Ofir Livne1, Dvora Shmulewitz2, Shaul Lev-Ran3, Deborah S Hasin4. 1. Lev Hasharon Medical Center, P.O. Box 90000, Netanya, 42100, Israel. 2. New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA. 3. Lev Hasharon Medical Center, P.O. Box 90000, Netanya, 42100, Israel; Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Ramat Aviv, Tel Aviv, 69978, Israel. 4. New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY, 10032, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA. Electronic address: dsh2@cumc.columbia.edu.
Abstract
BACKGROUND: Cannabis withdrawal syndrome (CWS) was newly added to the Diagnostic and Statistical Manual of Mental Disorders in its most recent edition, DSM-5. With cannabis use increasing among U.S. adults, information is needed about the prevalence and correlates of DSM-5 CWS in the general population. This study presents nationally representative findings on the prevalence, sociodemographic and clinical correlates of DSM-5 CWS among U.S. adults. METHOD: Participants ≥18 years were interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) in 2012-2013. Among the sub-sample of frequent cannabis users in the prior 12 months (≥3 times a week; N = 1527), the prevalence and demographic and clinical correlates of DSM-5 CWS were examined. RESULTS: In frequent cannabis users, the prevalence of CWS was 12.1%. The most common withdrawal symptoms among those with CWS were nervousness/anxiety (76.3%), hostility (71.9%), sleep difficulty (68.2%) and depressed mood (58.9%). CWS was associated with significant disability (p < 0.001), and with mood disorders (adjusted odds ratios [aOR] = 1.9-2.6), anxiety disorders (aOR = 2.4-2.5), personality disorders (aOR = 1.7-2.2) and family history of depression (aOR = 2.5) but not personal history of other substance use disorders or family history of substance use problems. CONCLUSIONS: CWS is highly comorbid and disabling. Its shared symptoms with depressive and anxiety disorders call for clinician awareness of CWS and the factors associated with it to promote more effective treatment among frequent cannabis users.
BACKGROUND:Cannabis withdrawal syndrome (CWS) was newly added to the Diagnostic and Statistical Manual of Mental Disorders in its most recent edition, DSM-5. With cannabis use increasing among U.S. adults, information is needed about the prevalence and correlates of DSM-5 CWS in the general population. This study presents nationally representative findings on the prevalence, sociodemographic and clinical correlates of DSM-5 CWS among U.S. adults. METHOD:Participants ≥18 years were interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) in 2012-2013. Among the sub-sample of frequent cannabis users in the prior 12 months (≥3 times a week; N = 1527), the prevalence and demographic and clinical correlates of DSM-5 CWS were examined. RESULTS: In frequent cannabis users, the prevalence of CWS was 12.1%. The most common withdrawal symptoms among those with CWS were nervousness/anxiety (76.3%), hostility (71.9%), sleep difficulty (68.2%) and depressed mood (58.9%). CWS was associated with significant disability (p < 0.001), and with mood disorders (adjusted odds ratios [aOR] = 1.9-2.6), anxiety disorders (aOR = 2.4-2.5), personality disorders (aOR = 1.7-2.2) and family history of depression (aOR = 2.5) but not personal history of other substance use disorders or family history of substance use problems. CONCLUSIONS: CWS is highly comorbid and disabling. Its shared symptoms with depressive and anxiety disorders call for clinician awareness of CWS and the factors associated with it to promote more effective treatment among frequent cannabis users.
Authors: J Hirvonen; R S Goodwin; C-T Li; G E Terry; S S Zoghbi; C Morse; V W Pike; N D Volkow; M A Huestis; R B Innis Journal: Mol Psychiatry Date: 2011-07-12 Impact factor: 15.992
Authors: Penny F Whiting; Robert F Wolff; Sohan Deshpande; Marcello Di Nisio; Steven Duffy; Adrian V Hernandez; J Christiaan Keurentjes; Shona Lang; Kate Misso; Steve Ryder; Simone Schmidlkofer; Marie Westwood; Jos Kleijnen Journal: JAMA Date: 2015 Jun 23-30 Impact factor: 56.272
Authors: Wilson M Compton; Beth Han; Christopher M Jones; Carlos Blanco; Arthur Hughes Journal: Lancet Psychiatry Date: 2016-08-31 Impact factor: 27.083
Authors: Deborah S Hasin; Eliana Greenstein; Christina Aivadyan; Malki Stohl; Efrat Aharonovich; Tulshi Saha; Rise Goldstein; Edward V Nunes; Jeesun Jung; Haitao Zhang; Bridget F Grant Journal: Drug Alcohol Depend Date: 2014-12-18 Impact factor: 4.492
Authors: Deborah S Hasin; Bradley T Kerridge; Tulshi D Saha; Boji Huang; Roger Pickering; Sharon M Smith; Jeesun Jung; Haitao Zhang; Bridget F Grant Journal: Am J Psychiatry Date: 2016-03-04 Impact factor: 18.112
Authors: W June Ruan; Risë B Goldstein; S Patricia Chou; Sharon M Smith; Tulshi D Saha; Roger P Pickering; Deborah A Dawson; Boji Huang; Frederick S Stinson; Bridget F Grant Journal: Drug Alcohol Depend Date: 2007-08-13 Impact factor: 4.492
Authors: Bridget F Grant; Deborah S Hasin; Frederick S Stinson; Deborah A Dawson; S Patricia Chou; W June Ruan; Roger P Pickering Journal: J Clin Psychiatry Date: 2004-07 Impact factor: 4.384
Authors: Jason P Connor; Daniel Stjepanović; Bernard Le Foll; Eva Hoch; Alan J Budney; Wayne D Hall Journal: Nat Rev Dis Primers Date: 2021-02-25 Impact factor: 52.329
Authors: Ofir Livne; Richard Feinn; Justin Knox; Emily E Hartwell; Joel Gelernter; Deborah S Hasin; Henry R Kranzler Journal: Alcohol Clin Exp Res Date: 2022-03 Impact factor: 3.455