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Prospective assessment of cannabis withdrawal in adolescents with cannabis dependence: a pilot study.

Abstract

OBJECTIVE

To prospectively identify and assess withdrawal symptoms in adolescents with cannabis dependence.

METHOD

Twenty-one adolescents ages 13 to 19 years voluntarily entering residential and day/outpatient substance abuse programs, with cannabis dependence as their only current substance of dependence, were assessed using the Teen-Addiction Severity Index, Substance Use Survey, Cannabis Withdrawal Scale, and the Structured Clinical Interview for DSM-IV Childhood Diagnoses Substance Use Disorders Module. Weekly assessments continued for 4 weeks. Thirteen youths attained a minimum of 2 weeks of abstinence.

RESULTS

Cannabis withdrawal symptoms were present in adolescents. Cannabis withdrawal was greatest in the first 2 weeks of abstinence with evidence that it continued well into week 3. Most withdrawal symptoms were endorsed with a high degree of frequency. Those symptoms endorsed with the greatest severity were restlessness, appetite change, and thoughts of and cravings for cannabis, with the highest ratings occurring in week 1. Over the course of the study, participants reported fewer symptoms with decreasing levels of severity. Youth ratings of overall severity of withdrawal were significantly and positively correlated with withdrawal symptoms of irritability (r = 0.56), depression (r = 0.56), twitches and shakes (r = 0.57), perspiring (r = 0.57), thoughts of (r = 0.86), and cravings for (r = 0.69) cannabis.

CONCLUSIONS

Findings support the presence of clinically significant cannabis withdrawal symptoms in adolescents with cannabis dependence seeking substance abuse treatment. This study also provides supporting evidence suggesting a vulnerability of adolescents to physiological cannabis dependence. The study supports the addition of cannabis withdrawal as a distinct entity for inclusion in DSM-V.

Authors+Show Affiliations

Dr. Milin and Ms. Walker are with and Dr. Dare was formerly with the Royal Ottawa Mental Health Centre and Institute of Mental Health Research; Dr. Manion is with the Provincial Centre of Excellence for Child and Youth Mental Health at Children's Hospital of Eastern Ontario.. Electronic address: rmilin@rohcg.on.ca.Dr. Milin and Ms. Walker are with and Dr. Dare was formerly with the Royal Ottawa Mental Health Centre and Institute of Mental Health Research; Dr. Manion is with the Provincial Centre of Excellence for Child and Youth Mental Health at Children's Hospital of Eastern Ontario.Dr. Milin and Ms. Walker are with and Dr. Dare was formerly with the Royal Ottawa Mental Health Centre and Institute of Mental Health Research; Dr. Manion is with the Provincial Centre of Excellence for Child and Youth Mental Health at Children's Hospital of Eastern Ontario.Dr. Milin and Ms. Walker are with and Dr. Dare was formerly with the Royal Ottawa Mental Health Centre and Institute of Mental Health Research; Dr. Manion is with the Provincial Centre of Excellence for Child and Youth Mental Health at Children's Hospital of Eastern Ontario.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18176332

Citation

Milin, Robert, et al. "Prospective Assessment of Cannabis Withdrawal in Adolescents With Cannabis Dependence: a Pilot Study." Journal of the American Academy of Child and Adolescent Psychiatry, vol. 47, no. 2, 2008, pp. 174-179.
Milin R, Manion I, Dare G, et al. Prospective assessment of cannabis withdrawal in adolescents with cannabis dependence: a pilot study. J Am Acad Child Adolesc Psychiatry. 2008;47(2):174-179.
Milin, R., Manion, I., Dare, G., & Walker, S. (2008). Prospective assessment of cannabis withdrawal in adolescents with cannabis dependence: a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 47(2), pp. 174-179. doi:10.1097/chi.0b013e31815cdd73.
Milin R, et al. Prospective Assessment of Cannabis Withdrawal in Adolescents With Cannabis Dependence: a Pilot Study. J Am Acad Child Adolesc Psychiatry. 2008;47(2):174-179. PubMed PMID: 18176332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective assessment of cannabis withdrawal in adolescents with cannabis dependence: a pilot study. AU - Milin,Robert, AU - Manion,Ian, AU - Dare,Glenda, AU - Walker,Selena, PY - 2008/1/8/pubmed PY - 2008/4/5/medline PY - 2008/1/8/entrez SP - 174 EP - 179 JF - Journal of the American Academy of Child and Adolescent Psychiatry JO - J Am Acad Child Adolesc Psychiatry VL - 47 IS - 2 N2 - OBJECTIVE: To prospectively identify and assess withdrawal symptoms in adolescents with cannabis dependence. METHOD: Twenty-one adolescents ages 13 to 19 years voluntarily entering residential and day/outpatient substance abuse programs, with cannabis dependence as their only current substance of dependence, were assessed using the Teen-Addiction Severity Index, Substance Use Survey, Cannabis Withdrawal Scale, and the Structured Clinical Interview for DSM-IV Childhood Diagnoses Substance Use Disorders Module. Weekly assessments continued for 4 weeks. Thirteen youths attained a minimum of 2 weeks of abstinence. RESULTS: Cannabis withdrawal symptoms were present in adolescents. Cannabis withdrawal was greatest in the first 2 weeks of abstinence with evidence that it continued well into week 3. Most withdrawal symptoms were endorsed with a high degree of frequency. Those symptoms endorsed with the greatest severity were restlessness, appetite change, and thoughts of and cravings for cannabis, with the highest ratings occurring in week 1. Over the course of the study, participants reported fewer symptoms with decreasing levels of severity. Youth ratings of overall severity of withdrawal were significantly and positively correlated with withdrawal symptoms of irritability (r = 0.56), depression (r = 0.56), twitches and shakes (r = 0.57), perspiring (r = 0.57), thoughts of (r = 0.86), and cravings for (r = 0.69) cannabis. CONCLUSIONS: Findings support the presence of clinically significant cannabis withdrawal symptoms in adolescents with cannabis dependence seeking substance abuse treatment. This study also provides supporting evidence suggesting a vulnerability of adolescents to physiological cannabis dependence. The study supports the addition of cannabis withdrawal as a distinct entity for inclusion in DSM-V. SN - 0890-8567 UR - https://www.unboundmedicine.com/medline/citation/18176332/Prospective_assessment_of_cannabis_withdrawal_in_adolescents_with_cannabis_dependence:_a_pilot_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0890-8567(09)62288-7 DB - PRIME DP - Unbound Medicine ER -