Characterizing sex differences in cannabis withdrawal during 28 days of cannabis abstinence
Bibliographic record
Abstract
Background: Despite rising rates of cannabis use disorder (CUD) worldwide, treatments for CUD remain ineffective. Cannabis withdrawal may be an optimal treatment target because it is a strong predictor of cannabis relapse. Symptoms begin 24 hours after cannabis cessation, peak within one week, and dissipate following 28 days of abstinence. Some research suggests that females experience greater cannabis withdrawal severity compared to males. However, these data are derived from studies that employed cross-sectional, retrospective designs or surveyed minimal abstinence periods (i.e., < 28 days). Since cannabis withdrawal can last for several weeks with fluctuations in severity, we examined sex differences in cannabis withdrawal severity during 28 days of cannabis abstinence.Methods: Males and females, between 18-80 years-old, with CUD or using cannabis ≥ 4 per week were enrolled. Participants were excluded if they had a current comorbid DSM-5 disorder (other than CUD). Participants underwent 28 days of cannabis abstinence supported by contingency management and weekly behavioural support sessions. Cannabis withdrawal symptoms were assessed at baseline and then weekly using the Marijuana Withdrawal Checklist (MWC). Cannabis abstinence was verified biochemically with twice-weekly urine analysis and the Timeline Follow-Back interview.Results: A total of 28 participants completed the study (n=5 males and n=3 females had dropped out). Twenty-three participants (n=14 male and n=9 female) remained cannabis abstinent throughout the study. Moreover, 5 participants (n=2 male and n=3 female) had relapsed. In total, twenty-three participants are included in our final analysis. After controlling for baseline MWC scores and recency of cannabis use, a repeated measures ANOVA revealed that there was a significant time effect (F4, 76 = 2.92, p = 0.03) in MWC total scores over the 28 days of cannabis abstinence, as well as a significant interaction between time and sex (F4,76 = 4.14, p < 0.01). However, there was no significant between-group sex difference found in total MWC scores (F1,19 = 1.18, p = 0.29). Withdrawal severity for males followed the previously established trajectory, where symptoms peaked at day 7 and then dissipated by day 28. However, symptoms for females followed a different trajectory, where symptoms remain stable between days 0 and 28. Conclusions: Our preliminary findings demonstrate that cannabis withdrawal severity follows a different trajectory in both males and females. Additionally, we found a significant time*sex interaction in cannabis withdrawal severity when controlling for baseline values and recency of use. These results highlight the potential value of developing sex-specific CUD therapies that target cannabis withdrawal to optimize successful cannabis cessation rates
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".