noids for inhalation. As with other psychoactive substances, smoking (and vaporization)
typically produces more rapid onset and more intense experiences of the desired effects. 
Individuals who regularly use cannabis can develop all the genera l diagnostic features
of a substance use disorder. Cannabis use diso rder is commonly observed as the only sub-
stance use disorder experienced by the individu al; however, it also frequently occurs con-
currently with other types of substance use di sorders (i.e., alcohol, cocaine, opioid). In
cases for which multiple types of substances are used, many times the individual may
minimize the symptoms related to cannabis, as  the symptoms may be less severe or cause
less harm than those directly related to the use of the other substances. Pharmacological
and behavioral tolerance to most of the effect s of cannabis has been reported in individuals
who use cannabis persistently. Generally, tolerance is lost when cannabis use is discontin-
ued for a significant period of time (i.e., for at least several months). 
New to DSM-5 is the recognition that abrupt cessation of daily or near-daily cannabis
use often results in the onset of a cannabis withdrawal syndrome. Common symptoms of
withdrawal include irritability, anger or ag gression, anxiety, depressed mood, restless-
ness, sleep difficulty, and decreased appetite or weight loss. Although typically not as
severe as alcohol or opiate withdrawal, the cannabis withdrawal syndrome can cause sig-
nificant distress and contribute to difficulty quitting or relapse among those trying to
abstain. 
Individuals with cannabis use disorder may use cannabis throughout the day over a
period of months or years, and thus may spend many hours a da y under the influence.
Others may use less frequently, but their use causes recurrent problems related to family,