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Greetings again everybody we're going to talk here about the substance-related and addictive disorders as the dsm-5 calls it also known more colloquially as the substance use disorders alright so there are two new withdrawal syndromes the dsm-5 recognizes the first of all just cannabis withdrawal syndrome the other is caffeine withdrawal syndrome which probably all experienced at one point or another the caffeine went up the cannabis one maybe had that one too I don't know anyhow the cannabis withdrawal syndrome is a you would think based on all the stuff that you hear in popular culture marijuana is not addictive and yes it is true that marijuana is not addictive to the same degree as other illicit drugs such as cocaine or or heroin however there are addictive properties to it as there are with pretty much anything that you take into your body such as caffeine or alcohol so yes there is a cannabis withdrawal syndrome and we now recognize this in the dsm-5 so the first criterion for cannabis withdrawal syndrome is that the patient has stopped using the marijuana after a period of heavy and prolonged use so that's really up in the air how long it depends on how much they used it and really just various factors based on the patient but the DSM says usually daily or almost daily over a period of at least a few months so a pretty significant history of cannabis use next they have to have three or more of the following signs or symptoms developing within approximately one week after cessation and these are irritability anger or aggression nervousness or anxiety sleep difficulty and that can be difficulty initiating sleep difficulty maintaining sleep a lot of times these patients will have strange dreams nightmares decrease appetite or weight restlessness depressed mood and then at least one of the following physical symptoms abdominal pain shakiness tremors sweating fever chills or headache also they can get this flu-like syndrome that we also see in caffeine withdrawal syndrome see it's got a cause significant distress or impairment and that can be either a place of employment your social setting if certainly if the patient has been arrested or charged with any kind of offence for having the marijuana and yet they still continue to use it and then also if you're talking about college or high school age kids using it getting caught that's distress or impairment as well regardless of whether it really distress is them when we talk about impairment here we're talking about negative consequences not just whether or not it bothers the patient and then finally D obviously it can't be attributable to another medical condition mental condition or other substance caffeine withdrawal syndrome is certainly something you can imagine probably because doctors have a tendency to sip on the coffee a lot and now that we've got these energy drinks Red Bull Blue Ox monster that have significant amounts of caffeine in it we also have those new energy shots the 5-hour...
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