Medical Cannabis WIthdrawal

Today Yahoo News published a piece by Lara Coughlin, Assistant Professor of Psychiatry, University of Michigan. Of the medical cannabis users this group interviewed, 59% were using for pain. The Yahoo News piece mentioned these symptoms of cannabis withdrawal

• sleep difficulties
• irritability
• anxiety

This terpenetargets has reviewed a few papers on endocannabinoids and running. These symptoms are also seen in withdrawal from running and other aerobic exercises. Add depression and inability to concentrate to the list. This study [1] was not published in a public access journal. Unless you have access to a university’s electronic journal library, are willing to pay the price to he publisher, or request a reprint from the author, you cannot read the study details. The University of Michigan website [2] expanded on these withdrawal symptoms to make cannabis withdrawal sound more like running withdrawal: sleep problems, depressed mood, decreased appetite, craving, restlessness, anxiety and irritability.

No Dr Coughlin, running withdrawal symptoms never go away with time. The crazed former runner simply switches to another aerobic activity to replace the anandamide high. These individuals may switch to bicycling, walking, swimming, or running in place while treading water in a pool. Did the patients you interviewed try to switch to endocannabinoids as they were weaning themselves from phytocannabinoids?

Show us the numbers and details!

The study is a study. Data are data, even if we cannot see them and have to take Yahoo News word for it. What is unfortunate is the way that the narrative in being presented to the news media. We are not told if these former users had been using medical cannabis to control pain so that they could function in life. Were they too injured to obtain natural endocannabinoids to deal with the pain? Did these former users quit “cold turkey” or did they wean themselves off?

Future directions?

Future directions are somewhat appalling to those who “suffer” from exercise additions. Coughlin and coworkers want to study the route of administration, attempts to abstain, and interactions with other physical and mental health factors. [2] For those with exercise addictions, endocannabinoids are a key component of mental health. “Routes of administration” depend on physical injuries, physical location, and so on. Perhaps future directions should include helping those who want to decrease their use of phytocannabinoids for pain to make up the difference with exercise derived endocannabinoids. Perhaps future directions should also include the phytocannabinoid withdrawal symptoms in those who are already exercising regularly for endocannabinoids. In such individuals who use phytocannabinoids for a painful injury or emotional trauma endure withdrawal symptoms?

Social implications

What about the woman (or man) with breast cancer? She is able to ride her bicycle to her chemo therapy sessions but the chemo has made her too sick to exercise to maintain her normal endocannabinoid levels. Plus those phytocannabinoids sure help with the nausea! Are we to let poor presentation of unseen studies stigmatize her use of medical cannabis? Make public the entirety of this study on PubMed Central. Engage in scientific discussions with patients and experts in the science of medical cannabis. When these conditions are met, then we can have a discussion with the general public and policy makers. Releasing partial information to the news media helps no one.

References

1. Coughlin LN, Ilgen MA, Jannausch M, Walton MA, Bohnert KM. Progression of cannabis withdrawal symptoms in people using medical cannabis for chronic pain. Addiction. 2021 Aug;116(8):2067-2075.
2. https://medicine.umich.edu/dept/psychiatry/news/archive/202101/more-half-people-using-cannabis-pain-experience-multiple-withdrawal-symptoms