says that smoking weed do’es not have withdrawls is either a very light smoker or is in denial .

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  99. SouthernFriedSkeptic Says:

    I’m curious. The first study mentioned seemed to imply that some or all of the participants engaged in both behaviors. If that is the case, was there any potential interaction between the two active ingredients that may influence withdrawal? Have there been other similar studies in which the participants did one or the other with none of the participants engaging in both behaviors? That seems like it would be better controlled. Or am I misreading information on the study?

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  100. CAF Says:

    As a Substance abuse counselor I see cannabis users as a constant in terms of people requiring and requesting assistance to cease use. I hear the same old arguments that have been offered since the sixties. These arguments are typical of the anarchist, nihilistic and existential philosophical leanings of those that popularized its use at that time. If howeever, it’s so benign why is it’s use so vociferously and vigorously defended? If it is so safe, meaningless and non-additive and not a gateway substance then it would be a simple thing to just not use it. There is however something going on here and if it doesn’t belong in the realm of addictions where does it fit? Psychological malady, sociological, spiritual?
    I recently had related to me the story of a judge who sentenced a young man to six months in jail for possession of cannabis. Use was determined to not be a factor after several drug tests. The judge stated that testing could not discover use of cannabis in the time frames in question when clearly the National Institute on Drug Abuse and other local and federal government institutions prove addiction and convict on these same tests daily. So the young man’s therapist was vilified by the judge and the supporting evidence of non use was ignored and no amelioration of his sentencing was given. It was ironic the therapist, those supporting the offender and the judge all took opposite sides from their normal positions when it comes to treatment and cannabis use yet the young man still was sentenced – strongly! In this instance the issue was not use but possession. So perhaps cannabis use/possession really isn’t a matter of addiction but one of it’s being an icon representing anarchy, nihilism, selfishness, psychological & civil maladjustment, sociological and spiritual ignorance.

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  101. So perhaps cannabis use/possession really isn’t a matter of addiction but one of it’s being an icon representing anarchy, nihilism, selfishness, psychological & civil maladjustment, sociological and spiritual ignorance.

    Wow! That’s some heavy shit, man!

    Like

  102. Peter Says:

    I was a heavy marijuana abuser for the last 2 years. i was smoking smoking 8-10 joints a day while studying at the university. i spent all my days indoor in front of the computer studying and researching different material. i didnt excersise at all for 2 years. i was diagnosed with depression in the past when i was younger. it seems that i was self medicating with MJ. at a point in the later stages of my abuse i was under a lot of stress from the studies and my relationship. i slept nearly 3-4 hours a day. at some point i started being paranoid, feeling that everyone was in a conspiracy against me and that this world didnt like me. one day a ‘friend’ game me some really strange shit which under the pressure i was into, it really cut my feet off. i had my first psychotic episode and panic attack. things got really strange after that. i got hospitalised for 4 days given high doses of anti psychotics. after leaving the hospital everything was different. i felt like i was living in hell and being through purgatory. i got anxiety, severe depression and depersonalization and all sort of mental disorders.
    i tried to take the pills but they just put me in a neutral state. the psychaiatrists just say it is a chemical problem but for some reason i couldnt grasp that explanation. what i was feeling was something which had to do with my subconsioius mind. i quitted the pills and started to analyse everything that was causing me all those mental disorders. little by little i was realizing who i was and what things made me feel bad. it was indeed purgatory and purification of the soul. it made me realise a lot of things about myself. a dive into the subconsious mind is described by modern psychiatrists as psychotic or schizophrenic disorder. the problem is that there are few experienced people who can help you get out of this situation. it is something that only you can understand cause no one knows whats in your mind and most of the times words just cannot express what is there. you just have to take control of your mind by yourself. what worked for me is getting back on strict body exercise and daily program good nutrition and loats of sleep. sleep was really hard to get since after quiting pot you will get a lot of anxiety and sleep disorder.
    anyway now i am back on track again without any medication or pot. i switched to smoking tobacco after quiting but now i realise that tobacco is much worse than pot. its more addictive and harder to quit. every time i light a cigarette i feel weak and catatonic. i am trying to quit smoking now as well. it had some anxiolitic effects in the beginning but as time goes by it just takes me to a mental state i dont like. its just a bad habit with a lot of health issues.
    so after all these what i can say for pot is the following.
    pot is a great substance if properly used. the problem with pot is the fact that it is illegal. and as with all illegal substances it doesnt come with instructions. the dealers just want to sell more to you because is a matter of profit. they dont give a fuck about you and they are not going to help you in anyway. if you use it wisely and you dont abuse it in ways that you will harm yourself, it will be something that you can enjoy as long as you wish.
    so before you let yourself into overdoing it, study first. there are a lot of books and online material on how you could benefit from this experience. know your limits and above all examine and know yourself. always take some time off pot and learn hot to lean back once in a while and make an assesment of your thoughts, who you are and where this experience is leading you. you should always be the one behind the steering and not pot. learn how to deal with your problems by yourself and not to cover them with pot.
    my last quote is, dont make pot your god.

    Like

  103. wmdkitty Says:

    “I tend to smoke weed in bursts- multiple times a day day for a few weeks or months, then not at all for much longer than that. When I stop, nothing happens. The only withdrawal I go through is a brief “damnit I really wish I had some more weed” phase that lasts maybe a couple days. Then I forget about it.
    Absolutely no other effects, whatsoever. I suffer horrible withdrawal if I come off Paxil cold-turkey… I know what physical withdrawal feels like… I really don’t think weed causes it at all.”

    This has been my experience, as well. Granted, with my meds, I can “coast” for up to 48 hours without, but after that, I start displaying classic withdrawal symptoms. (Including nausea and vomiting, at times.)
    On the other hand, with cannabis, while I’d certainly enjoy having more, I don’t particularly *care* if I have it or not — it’s a luxury.

    Like

  104. Myrdek Says:

    Drugmonkey : You have to be the dumbest scientist on these blogs. I don’t know what you have against marijuana but you have a obvious emotional bias against it

    Like

  105. DrugMonkey Says:

    You have to be the dumbest scientist on these blogs.
    That is entirely possible. There are some reasonably smart folks around here so this would be no insult to me, personally.
    I don’t know what you have against marijuana but you have a obvious emotional bias against it
    Did you have any actual reason to support this claim or are you pursuing your emotional bias in favor of cannabis?

    Like

  106. Matt Platte Says:

    I’m curious about a comparison with other drugs that cause a similar level/type of high, as opposed to nicotine.

    I can still remember my first nicotine buzz. It was January, outside the Brookville Hotel in Bob Dole’s Kansas home town. And “buzz” is indeed the correct term. It was sort of like low-voltage alternating current arcing across my skin. Fingertips went numb, lips too. I felt more alive; faster – but not in the same way marijuana slows time. In short, I felt *better* than the television commercials promised.
    Of course, the intense physical experience was only good for the first couple of smokes. Eventually I just quit.

    Like

  107. Isabel Says:

    Zimmer, Lynn and Morgan, John. Marijuana Myths, Marijuana Facts: A Review Of The Scientific Evidence. New York: The Drug Policy Alliance. 1997, 241 pages.
    This is a great reference book – unfortunately it hasn’t been updated in a while. However it clearly explains and illustrates, with lots of examples from the scientific literature, the bias many people are trying to communicate to DrugMonkey. These biases continue in more recent studies, in my opinion. And yes, the studies are worse than normal! And so what that they are flawed in different ways?
    Another problem has been access to cannabis (by potential researchers).
    The question is Why is Cannabis held to such a different standard in the first place?

    Like

  108. Harald Korneliussen Says:

    Wow, a discussion kept alive a year after initial publishing (and the author still participates, no less!)
    Obviously you’re writing things that keep people interested. I’ll take the opportunity to thank you for the blog, and inform you that I’m cautiously subscribing to your RSS feed. There are hardly many scientists who write in English about addiction and substance use research. I’m just a layperson, but I take some pride in trying to stay informed about what the science says, and not just the legalize-eet-mon crowd (thanks for that wonderful expression, btw)

    Like

  109. red rabbit Says:

    It’s hard to get funding to do research on cannabis. Not so hard to get volunteers though…
    Some of these commenters are very attached to their weed I think, and very upset at the suggestion that it may have long-term consequences.
    Another anecdote: “chamba” is the word for marijuana in one particular African country. It is the same word for “madman.” The reason for this is the occasional person who smokes him/herself into a schizophrenic-like state which persists long after the buzz wears off. Not pretty.
    I have many friends who smoke A LOT of weed, and I have seen ones who quit no problem and others who go through the nicotine-like withdrawal period, with false starts and restarts and bad moods and all. I don’t know where the difference lies.
    I think decriminalisation and taxation is the way to go. Cheech and Chong, not such a threat, but the organised crime all that weed money goes to support, I could do without (I see it, they grow it here). But then, I am of the school of thought that teenagers at age 16 should have the choice between a “drinking license” and a “driving license” and that one precludes getting the other til age 21.

    Like

  110. dt Says:

    The fact that cannabis is addictive does not mean that individuals should not be able to weigh for themselves the risks and benefits of smoking it. Under a rational drug regulation regime, a drug would be illegal only if a reasonable person could not decide that the benefits of its use outweigh the risks. Despite this research, a reasonable person could decide that the benefits of cannabis use outweigh the risks, including the risk of experiencing withdraw.
    The desire for altered states of consciousness seems almost as basic as the desire for sex. Drug education that focuses only on risks and that counsels abstinence is just as naive as abstinence-only sex education. People should be taught how to make these decisions in a responsible way.
    It’s sad that so many people are under the false impression that cannabis is somehow harmless. It’s also sad that so many people do not take into consideration the possible benefits of altered states of consciousness. It’s not necessarily about “getting high” in some asinine way, and it’s also not necessarily about some new age spiritual woo-factor. It’s about increased creativity and stress relief. It’s about looking at the world from a different perspective. It’s about the fact that cannabis-facilitated conversations tend to be much more interesting than those facilitated by alcohol.
    An informed decision about whether to smoke requires knowledge of the threshold of cannabis addictiveness. From the studies described above we know that people who smoke 25 days or more per month for at least 6 months become addicted. But does occasional or isolated use produce symptoms of withdraw? Also, I would hypothesize that cannabis with a high THC to CBD ratio is more addictive than cannabis with a better balance of THC and CBD. It would be interesting to see research on this subject.
    I think the widespread misinformation about cannabis is a product of the fact that it’s illegal. As DrugMonkey mentions in the comments, the current drug regulation regime is not based on a rational assessment of risk. Once people realize this, many begin to believe the opposite of what the government says. This includes the unscientific folk-wisdom that cannabis is “psychologically but not physically addictive.” Such misinformation, rather than any necessary consequence of using the drug, probably accounts for much of the abuse and addiction to cannabis that drug counselors and scientists observe.

    Like

  111. DrugMonkey Says:

    The El Sohly data (linked here) show pretty consistent trends in which cannabidiol is low relative to delta9THC in the US market. Perhaps 5-10%. Not sure which property of CBD you are hypothesizing to be protective but at least from animal models this 10:1 ratio does not suggest that CBD is going to vary enough (in the US market). I have heard rumour, related to the Sativex development, that there are high CBD strains in the world- but obviously they have low market share. From that perspective, it must make for an inferior, less preferred recreational product. this should be taken into account in your proposals..

    Like

  112. El Picador Says:

    It’s about the fact that cannabis-facilitated conversations tend to be much more interesting than those facilitated by alcohol.
    Heh. “Interesting” is one way to put it. Sorry but this is far from a “fact”. Perhaps you find conversations either stoned or with stoners to be more interesting but I find conversations with stoned people to be interesting only in so far as they are intoxicated. The actual subject matter is another story.

    Like

  113. Isabel Says:

    El Picador,
    dt, in his/her very interesting comment, was comparing cannabis-induced conversations to those facilitated by alcohol. I’m wondering if you find those inspired by alcohol to be more interesting.
    “It’s not necessarily about “getting high” in some asinine way, and it’s also not necessarily about some new age spiritual woo-factor. It’s about increased creativity and stress relief. It’s about looking at the world from a different perspective.”
    Yes.

    Like

  114. El Picador Says:

    Yes Isabel I am familiar with the weedies wh think they are all deep and shit. They are not.

    Like

  115. Isabel Says:

    Oh, okay.
    I hear you loud and clear, El Picador.

    Like

  116. dt Says:

    I have heard rumour, related to the Sativex development, that there are high CBD strains in the world- but obviously they have low market share. From that perspective, it must make for an inferior, less preferred recreational product.
    High CBD strains never had a chance to compete with high THC strains on an open market. The high THC and low CBD content of modern cannabis could be just a happenstance of the growers’ efforts to make a more potent product, not a reflection of market preferences. Cannabinoid content might look a lot different on an open market, especially if things like THC and CBD content were identified on a label.

    Like

  117. Tom Says:

    After reading numerous conflicting studies (i.e. one study suggests a link between cannabis and schizophrenia. While another suggests cannabis relieves the symptoms of schizophrenia). I am on the search for data, facts, truth, etc and this is how I found your study. I find the data interesting and I have a few questions. Was the statistical significance above 95%? Were the subjects possibly lying or was hyperbole possibly used in the description of their symptoms? How would a researcher really know without proof of use, quality of substance, amount of THC/nicotine content in the subjects’ past substance intake? In my opinion, drawing conclusions from psychological statistics are like trying to conclude the meaning of Salvador Dali’s painting, The Persistence of Memory. It shows you the pocket watches, but why are they melting and have different time? Why is one on a table, one in tree, and what does this have to do with memory? See my point? Thanks for your hard work in this study. I really appreciate it.

    Like

  118. Casey Says:

    I came back to check on this discussion….It’s safe to say I’ve been spoiled by the discussions on other blogs around here. Sorry I came by, won’t be back again.

    Like

  119. Charlotte Says:

    “# Anger or aggression
    # Decreased appetite or weight loss
    # Irritability
    # Nervousness/anxiety
    # Restlessness
    # Sleep difficulties including strange dreaming”
    This is nothing short of a list of all of the reasons I STARTED smoking marijuana, at the age of 19.
    Before marijuana, I was a very angry girl. I frequently skipped meals (I weighed 110, at 5’8″, if that’s any indication). I was extremely nervous (especially in social situations). As far back as I can remember, I’ve been a complete insomniac…and I’ve been having extremely “strange dreaming” since I was a toddler (my mother claims our family is especially prone to “visions”, but she reads tarot cards…so, you know, take that with a grain of salt).
    So, either my mom smoked so much weed while she was pregnant with me that I was born addicted (I wasn’t raised with her, so it could not be 2nd-hand)…
    OR…perhaps these “symptoms of withdrawal” are simply the normal personalities/psychologies of the sort of people attracted to the benefits of marijuana:
    – being able to eat
    – being able to socialize without fear
    – being chill about the small stuff
    – sleep!
    Please respond. I’m interested in what you’d have to say to this.

    Like

  120. Bob Says:

    If your nicotine withdrawal is worse than your Marijuana withdrawal, you didn´t smoked heavily everyday or you smoke crap. I stopped cigarettes 10 days ago and i feel nothing more than a cravings. When i stoppedd weed for 10 days i got diarrhea, couldn´t eat, couldn´t sleep, freazing, cold sweats, nightmares when i could sleep for few hours,blurred vision, huge depression/anxiety/panic attacks, pain throughout the body like a flu, shaking. In other words: Hell.
    For Charlote- when you break the habit of smoking pot, you eat less than you used to it before start smoking, you feel stressed, much more than you were before….this goes on with all the other symptoms.

    Like

  121. Bob Says:

    If your nicotine withdrawal is worse than your Marijuana withdrawal, you didn´t smoked heavily everyday for a long time or you smoke crap. I stopped cigarettes 10 days ago and i feel nothing more than cravings. When i stoppedd cannabis for 10 days i got diarrhea, couldn´t eat, couldn´t sleep, freazing, cold sweats, nightmares when i could sleep for few hours,blurred vision, huge depression/anxiety/panic attacks, pain throughout the body like a flu, stomach cramps, shaking. In other words: Hell.
    For Charlote- when you break the habit of smoking pot, you eat less than you used to before start smoking, you feel stressed, much more than you were before….this goes on with all the other symptoms.

    Like

  122. Doogs Says:

    Doogs
    I went back to my hometown for christmas break a few days ago, (not bringing my stash), and I started feeling a little nausea (I thought this had been from not eating, that feeling in your gut you get from being hungry), but I also didn’t have an appetite. I also could not sleep the first few nights. The same effects happened for thanksgiving break a month earlier. I came onto this website to see if my symptoms were congruent with those studied, and I am quite happy to see that all my problems _might_ just have to do with THC withdrawal (that’s a problem easily fixed).
    My purpose for making this post is to say that this website has been extremely helpful, since any person I would talk to about marijuana is only going to have some “anecdotal” view of the withdrawal symptoms. You offer many scientific explanations (especially talking about the receptors for THC), and a good harsh reality that there may be consequences to routinely using marijuana. It is nice to know what has been scientifically documented as a possible symptom of withdrawal. That way, I know that if my lack of appetite/nausea does not go away in a few days – 2 weeks, I should promptly go to my doctor (maybe a parasite could cause those symptoms?)
    The one thing we can’t let ourselves do is blindly take a drug like marijuana, deny that there could potentially be any effects, and then use that drug for prolonged periods of time blissfully ignorant.
    Also, if we do have symptoms out of the ordinary, it is good to know if they might be related to marijuana use/withdrawal – otherwise, if there has been no documented proof of a symptom (let’s speculate itchy-skin), and I just assumed that the itchy skin was due to my THC withdrawal, I would be losing precious time to diagnose something that may be more serious.
    One last thing, looking back on my life, I’m pretty sure I have had these withdrawal symptoms during weekend trips away from my home, and it would have been very beneficial for my psyche to know that it was just my body being mean to me for taking away the green. Otherwise, I would start freaking out about being unable to sleep, eat, etc…
    Thanks DM and others that provided the scientific, logical data for me to interpret. I feel I can make an informed decision about my drug use now.

    Like

  123. anandine Says:

    I used to smoke cigarettes and had a hell of a time quitting. It was an off-and-on miserable several months. I now smoke 5 or 6 joints a day, except when I go on a trip somewhere. Then I find I don’t sleep well the first night but do not notice any other symptoms.

    Like

  124. quest Says:

    Curious about throw 10% of weed smokers who get addicted.
    I read a peer reviewed article that reported that a startlingly high percent of teens who smoke one cigarette are addicted after the one cigarette …much higher than older folks. The article hypothisized that the effect was a result of teens brains still developing.
    So is there comparable data about differential rate ofaddiction to weed based on age?
    If not. would you hypothesize the same age effect attributable to greater vulnerability of teens due to their brains going through major development.

    Like

  125. Kandas Says:

    Ok, for the last 6 years I have smoked a minimum of three joints per day, never less and always more. I also smoke cigarettes. (I smoke weed on its own, I haven’t mixed tobacco in it for the last year) I am now trying to quit both at once, as I have failed repeatedly to quit either one while still indulging in the other. I have found that on day 2 (no weed) and day 1 (no cigarettes) I have experienced the following symptoms, which I strongly believe to be cannabis withdrawal.

    * Loss of appetite (I haven’t eaten in 2 days and I am not hungry at all – I do take in lots of fluids)
    * Profuse sweating, I mean I wake up in a swimming pool and I look like someone who is caught up in a 100degree day
    * Chills and hot flashes, sometimes all at once, I can almost describe it as having a fever as it feels similar, this also further induces sweating
    * I feel disorientated and light headed all the time
    * Feels like something is stuck in my throat (no, I do not have any other diseases)
    * Splitting headache which I wake up to and go to sleep with, no pain medication I have taken has helped
    * Bursts of anger, highly strung and hella irritated
    * Very emotional, I seem to cry more easily than usual
    * Shaking, gah I feel like I have Parkinson’s
    * Increase in mucus, coughing and discomfort in chest

    The cannabis withdrawal is completely over shadowing the nicotine withdrawal, I realize it might be because I have been a very heavy smoker for the last 6 years (never took a break in between, I have been high every single day). I have been smoking cigarettes for the last 13 years, so I expect those symptoms to kick in pretty soon, basically bracing myself for it to show up any second now.

    What I have found is that since not abusing cannabis, (yes, abusing because no normal person smokes cannabis for 6 years non stop, I am an addict and I admit that) there has been some subtle changes…..

    * Pains in chest have decreased rapidly
    * Tightness in chest have decreased somewhat
    * I have had less heart palpitations (at a stage I thought I was going to have a bloody heart attack, I could feel my heart beating and I knew it was irregular, pretty damn hard to miss or ignore that one)
    * Concentration is starting to improve, almost like my train of thoughts are becoming clearer
    * I have started to WANT to spend more time with friends and family, whereas I never used to be interested at all

    Don’t get me wrong, I LOVE weed very, very, very much….but it just came to a point where I was really over doing it, so much that I have started to dislike the feeling because it just wasn’t the same anymore. Happens when you take it that 100 steps too far.

    Just my two cents, I believe that yes, you can become addicted to cannabis, just as you can be addicted to anything you do in excess for extended periods of time and yes, as with anything else there are definite withdrawal symptoms. Someone who enjoys a joint on a irregular basis will not experience any symptoms and the drug will be harmless, but the more you do it, for longer…the more harmful and distressing it becomes.

    Here’s to hoping I actually survive this 🙂

    Like


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