Nabilone Produced Sustained Positive Effects in Cannabis Smokers and May Be Better Than Dronabinol for Dependence Treatment

In regular marijuana smokers, nabilone produced dose-related positive mood effects with better bioavailability and a slower onset than dronabinol, supporting its potential as a medication for cannabis dependence.

Bedi, Gillinder et al.·Addiction biology·2013·Moderate EvidenceRandomized Controlled Trial
RTHC-00651Randomized Controlled TrialModerate Evidence2013RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
N=14

What This Study Found

Fourteen regular marijuana smokers completed a within-subjects comparison of nabilone (2, 4, 6, 8 mg), dronabinol (10, 20 mg), and placebo across seven sessions. Both drugs increased ratings of feeling good, strong effects, and being "high." Nabilone had a slower onset but more sustained effects, and its effects were more dose-related than dronabinol's.

Nabilone at 6-8 mg modestly reduced psychomotor speed, but overall was well tolerated. Heart rate increased dose-dependently with nabilone. The more predictable dose-response relationship and better bioavailability suggest nabilone may be more suitable than dronabinol as an agonist replacement therapy for cannabis dependence.

Key Numbers

14 participants smoking 6.6 days/week. Nabilone tested at 2, 4, 6, 8 mg. Dronabinol at 10, 20 mg. Both increased positive mood ratings. Nabilone: slower onset, more dose-related. Nabilone 6-8 mg: modest psychomotor slowing. Dose-dependent heart rate increase with nabilone.

How They Did This

Outpatient, within-subjects, double-blind, randomized protocol. 14 participants (4 female, 10 male) smoking marijuana 6.6 days/week. Seven sessions comparing nabilone (4 doses), dronabinol (2 doses), and placebo. Time-dependent subjective, cognitive, and cardiovascular effects measured.

Why This Research Matters

Dronabinol (oral THC) has been tested for cannabis dependence but failed to prevent relapse, possibly due to poor bioavailability. Nabilone's better bioavailability and more predictable dose-response could make it a superior agonist therapy, similar to how methadone or buprenorphine work for opioid dependence.

The Bigger Picture

Agonist replacement therapy (replacing the drug of abuse with a controlled, longer-acting version) has been highly successful for opioid dependence. This study took a step toward evaluating whether a similar strategy could work for cannabis dependence, with nabilone as the candidate medication.

What This Study Doesn't Tell Us

Small sample of 14 participants. All were current regular users, not treatment-seeking. Acute effects of single doses do not predict outcomes of sustained treatment. Outpatient setting means compliance and environmental factors were not controlled. The study assessed subjective effects but not actual cannabis reduction.

Questions This Raises

  • ?Would sustained nabilone treatment reduce cannabis use in treatment-seeking individuals?
  • ?What nabilone dose would balance therapeutic effects with side effects in a clinical trial?
  • ?Would combining nabilone with behavioral therapy improve outcomes?

Trust & Context

Key Stat:
Nabilone had better bioavailability and more dose-predictable effects than dronabinol
Evidence Grade:
Within-subjects controlled study in current users; moderate evidence for pharmacological profile but no cessation outcomes.
Study Age:
Published in 2013. Nabilone and other agonist therapies for cannabis dependence have continued to be investigated.
Original Title:
Subjective, cognitive and cardiovascular dose-effect profile of nabilone and dronabinol in marijuana smokers.
Published In:
Addiction biology, 18(5), 872-81 (2013)
Database ID:
RTHC-00651

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

Frequently Asked Questions

What is the difference between nabilone and dronabinol?

Both are synthetic cannabinoids that activate the same receptors as THC. Dronabinol is synthetic THC itself, while nabilone is a THC analogue with different pharmacological properties. Nabilone has better bioavailability (more of the drug reaches the bloodstream) and a more predictable dose-response relationship.

How would nabilone help with cannabis dependence?

The concept is agonist replacement therapy, similar to methadone for heroin dependence. By providing a controlled, oral cannabinoid, nabilone could reduce withdrawal symptoms and cravings while avoiding the rapid onset and variable dosing of smoked cannabis. Its slower onset and sustained effects make it potentially suitable for this purpose.

Read More on RethinkTHC

Cite This Study

RTHC-00651·https://rethinkthc.com/research/RTHC-00651

APA

Bedi, Gillinder; Cooper, Ziva D; Haney, Margaret. (2013). Subjective, cognitive and cardiovascular dose-effect profile of nabilone and dronabinol in marijuana smokers.. Addiction biology, 18(5), 872-81. https://doi.org/10.1111/j.1369-1600.2011.00427.x

MLA

Bedi, Gillinder, et al. "Subjective, cognitive and cardiovascular dose-effect profile of nabilone and dronabinol in marijuana smokers.." Addiction biology, 2013. https://doi.org/10.1111/j.1369-1600.2011.00427.x

RethinkTHC

RethinkTHC Research Database. "Subjective, cognitive and cardiovascular dose-effect profile..." RTHC-00651. Retrieved from https://rethinkthc.com/research/bedi-2013-subjective-cognitive-and-cardiovascular

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.