|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|
|Discipline :||TRA (Traitement et prise en charge / Treatment and care)|
Thésaurus TOXIBASECANNABIS ; PRISE EN CHARGE ; SEVRAGE ; SYNDROME DE SEVRAGE ; PHARMACOTHERAPIE ; SYMPTOME ; DIAGNOSTIC ; COMORBIDITE ; ABSTINENCE
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|