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Abstract
Cannabis withdrawal syndrome (CWS) was newly added to the Diagnostic and Statistical
Manual of Mental Disorders in its most recent edition, DSM-5. With cannabis use increasing
among U.S. adults, information is needed about the prevalence and correlates of DSM-5
CWS in the general population. This study presents nationally representative findings
on the prevalence, sociodemographic and clinical correlates of DSM-5 CWS among U.S.
adults. Participants ≥18 years were interviewed in the National Epidemiologic Survey
on Alcohol and Related Conditions-III (NESARC-III) in 2012-2013. Among the sub-sample
of frequent cannabis users in the prior 12 months (≥3 times a week; N=1,527), the
prevalence, demographic and clinical correlates of DSM-5 CWS were examined. In frequent
cannabis users, the prevalence of CWS was 12.1%. The most common withdrawal symptoms
among those with CWS were nervousness/anxiety (76.3%), hostility (71.9%), sleep difficulty
(68.2%) and depressed mood (58.9%). CWS was associated with significant disability
(p<0.001), and with mood disorders (adjusted odds ratios [aOR]=1.9-2.6), anxiety disorders
(aOR=2.4-2.5), personality disorders (aOR=1.7-2.2) and family history of depression
(aOR=2.5) but not personal history of other substance use disorders or family history
of substance use problems. CWS is highly comorbid and disabling. Its shared symptoms
with depressive and anxiety disorders call for clinician awareness of CWS and the
factors associated with it to promote more effective treatment among frequent cannabis
users.