somnia. For the diagnosis, withdrawal symptoms  must cause clinically significant distress
or impairment in social, occu pational, or other important ar eas of functioning (Criterion
C). Many cannabis users report smoking cannabi s or taking other substances to help re-
lieve withdrawal symptoms, and many report  that withdrawal symptoms make quitting
difficult or have contributed to relapse. Th e symptoms typically ar e not of sufficient se-
verity to require medical attention, but medica tion or behavioral strategies may help alle-
viate symptoms and improve prognosis in those trying to quit using cannabis.
Cannabis withdrawal is commonly observed in individuals seeking treatment for can-
nabis use as well as in heavy cannabis users who are not seeking treatment. Among indi-
viduals who have used cannabis regularly during  some period of their lifetime, up to one-
third report having experienced cannabis wi thdrawal. Among adults and adolescents en-
rolled in treatment or  heavy cannabis users, 50%–95% report cannabis withdrawal. These
findings indicate that cannabis withdrawal occurs am ong a substantial subset of regular
cannabis users who try to quit. 
Development and Course
The amount, duration, and frequency of canna bis smoking that is required to produce an
associated withdrawal disorder during a quit attempt are unknown. Most symptoms have
their onset within the first 24–72 hours of ce ssation, peak within the first week, and last
approximately 1–2 weeks. Sleep difficulties may last more than 30 days. Cannabis with-
drawal has been documented among adolescents and adults. Withdrawal tends to be more
common and severe among adults, most likely related to the more persistent and greater
frequency and quantity of use among adults.