| Titre : | Clinical management of cannabis withdrawal (2022) |
| Auteurs : | J. P. CONNOR ; D. STJEPANOVIC ; A. J. BUDNEY ; B. LE FOLL ; W. D. HALL |
| Type de document : | Article : Périodique |
| Dans : | Addiction (Vol.117, n°7, July 2022) |
| Article en page(s) : | 2075-2095 |
| Langues: | Anglais |
| Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
| Mots-clés : |
Thésaurus mots-clés CANNABIS ; PRISE EN CHARGE ; SEVRAGE ; SYNDROME DE SEVRAGE ; PHARMACOTHERAPIE ; SYMPTOME ; DIAGNOSTIC ; COMORBIDITE ; ABSTINENCE |
| Résumé : |
BACKGROUND AND AIMS: Cannabis withdrawal is a well-characterized phenomenon that occurs in approximately half of regular and dependent cannabis users after abrupt cessation or significant reductions in cannabis products that contain Delta9-tetrahydrocannabinol (THC). This review describes the diagnosis, prevalence, course and management of cannabis withdrawal and highlights opportunities for future clinical research.
METHODS: Narrative review of literature. RESULTS: Symptom onset typically occurs 24-48 hours after cessation and most symptoms generally peak at days 2-6, with some symptoms lasting up to 3 weeks or more in heavy cannabis users. The most common features of cannabis withdrawal are anxiety, irritability, anger or aggression, disturbed sleep/dreaming, depressed mood and loss of appetite. Less common physical symptoms include chills, headaches, physical tension, sweating and stomach pain. Despite limited empirical evidence, supportive counselling and psychoeducation are the first-line approaches in the management of cannabis withdrawal. There are no medications currently approved specifically for medically assisted withdrawal (MAW). Medications have been used to manage short-term symptoms (e.g. anxiety, sleep, nausea). A number of promising pharmacological agents have been examined in controlled trials, but these have been underpowered and positive findings not reliably replicated. Some (e.g. cannabis agonists) are used 'off-label' in clinical practice. Inpatient admission for MAW may be clinically indicated for patients who have significant comorbid mental health disorders and polysubstance use to avoid severe complications. CONCLUSIONS: The clinical significance of cannabis withdrawal is that its symptoms may precipitate relapse to cannabis use. Complicated withdrawal may occur in people with concurrent mental health and polysubstance use. |
| Domaine : | Drogues illicites / Illicit drugs |
| Sous-type de document : | Revue de la littérature / Literature review |
| Refs biblio. : | 92 |
| Affiliation : | National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, QLD, Australia |
| Cote : | Abonnement |
| Lien : | https://doi.org/10.1111/add.15743 |
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