Cannabis Withdrawal 517
dysphoria, or social withdrawal occurs. These psychoactive effects are accompanied by
two or more of the following signs, developi ng within 2 hours of cannabis use: conjuncti-
val injection, increased appetite, dry mouth, and tachycardia (Criterion C). 
Intoxication develops within minutes if the cannabis is smoked but may take a few
hours to develop if the cannabis is ingested orally. The effects usually last 3–4 hours, with
the duration being somewhat lo nger when the substance is in gested orally. The magnitude
of the behavioral and physiological changes depends on the dose, the method of adminis-
tration, and the characteristics of the individual using the substance, such as rate of absorp-
tion, tolerance, and sensitivity to the effects of the substance. Because most cannabinoids,
including delta-9-tetrahydrocannabinol (delta-9-T HC), are fat soluble, the effects of canna-
bis or hashish may occasionally persist or re occur for 12–24 hours because of the slow re-
lease of psychoactive substances from fa tty tissue or to ente rohepatic circulation.
Prevalence
The prevalence of actual episodes of cannabis intoxication in the general population is un-
known. However, it is probable that most ca nnabis users would at some time meet criteria
for cannabis intoxication. Given this, the prev alence of cannabis users and the prevalence
of individuals experiencing canna bis intoxication are likely similar.
Functional Consequences of Cannabis Intoxication
Impairment from cannabis intoxication ma y have serious consequences, including dys-
function at work or school, social indiscretion s, failure to fulfill role  obligations, traffic ac-
cidents, and having unprotected sex. In rare cases, cannabis intoxication may precipitate a