Among drugs tested for cannabis use disorder, those acting on the endocannabinoid system, particularly CB1 receptor agonists like nabilone, show the most promise for managing withdrawal, cravings, and relapse.
People seeking treatment for cannabis use disorder, addiction medicine providers, pharmacotherapy researchers
CB1 agonists most promising for CUD
What the researchers found
This review of randomized placebo-controlled trials found that CB1 receptor agonists (such as nabilone) showed the most promise for treating cannabis use disorder, while serotonergic, GABAergic, and other compound classes had more limited or mixed evidence.
Why it matters
There is currently no FDA-approved medication for cannabis use disorder, even as CUD rates rise with legalization. Identifying which medication classes work best could lead to effective treatments.
The numbers in context
The review covered compounds including nabilone (CB1 agonist), bupropion (serotonergic), zolpidem (GABAergic), and others across multiple RCTs. CUD rates are increasing with cannabis legalization worldwide.
How the study worked
Narrative review evaluating evidence from randomized, placebo-controlled trials of pharmacotherapies for cannabis use disorder, organized by compound target and outcome (withdrawal symptoms, craving, relapse/use).
What this study cannot tell us
Narrative rather than systematic review. Most trials have small sample sizes. Many compounds studied in limited populations. Females, certain racial/ethnic groups, and different age groups may respond differently.
How to read the evidence
Narrative review of RCTs provides organized evidence summary, but is not systematic and individual trials are often small.
When this study was published
2024 narrative review of clinical trial evidence
The bigger picture
The finding that endocannabinoid-system drugs work best mirrors the approach used for other substance use disorders, where agonist therapies (like methadone for opioids or nicotine replacement for tobacco) have proven most effective.
Questions still open
- Will any of these medications reach FDA approval for CUD? How should treatment be tailored for populations that experience CUD differently?
Common questions
Is there an approved medication for cannabis use disorder?
What type of medication showed the most promise?
Read the original research
Exploring Novel Pharmacotherapy Candidates for Cannabis Use Disorder: Uncovering Promising Agents on the Horizon by Mechanism of Action.
Drugs, 84(11), 1395-1417
Citation
Alayoubi, Myra; Henry, Brittany A; Cahill, Catherine M; Cooper, Ziva D. (2024). Exploring Novel Pharmacotherapy Candidates for Cannabis Use Disorder: Uncovering Promising Agents on the Horizon by Mechanism of Action.. Drugs, 84(11), 1395-1417. https://doi.org/10.1007/s40265-024-02098-1
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