From the Guidelines
Nabilone and nabiximols are the most effective medications for reducing cannabis craving and symptoms of Cannabis Withdrawal Syndrome (CWS) in individuals with Cannabis Use Disorder (CUD), as evidenced by a 2021 study published in the British Journal of Anaesthesia 1. When considering medication to stop marijuana addiction, it's essential to prioritize treatments that address the underlying symptoms of CWS and reduce cravings.
- Nabilone, a synthetic analogue of D9-THC, has anxiolytic, anti-emetic, and analgesic properties, making it a suitable option for managing CWS symptoms 1.
- Nabiximols, another medication, has also shown promise in reducing cannabis craving and CWS symptoms, similar to nicotine replacement therapy in tobacco smokers 1. However, it's crucial to note that the most appropriate dosages for these interventions are not well established, and expert guidance from clinicians familiar with prescribing or authorizing cannabis, nabilone, or nabiximols is recommended 1.
- The use of these medications should be approached with caution, particularly in perioperative patients, as CWS can cause further harm and increase the risk of relapse 1. In real-life clinical practice, it's essential to weigh the potential benefits and risks of using these medications and to prioritize a comprehensive treatment plan that includes counseling and support groups.
- Clinicians should exercise caution when prescribing these medications, ensuring that the already accepted dosages are not exceeded, and closely monitoring patients for adverse effects 1.
From the Research
Medications for Marijuana Addiction
- There are currently no approved pharmacotherapies for the treatment of cannabis use disorders 2, 3, 4, 5.
- Various medications have been studied for their potential in treating cannabis use disorder, including:
- Δ9-tetrahydrocannabinol (THC) preparations, which may reduce the intensity of withdrawal symptoms 2.
- Selective serotonin reuptake inhibitor (SSRI) antidepressants, mixed action antidepressants, anticonvulsants, and mood stabilizers, which have shown no significant difference in abstinence rates compared to placebo 2.
- Buspirone and N-acetylcysteine, which have shown some promise in reducing cannabis use, but more research is needed to confirm their effectiveness 2, 3, 6, 4.
- Gabapentin, an anticonvulsant, which has shown some positive effects on withdrawal symptoms and craving, but more research is needed to confirm its effectiveness 3, 6, 4.
- Oxytocin, a neuropeptide, which has shown some promise in reducing cannabis use, but more research is needed to confirm its effectiveness 6.
Limitations of Current Research
- The current evidence base for pharmacotherapies for cannabis use disorder is limited, with many studies having small sample sizes and inconsistent results 2, 3, 4.
- More research is needed to develop effective treatments for cannabis use disorder, including larger, well-designed clinical trials 2, 3, 6, 4, 5.