Fast Five Quiz: Marijuana--Medical Uses and Personal Abuses

Sage W Wiener, MD; Michael E Schatman, PhD, CPE


August 20, 2018

Cannabis-induced sleep disorder requires a prominent and severe disturbance in sleep. The disturbance must not occur exclusively during the course of delirium. The disturbance must also cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Evidence from the history, physical examination, or laboratory findings must suggest both of the following:

  • The symptoms in the first criterion developed during or soon after cannabis intoxication, or after withdrawal from or exposure to it.

  • Cannabis is capable of producing the symptoms in the first criterion. The disturbance is not better explained by a sleep disorder that is not substance/medication-induced. Such evidence of an independent sleep disorder could include that symptoms precede the onset of the cannabis use; symptoms persist for a substantial period (ie, about a month) after the cessation of acute withdrawal or severe intoxication; or other evidence that suggests an independent nonsubstance/medication-induced sleep disorder (ie, a history of recurrent nonsubstance/medication-related episodes).

According to the DSM-5, at least two of the following signs, developing within 2 hours of cannabis use, are required for the diagnosis of cannabis intoxication:

  • Conjunctival injection

  • Increased appetite

  • Dry mouth

  • Tachycardia

Sustained remission for cannabis use disorder requires that none of the criteria for cannabis use disorder have been met at any time during a period of 12 months or longer (with an exception for craving).

For the diagnosis of cannabis withdrawal, three or more of the following signs and symptoms must develop within approximately 1 week after cessation of heavy, prolonged use:

  • Irritability, anger, or aggression

  • Nervousness or anxiety

  • Sleep difficulty (ie, insomnia, disturbing dreams)

  • Decreased appetite or weight loss

  • Restlessness

  • Depressed mood

  • At least one of the following physical symptoms causing significant discomfort: abdominal pain, shakiness/tremors, sweating, fever, chills, or headache

For more on cannabis-related conditions, read here.


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