Abstract
A milestone in cannabis research is the establishment of a clinically relevant cannabis withdrawal syndrome, yet little is known about the underlying mechanisms. We investigated the predictive role of mental health and cognitive factors in withdrawal severity during an active attempt to cut down, relative to uninterrupted cannabis use. Ninety heavy cannabis users were randomly assigned to an experimental or control group. The experimental group was asked to cut down substance use for 1 week. Past week substance use, substance use-related problems, depressive symptoms, cravings, and cognitive control were assessed at baseline. Past week substance use and withdrawal severity were assessed at follow-up. The experimental group reduced their cannabis use more and experienced more withdrawal than the control group. Hierarchical regression analysis per predictor indicated that cannabis use-related problems, depressive symptoms, and cannabis craving, but not cognitive control, predicted stronger withdrawal. Craving uniquely predicted withdrawal in the experimental group. A combined hierarchical regression indicated that only depressive symptoms and cannabis use-related problems uniquely predicted withdrawal across groups. These results suggest that depressive symptoms and cannabis use-related problems are generally indicative of cannabis withdrawal severity, whereas craving specifically predicts cannabis withdrawal during an active attempt to cut-down cannabis use.
Highlights
One of the milestones in cannabis research is the establishment of a clinically relevant cannabis withdrawal syndrome [1]
Participants that dropped out differed on none of the baseline measures from the participants that remained in the study as indexed by independent sample t-test comparisons, except on the CUDIT-R, which was higher in the participants that dropped out [t(88) = −2.2, p = 0.032]
From a clinical perspective, predicting who will could help tailoring treatment. In this first study in near-daily cannabis users, we investigated if cognitive and mental health factors could predict withdrawal severity during an active attempt to cut down cannabis use
Summary
One of the milestones in cannabis research is the establishment of a clinically relevant cannabis withdrawal syndrome [1]. Cannabis withdrawal is a new diagnostic criterion for cannabis use disorders (CUDs) in the latest edition of the diagnostic statistical manual [DSM-5; [2]]. Cannabis withdrawal refers to mental (e.g., mood swings, sleep disruptions) and physical (e.g., headaches, nausea) discomfort that cannabis users may experience after discontinuation or reductions in use. Supporting the maintenance of addictive behaviors, poor cognitive functioning and mental health may play an important role in the severity of mental discomfort during withdrawal. We assessed the role of both cognitive and mental health factors in the subjective severity of cannabis withdrawal during an active attempt to cut down cannabis use in heavy cannabis users
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