If you're using weed for medicinal reasons, it can wreak havoc on your mental or physical health.
This article originally appeared on VICE UK.
I gave up smoking cannabis eight years ago. I’d been promoted—from telemarketing supervisor to the noble heights of telemarketing manager—and I couldn’t come to work high anymore. My abiding memory of the following week was a nightly stream of terrifying dreams. It was like I was dreaming in stereo, as my brain experienced the novelty of truly deep sleep for the first time in years.
Within a week, once the night terrors and the cold sweats had stopped, my short-term memory started to improve. I had more energy. I was more sociable in and outside of work. I left the job within a few months and started doing something I loved. Everything about my life improved. But giving up weed isn’t so easy for everyone, and for some, it’s fraught with acute problems—physical, mental, and emotional.
"Stopping my consumption of cannabis used to mean a lot of pain: vomiting, diarrhea, and not being able to sleep or eat," says Alex Fraser, 26. Alex has Crohn’s disease, which was diagnosed when he was 19. He just had an ileostomy, in which a diseased part of his bowel was removed. This has drastically improved his quality of life, but he’s still hugely reliant on cannabis to keep him up and running.
"Despite the surgery, I still have issues with eating, nausea, and sleep," he says. "If I don’t have cannabis, I end up using meds like Zopiclone for sleep and Oxycodone for pain. But nothing particularly helps my nausea or appetite, except cannabis."
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Alex, who generally vapes but occasionally smokes and eats marijuana, also relies on it to keep his mental health in check. "It’s extremely helpful with the mental health issues I’ve had since surgery. Anxiety attacks, self-esteem issues, and my energy levels are all improved or eliminated with cannabis," he explains.
Jon Liebling is a Director of the United Patient’s Alliance, which is currently lobbying hard for the legalization of medical weed in the UK. Liebling has a long history of profound mental health issues and has recently been diagnosed with complex PTSD.
"I've been managing my anxiety, depression, and suicidal thoughts most of my life, but have kept myself relatively happy with the use of cannabis," says Liebling. "About two years ago, I had a number of traumatic events take place in a rather short period of time. I realized I needed a bit more help, so I asked my doctor to refer me to a therapist. When I informed him I used cannabis, he refused to refer me unless I stopped using. He prescribed me Prozac and Diazepam. I’ve always had suicidal thoughts, but what’s kept me alive is my dissatisfaction with them. Prozac made my thoughts happier, but also, made me happier with those suicidal tendencies. So I acted on them for the first time in 20 years."
Liebling went back to his doctor and found that a locum was working that day. She immediately removed him from his Prozac prescription and referred him to talking therapy. She also told him to return to managing his condition with cannabis, and he’s thankfully still here to tell the tale.
Unfortunately, beyond anecdotal evidence, it’s quite hard to back up Alex and Liebling’s comments with science because currently, there just isn’t much out there. Plus, their personal health conditions—despite being undoubtedly severe—are not indicative of the population as a whole. A 2010 paper called "Assessment and management of cannabis use disorders in primary care" suggests that to differentiate between a psychiatric disorder and chronic cannabis intoxication, a patient should cease cannabis use for two to four weeks. In a small 20-person impatient study of withdrawal, it found that "mean baseline depression symptom scores reduced to normal levels after four weeks of abstinence."
One of the study’s creators was Professor Adam Winstock, founder of the Global Drug Survey—a study of how the world consumes drugs—and a consultant psychiatrist and addiction medicine specialist. Between these two roles, he’s analyzed the drug-taking habits of approximately 500,000 people, and 300,000 cannabis users. He’s extremely well-placed to advise on dealing with the more established effects of cannabis withdrawal. For most people, as it was with me during my promotion back in the mid-2000s, that means: a) insomnia and vivid dreams; and b) nicotine withdrawal. A huge part of the first problem comes from an unlikely source.
"Lots of people who smoke lots of weed drink too much caffeine: Red Bull, tea, coffee, fizzy drinks. This is often to offset the sedating effects of weed. If you keep drinking 15 cups of tea when you’ve given up weed, this is going to worsen your insomnia, which will make you agitated," says Winstock.
If you’ve grown up smoking joints with tobacco in them, there’s a good chance you will also experience cravings from the nicotine withdrawal. For those looking to give up weed, Winstockadvocates giving up cannabis and nicotine at the same time—but adds that, crucially, you should gradually reduce your tobacco intake in the run-up to quitting. This will have an unexpected second benefit in the fight against withdrawal sleeplessness.
"Tobacco metabolizes caffeine. It breaks it down," he explains. "So when you stop smoking tobacco, your caffeine levels go through the roof. You're left with this double whammy: of not only taking a stimulant drug [caffeine] that you likely drink too much of anyway, but you're taking a stimulant drug whose levels are going to go through the roof because tobacco is no longer breaking it down."
Winstock also says that the intensity of your withdrawal will likely be affected by the type of weed you smoke. "If you smoke a high THC cannabis, then I think the insomnia would be worse—your weird dreams would be worse, your craving would be worse, and your low mood would be worse."
Withdrawal symptoms with weed peak around day two or three and are generally over after seven. Sleeplessness and vivid dreams may last for two weeks, but Winstock’s absolute gold standard advice for giving up weed is to "get into good sleep hygiene." Admittedly easier said than done, but there are some common sense habits that will help.
"Exercise is probably the best thing you can do," he says. "Obviously, you shouldn't over-exert yourself, but if you’re exhausted when you go to bed, you’re much more likely to sleep well. Turn off screens a couple of hours before bed, and avoid caffeine. And don’t give up and call your dealer if you don't sleep well! It will get easier soon."
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To take part in this year's Global Drug Survey, an anonymous study on how the world uses drugs, click here.