A new study found that regular marijuana users experience withdrawal symptoms more frequently than previously assumed.

Though marijuana isn’t associated with addiction, habitual use could develop into problem behavior such as dependence. This could lead to cannabis use disorder, found in 30% of marijuana users, and associated with withdrawal symptoms when trying to quit or an ability to quit, according to the National Institute on Drug Abuse.  

A new study published in JAMA Network Open suggests that withdrawal symptoms affects more than problematic users, however. Researchers collected data from 47 previous studies, which included more than 23,500 participants, and found that nearly half of marijuana users experience cannabis withdrawal syndrome.

“These findings suggest that cannabis withdrawal syndrome appears to be prevalent among regular users of cannabis,” the study’s authors wrote.

Cannabis withdrawal syndrome (CWS) qualifies as experiencing at least three of the following symptoms within seven days of reduced marijuana use: anger, anxiety, trouble falling asleep, appetite problems, restlessness, depression, or bodily reactions like headaches or vomiting. Compared to other drugs and addictive substances, these withdrawal symptoms tend to be moderate and temporary.

Daily marijuana use or consuming tobacco or other drugs alongside marijuana were more associated with developing cannabis withdrawal syndrome, researchers wrote. Identifying the prevalence of CWS is important because it allow clinicians and mental health professionals better advise patients. In some cases, those who use marijuana to self-medicate for mental illness may be exacerbating those symptoms.

“When medical marijuana clients were asked about actual symptom relief, fewer than half report such relief, while others reported return of anxiety symptoms on cessation of use, suggesting the symptoms might be due to cannabis withdrawal,” the authors wrote. “Because many CWS criteria are depression or anxiety symptoms, regular users may seek cannabis to obtain short-term symptom relief, unaware that this use could perpetuate a longer-term withdrawal problem.”

Those who experience cannabis withdrawal symptoms are recommended to take over-the-counter medication to relieve physical symptoms and talk to a trained profession for counseling.

“Clinicians should be aware of the high prevalence of CWS and should consider screening for CWS, particularly among those who are at greater risk, in order to counsel patients and support individuals who are reducing their use of cannabis,” the authors concluded.