Purpose:To describe patterns of cannabis withdrawal among a large sample of those who use medical cannabis and test the association between withdrawal symptomology and functioning.

Procedures:Adults ages 21 and older (N = 801) who were seeking medical cannabis certification (either for the first time or as a renewal) for chronic pain at medical cannabis clinics in southern Michigan completed baseline measures of cannabis use, withdrawal symptomology, functioning and other related constructs. Patients were included in the current study if they endorsed using cannabis at least weekly over the past three months. Of the persons in the baseline sample (N = 801), 83% endorsed using cannabis at this level of frequency and duration (N = 665).

Findings:Approximately two-thirds of the sample (67.8%) reported at least one moderate or severe withdrawal symptom. The most commonly observed symptom was sleep difficulties (50.3%), followed by anxiety (27.8%), irritability (26.7%), and appetite disturbance (25.2%). Patients with low mental functioning had significantly higher rates of withdrawal symptom endorsement than patients with high mental functioning. However, no association was observed between physical functioning and withdrawal symptom endorsement. These patterns of association were consistent in multivariate analyses that controlled for other potentially confounding variables.

Conclusions:Cannabis withdrawal symptomology is highly prevalent among patients who use medical cannabis at least three times a week. Helping patients recognize the association between poorer functioning and withdrawal may be an effective way to highlight potentially negative consequences of regular and moderate heavy use.

目的：描述大量使用医用大麻的人中的大麻戒断模式，并测试戒断症状与功能之间的关联。

程序：在密歇根州南部的医疗大麻诊所寻求慢性疼痛认证的21岁及以上（N = 801）的成人（首次或续签）大麻认证完成了大麻使用，戒断症状，​​功能正常的基线测量和其他相关构造。如果患者在过去三个月中至少每周使用一次大麻，则被纳入本研究。在基线样本中的人（N = 801）中，有83％的人在此频率和持续时间水平（N = 665）使用大麻进行了认可。

结果：大约三分之二的样本（67.8％）报告了至少一种中度或重度戒断症状。最常见的症状是睡眠困难（50.3％），其次是焦虑（27.8％），烦躁（26.7％）和食欲不振（25.2％）。精神功能低下的患者的戒断症状认可率明显高于精神功能高的患者。但是，没有观察到身体功能和戒断症状认可之间的关联。这些关联模式在控制其他潜在混淆变量的多变量分析中是一致的。

结论：每周至少使用3次医用大麻的患者中，大麻戒断症状非常普遍。帮助患者认识到功能较差和戒断之间的联系可能是强调定期和中度大量使用可能产生的负面后果的有效方法。