Pharmacotherapy for Cannabis Dependence
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Cannabis is the most widely used illicit drug in the world. Treatment admissions for cannabis use disorders have risen considerably in recent years, and the identification of medications that can be used to improve treatment outcomes among this population is a priority for researchers and clinicians. To date, several medications have been investigated for indications of clinically desirable effects among cannabis users (e.g. reduced withdrawal, attenuation of subjective or reinforcing effects, reduced relapse). Medications studied have included those: (i) known to be effective in the treatment of other drug use disorders; (ii) known to alleviate symptoms of cannabis withdrawal (e.g. dysphoric mood, irritability); or (iii) that directly affect endogenous cannabinoid receptor function. Results from controlled laboratory studies and small open-label clinical studies indicate that buspirone, dronabinol, fluoxetine, lithium and lofexidine may have therapeutic benefit for those seeking treatment for cannabis-related problems. However, controlled clinical trials have not been conducted and are needed to both confirm the potential clinical efficacy of these medications and to validate the laboratory models being used to study candidate medications. Although the recent increase in research towards the development of pharmacotherapy for cannabis use disorders has yielded promising leads, well controlled clinical trials are needed to support broad clinical use of these medications to treat cannabis use disorders.
KeywordsNaltrexone Atomoxetine Buspirone Rimonabant Nefazodone
We thank the US National Institute on Drug Abuse (Dr Vandrey: DA12471 and DA025794; Dr Haney: DA09236 and DA19239) for its support. Dr Vandrey also thanks the Johns Hopkins University School of Medicine Department of Psychiatry and Behavioral Sciences for support. The authors have no conflicts of interest that are directly relevant to the content of this review.
- 6.UNODC. World drug report: 2007. New York: United Nations Office on Drugs and Crime, 2007Google Scholar
- 7.SAMHSA. Treatment episode data set (TEDS) 1995–2005: national admissions to substance abuse treatment services. Rockville (MD): DHHS, 2008Google Scholar
- 8.EMCDDA. Annual report on the state of the drugs problem. Lisbon: European Monitoring Centre for Drugs and Drug Addiction, 2007Google Scholar
- 9.AIHW. Alcohol and other drug treatment services in Australian Capital Territory 2005–06: findings from the National Minimum Data Set. Canberra (ACT): Australian Institute of Health and Welfare, 2007Google Scholar
- 22.Fiore MC, Bailey WC, Cohen SJ, et al. Treating tobacco use and dependence: clinical practice guideline. Rockville (MD): US Department of Health and Human Services, 2000Google Scholar
- 23.Silagy C, Lancaster T, Stead L, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2004; (3): CD000146Google Scholar
- 24.Mattick RP, Breen C, Kimber J, et al. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev 2003; (2): CD002209Google Scholar
- 26.Lichtman AH, Martin BR. Cannabinoid tolerance and dependence. In: Pertwee RG, editor. Handbook of experimental pharmacology: cannabinoids. Berlin: Springer-Verlag, 2005:691–717Google Scholar
- 59.Simpson D, Perry CM. Atomoxetine. Pediatr Drugs 2003; 5:407–15Google Scholar