When should a doctor support cannabis withdrawal?

A doctor should support cannabis withdrawal if the symptoms are severe, mental warning signs appear or you cannot stop use on your own. Whether withdrawal needs medical support therefore depends mainly on three things: how severe the symptoms are, whether mental warning signs are added, and whether you can get through it on your own.

What typically happens when you stop

Many people feel irritability, restlessness, sleep problems or a strong craving for cannabis when they stop. According to drugcom, withdrawal symptoms usually begin 24 to 48 hours after the last use and generally last up to one week, at most up to 14 days. Another drugcom topic gives three to four weeks until they largely subside. How strong the symptoms are depends on the amount, the duration of use and the person. No one can give you a reliable prediction for your case across the board, and this article cannot either.

It is also important whether other substances are involved. If you also take alcohol or medication, mention this openly to your doctor, because it influences the assessment.

These warning signs point to medical help

Not every unpleasant phase needs a doctor straight away. Certain signs do, however, suggest that you should get help:

• Strong mood swings or persistent low spirits
• Anxiety, panic attacks or sleep disorders over a longer period
• Disturbed perception, persecutory thoughts or confusion
• Physical complaints that worry you
• Several failed attempts to stop use on your own
• Continued use despite problems at school, at work or in relationships

If you think about suicide, speak to a trusted person straight away. In an acute crisis, call the emergency number 112. The Telefonseelsorge crisis line is also a point of contact. Do not wait for an appointment in this situation.

Taking psychological dependence seriously

With ongoing use, a psychological dependence can develop. The BIÖG states that roughly one in eight people who use cannabis becomes dependent. Typical signs are that you continue to use although you want to stop, and that use takes up more and more room in everyday life.

The article How can I recognise cannabis dependence? describes how to recognise dependence. If you recognise yourself in this, that is a good reason for a conversation with a doctor.

Which doctor is suitable

The first step is usually the GP practice. There you can describe your use honestly and clarify whether a referral makes sense. For more severe mental complaints, specialists in psychiatry or psychotherapy are suitable. For questions about addiction, there are also doctors with experience in addiction medicine.

The article When should you talk to your GP about cannabis? explains how to approach the conversation with your GP.

What to say in the doctor's appointment

An honest account helps you more than a polished one. Prepare these points:

• How often and how much you use
• How long you have been using and whether the amount has changed
• Which other substances, alcohol or medication you take
• Which physical or mental complaints have occurred since you stopped
• Which pre-existing conditions you have and which medication you take regularly

Doctors are bound by confidentiality. That is exactly what they are there for, and you do not need to sugarcoat anything with them.

Outpatient or inpatient support: what fits

Withdrawal can take place as an outpatient with medical support and conversations at a counselling service. If the symptoms are severe or your environment encourages use, inpatient treatment can make sense. The article When is an addiction clinic sensible for cannabis use? describes the criteria for this.

Keeping an eye on the course

Withdrawal does not run the same way for everyone. If you keep a short diary about sleep, mood and craving, you notice changes earlier and can describe them to your doctor precisely. Note in one or two sentences each day how you feel, how you slept and whether the wish for cannabis was stronger or weaker.

Physical changes belong in the diary too. If complaints persist or worry you, raise them at the practice.

What doctors check in the conversation

As a rule, the doctor asks about use behaviour, mental complaints and physical illnesses. This includes questions about sleep, mood, anxiety and heart complaints. On this basis, it is decided whether outpatient support is enough, whether further examinations are needed, or whether a referral to a specialist service makes sense.

Your living situation can also play a role, for example if you live alone or have no one to turn to. You can raise this openly.

Organising withdrawal and everyday life

Withdrawal is easier when everyday life is relieved. Plan fewer obligations in the first weeks, and postpone important decisions where possible. Let the people close to you know. A short sentence such as “I'm stopping cannabis at the moment and will get in touch when I can” is usually enough.

If cannabis is taken for granted in your environment, an agreement with housemates can help. The article Can you get through cannabis withdrawal at home? addresses this situation.

Combining medical support and self-help

Medical support and self-help do not exclude each other. The practice checks health and medication, while a group or counselling service supports everyday life. Ask your GP which offers are known in your region. The DHS addiction help directory also lists services near you that provide information on outpatient support.

What you can do now

1. Note since when and how much you have been using, and which complaints occur.
2. Arrange an appointment at your GP practice and raise the topic openly.
3. Ask for counselling at an addiction counselling service if you cannot make progress on your own.
4. For suicidal thoughts or acute danger, call the emergency number 112 straight away.

For an overview, see Help and counselling. If you first want to speak with a counsellor, the addiction counselling service near you can help. There you can clarify which next step suits you.