More than half of those who use cannabis for pain have multiple withdrawal symptoms.

A new study finds that more than half of people who use medical marijuana products to relieve pain also experience clusters of multiple withdrawal symptoms when they stop using them.

Over the next two years, about 10% of the patients in the study experienced worsening changes in their sleep, mood, mental state, energy, and appetite as they continued to use cannabis.

Many of them may be unaware that their symptoms are caused by their brain and body’s reaction to the lack of substances in the cannabis products they’re smoking, vaping, eating, or applying to their skin, according to the University of Michigan Addiction Center psychologist who led the study.

When a person experiences more than a few of these symptoms, this is referred to as cannabis withdrawal syndrome, and it can indicate a higher risk of developing more serious issues, such as a cannabis use disorder.

A team from the University of Michigan Medical School and the VA Ann Arbor Healthcare System reports findings from detailed surveys of 527 Michigan residents conducted over a two-year period in the journal Addiction. All were involved in the state’s system for certifying people with certain conditions for the use of medical cannabis, and all were suffering from non-cancer-related pain.

“Some people report significant benefits from medical cannabis,” says Lara Coughlin, Ph.D., the addiction psychologist who led the study. “However, our findings suggest a real need to raise awareness about the signs of withdrawal symptoms developing in order to reduce the potential downsides of cannabis use, particularly among those who experience severe or worsening symptoms over time.”

Long-term research into medical cannabis use

The researchers asked the patients if they had experienced any of 15 different symptoms, ranging from difficulty sleeping and nausea to irritability and aggression, after being away from cannabis for an extended period of time.

The researchers used an analytic method to empirically categorize the patients as having no or mild symptoms at the start of the study, moderate symptoms (meaning they experienced multiple withdrawal symptoms), and severe withdrawal issues that included most or all of the symptoms.

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