Diagnostic Criteria

A. Cessation of cannabis use that has been heavy and prolonged (i.e., usually daily or almost daily use over a period of at least a few months).

B. Three (or more) of the following signs and symptoms develop within approximately 1 week after Criterion A:

  1. Irritability, anger, or aggression.
  2. Nervousness or anxiety.
  3. Sleep difficulty (e.g., insomnia, disturbing dreams).
  4. Decreased appetite or weight loss.
  5. Restlessness.
  6. Depressed mood.
  7. At least one of the following physical symptoms causing significant discomfort: abdominal pain, shaking/tremors, sweating, fever, chills, or headache.

C. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

Note: Cannabis withdrawal can only occur in the presence of a moderate or severe cannabis use disorder. It is not permissible to record a comorbid mild cannabis use disorder with cannabis withdrawal.

Differential Diagnosis

Because many of the symptoms of cannabis withdrawal are also symptoms of other substance withdrawal syndromes or of depressive or bipolar disorders, careful evaluation should focus on ensuring that the symptoms are not better explained by cessation from another substance (e.g., tobacco or alcohol withdrawal), another mental disorder (generalized anxiety disorder, major depressive disorder), or another medical condition.

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