Marijuana withdrawal is real, it is recognized, and it is the reason a lot of people who mean to stop do not. NIDA says a person may have withdrawal symptoms after stopping or sharply cutting back heavy or long-term cannabis use, even without a cannabis use disorder [1]. One study it cites estimated that 12.1% of people who frequently use cannabis experience cannabis withdrawal [1].
This page covers what the symptoms are, when they start, when they peak, how long they last, whether any of it is dangerous, what changes the picture, how long THC itself stays in urine, and what treatment can and cannot do. Our wider guide to withdrawal symptoms covers other drugs, and our marijuana section covers the drug itself.
Does Marijuana Withdrawal Really Happen?
Yes, and the answer has changed over time. SAMHSA’s detox protocol records the shift. It notes that many once said there was no acute abstinence syndrome after stopping THC [2]. It then says most experts now believe a THC-specific withdrawal syndrome does occur in some patients who are heavy users [2].
Two decades of research later, the picture is firmer. A 2022 clinical review published in Addiction and hosted by the NIH’s PubMed Central describes cannabis withdrawal as a well-characterized phenomenon [3]. It occurs in approximately half of regular and dependent cannabis users after abrupt cessation, or after significant reductions, in cannabis products containing THC [3].
That is a much bigger share than the figure in the opening, and the reason is that the two count different people. NIDA’s 12.1% is drawn from everyone who frequently uses cannabis [1]. The review’s half is drawn from regular and dependent users who actually stop, or who cut back sharply [3]. Neither figure tells you what will happen to you.
Dependence is not the same as a disorder, and NIDA keeps them apart. Withdrawal can happen even in someone who does not meet the criteria for cannabis use disorder [1]. NIDA also reports that studies have estimated 22% to 30% of people who use cannabis have the disorder, and that the strongest predictor is how often someone uses it [1].
Marijuana Withdrawal Symptoms
NIDA lists them as anger, irritability, aggression, feeling nervous or anxious, restlessness, decreased appetite or weight, depression, insomnia, strange or unsettling dreams, headaches, sweating, abdominal pain and tremor [1].
The 2022 review sorts them by how common they are. The most common features are anxiety, irritability, anger or aggression, disturbed sleep and dreaming, depressed mood and loss of appetite [3]. Less common physical symptoms include chills, headaches, physical tension, sweating and stomach pain [3].
SAMHSA’s protocol groups them the same way. The symptoms seen most often are anxiety, restlessness and irritability, sleep disturbance, and a change in appetite, usually a loss of it [2]. Seen less often are tremor, sweating, a raised heart rate and stomach upset including nausea, vomiting and diarrhea [2].
Notice what all three lists have in common. Sleep and mood do most of the damage. That is why people describe the week as unbearable without being able to point to anything obviously wrong.
How Soon It Starts
Within a day or two. SAMHSA’s protocol says the THC abstinence syndrome usually starts within 24 hours of cessation [2]. The 2022 review puts onset at 24 to 48 hours after stopping [3].
How much someone has to use before withdrawal shows up is not known. SAMHSA says the amount of THC needed to produce withdrawal is unknown, and that it can be assumed heavier consumption is more likely to be associated with symptoms [2]. That is a hedge, and it is the source’s own.
The Timeline: Peak Days and What Lasts Longer
The peak comes early. The 2022 review says most symptoms generally peak at days 2 to 6 [3]. Some symptoms last up to 3 weeks or more in heavy cannabis users [3].
So the usual shape is a bad few days, a fading week or so, and a tail that varies. SAMHSA adds the piece that catches people out: cognitive difficulties, including depression, have been reported, and they may persist, though they usually improve with time [2].
If you are timing this against a treatment plan rather than a calendar, our page on how long rehab takes covers the longer question.
Is It Dangerous?
The honest answer has two halves, and both come from the same paragraph of SAMHSA’s protocol.
The first half: there are no medical complications of withdrawal from THC, and medication is generally not required to manage it [2]. Symptoms usually require no immediate medication during the detox period and are usually self-limiting [2].
The second half, in the very next sentences: the clinician should be aware of the potential for more persistent problems, and screening the patient for suicidal ideation or other mental health problems is warranted [2]. NIDA lists depression among the withdrawal symptoms [1], and the 2022 review lists depressed mood among the most common features [3].
If someone is having a seizure, is unresponsive or has trouble breathing, call 911. For a mental-health crisis call or text 988.
That is the real risk here. Not the body. The week where sleep is gone, mood is flat and the drug is the only thing that has ever fixed it quickly.
Help with cannabis use disorder in Washington
The Recovery Village Ridgefield is our campus in Ridgefield, Washington. Its own page cards medical detox, inpatient treatment, partial hospitalization programming, intensive outpatient programming, dual diagnosis treatment and medically-assisted treatment, and it describes that last card as being for severe opioid or alcohol use disorders. Ask admissions which of those is open when you call, and which fits what you are stopping.
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The Recovery Village Ridgefield is part of our family of treatment centers. See the Recovery Village Ridgefield campus.
What Changes the Timeline
How much and how long. SAMHSA will not put a number on the threshold, but it does say heavier consumption is more likely to be associated with withdrawal [2]. The 2022 review attaches the longest tail specifically to heavy users [3].
Whether it is a stop or a cut. The review counts significant reductions, not only stopping outright [3]. People who taper their own use and feel terrible are not imagining it.
Sleep before you started. Insomnia is one of the most common features [1][3]. Someone who already slept badly has less room to lose.
Mood and mental health. Depression is on all three symptom lists [1][2][3], and SAMHSA says persistent problems are the thing a clinician should be watching for [2].
Other drugs. Stopping cannabis alongside alcohol or a sedative is a different situation, and alcohol withdrawal carries risks cannabis withdrawal does not. Tell the assessing clinician everything.
How Long THC Itself Stays in Urine
Longer than the withdrawal does, which is why people confuse the two. SAMHSA’s urine toxicology table gives cannabinoids three detection periods: 1 to 3 days for casual use, 5 to 10 days for daily use, and up to 30 days for chronic use [4].
Those are typical periods for a urine screen, not a promise about any individual, and the same table shows how far cannabis sits from the rest — alcohol is 12 to 24 hours and cocaine is 1 to 3 days [4]. A positive test weeks after the last use is not evidence that withdrawal is still running.
Treatment: What Works and What Is Not Approved
No medicine is approved for this. NIDA states there are currently no FDA-approved medications for the treatment of cannabis use disorder or for medically assisted withdrawal, and that research is ongoing [1]. The 2022 review says the same about withdrawal specifically [3].
What is supported is talking work. NIDA reports that behavioral interventions such as cognitive behavioral therapy, motivational enhancement therapy and contingency management can be effective in treating cannabis use disorder [1]. The 2022 review puts supportive counseling and psychoeducation first for the withdrawal itself, while noting the evidence base is limited [3].
That does not mean nothing can be prescribed. SAMHSA notes that medication is generally not required, and that other problems during withdrawal can be managed with supportive, non-addictive options [2]. Which ones, and whether any are appropriate, is a prescriber’s decision about a particular person. Our page on medication-assisted treatment explains where approved medication does have a role, which is with opioids and alcohol.
Why a Supervised Setting Helps
Not because the body needs rescuing. Because the week is when people quit quitting.
SAMHSA’s own reason for supervision here is the screening: watching for suicidal ideation and other mental health problems while the worst of it passes [2]. A setting that does that is doing the thing the evidence asks for.
There is a second reason, and it is practical. Sleep, appetite and mood are all treatable problems in their own right, and having someone to ask about them beats guessing. Our guide to medical detox sets out what that setting involves.
Most people do not need a bed for this. Cannabis withdrawal is usually managed in outpatient care, and our guide to outpatient rehab covers what that asks of a week. Where a person is also stopping something else, or where mental health is the bigger problem, inpatient rehab is the setting to ask about.
What Happens After Detox
Getting through the week is not the treatment. NIDA is blunt about this across substances: detoxification alone, without treatment afterwards, generally leads to a return to drug use [5].
For cannabis specifically, what comes next is the behavioral work NIDA names — cognitive behavioral therapy, motivational enhancement therapy and contingency management [1]. That is a course of appointments, not a week.
If a person does use again, that is information rather than a verdict. NIDA’s position is that a return to use does not mean treatment has failed; it means speaking with a doctor about resuming treatment, changing it, or trying another one [5].
Money is usually the next question. Our own cost page puts a 30-day intensive outpatient program at $3,000 to $10,000 and standard outpatient care at about $5,000 for a three-month program; those are our published ranges, not federal figures. See how much rehab costs and does insurance cover rehab.
Frequently Asked Questions
How long does marijuana detox take? Symptoms usually start 24 to 48 hours after stopping and most of them peak at days 2 to 6. Some symptoms last up to 3 weeks or more in heavy cannabis users. SAMHSA adds that cognitive difficulties, including depression, may persist but usually improve with time. Detection of THC in urine lasts longer than the withdrawal does.
What is the worst day? Somewhere in the first week. A 2022 clinical review found that most symptoms generally peak at days 2 to 6 after stopping. What makes those days hard is rarely physical: the most common features are anxiety, irritability, anger, disturbed sleep and dreaming, depressed mood and loss of appetite. Sleep is often the part people find hardest to sit out.
Can I do this at home? Many people do, and SAMHSA says medication is generally not required and the symptoms are usually self-limiting. But the same protocol says screening for suicidal ideation or other mental health problems is warranted. If someone is having a seizure, is unresponsive or has trouble breathing, call 911. For a mental-health crisis call or text 988. Talk to a clinician first.
What medications are used? None that are approved. NIDA states there are currently no FDA-approved medications for treating cannabis use disorder or for medically assisted withdrawal, and that research is ongoing. A prescriber may still treat sleep, anxiety or nausea during the week, but which medicine, if any, is a decision about a particular person and not something to plan from a web page.
What comes after detox? Treatment does. NIDA reports that behavioral interventions such as cognitive behavioral therapy, motivational enhancement therapy and contingency management can be effective for cannabis use disorder. It also warns that detoxification alone, without subsequent treatment, generally leads to a return to drug use. Ask for the continuing care plan before the week ends.
Sources
- National Institute on Drug Abuse. Cannabis (Marijuana). National Institute on Drug Abuse. https://nida.nih.gov/research-topics/cannabis-marijuana
- Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment, Chapter 4: Physical Detoxification Services for Withdrawal From Specific Substances — Marijuana and Other Drugs Containing THC. Substance Abuse and Mental Health Services Administration. https://www.ncbi.nlm.nih.gov/books/NBK64116/
- Connor, J.P., Stjepanović, D., Budney, A.J., Le Foll, B., & Hall, W.D. (2022). Clinical Management of Cannabis Withdrawal. Addiction, via PubMed Central, National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC9110555/
- Center for Substance Abuse Treatment. (2006). Substance Abuse: Clinical Issues in Intensive Outpatient Treatment, Appendix B, Exhibit B-1: Urine Toxicology Detection Periods for Different Substances. Substance Abuse and Mental Health Services Administration. https://www.ncbi.nlm.nih.gov/books/NBK64092/
- National Institute on Drug Abuse. (2020). Drugs, Brains, and Behavior: The Science of Addiction — Treatment and Recovery. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
This page is for general information and is not medical advice. Only a licensed clinician who
knows your history can tell you what is right for you. If you or someone you know is in
immediate danger, call 911. For free, confidential support 24/7, call or text 988.
Author
Chief Medical Officer,
The Recovery Village
