Dronabinol reduced opioid withdrawal severity but didn't improve naltrexone treatment retention
A synthetic THC pill (dronabinol) reduced opioid withdrawal symptoms during detox, but did not increase rates of completing naltrexone treatment for opioid dependence.
Quick Facts
What This Study Found
Sixty opioid-dependent participants were randomized to receive dronabinol (30mg/day) or placebo during inpatient detoxification and transition to extended-release naltrexone. Dronabinol significantly reduced the severity of opioid withdrawal symptoms during the inpatient phase.
However, successful induction onto naltrexone (66% dronabinol vs. 55% placebo) and 8-week treatment completion rates (35% in both groups) were not significantly different. A post hoc finding revealed that 32% of participants who smoked marijuana during the outpatient phase, regardless of their assigned group, had lower insomnia and anxiety and were more likely to complete the full 8-week trial.
The study suggests dronabinol has a role in acute withdrawal management but may not be sufficient to improve longer-term treatment retention.
Key Numbers
60 participants (40 dronabinol, 20 placebo). Dronabinol reduced withdrawal severity (p=0.006). Naltrexone induction: 66% dronabinol vs. 55% placebo (not significant). 8-week completion: 35% in both groups. 32% who smoked marijuana outpatient were more likely to complete treatment.
How They Did This
Randomized, double-blind, placebo-controlled trial. 40 participants received dronabinol 30mg/day and 20 received placebo during inpatient detoxification and naltrexone induction. All received extended-release naltrexone injections. Dronabinol or placebo continued for 5 weeks outpatient.
Why This Research Matters
Opioid withdrawal is a major barrier to starting and maintaining treatment. Finding medications that ease this transition could save lives. While dronabinol helped with acute withdrawal, the treatment retention challenge remains unsolved.
The Bigger Picture
The endocannabinoid system interacts with the opioid system in ways that may help manage withdrawal. This study adds to evidence that cannabinoids could play a supportive role in opioid treatment, even if they are not a standalone solution for treatment retention.
What This Study Doesn't Tell Us
Unequal group sizes (2:1 randomization). The post hoc marijuana use finding was not pre-planned and should be interpreted cautiously. Sample size may have been insufficient to detect moderate differences in retention. Outpatient marijuana use was self-selected, introducing selection bias.
Questions This Raises
- ?Could higher or different dosing of dronabinol improve treatment retention?
- ?Does the post hoc finding about marijuana use during opioid treatment warrant a dedicated clinical trial?
- ?Would CBD be effective for opioid withdrawal without psychoactive effects?
Trust & Context
- Key Stat:
- Dronabinol reduced withdrawal severity (p=0.006) but not treatment retention
- Evidence Grade:
- Randomized, double-blind, placebo-controlled trial with moderate sample size. Primary withdrawal outcome was positive; retention outcomes were null.
- Study Age:
- Published in 2015. Research on cannabinoids in opioid treatment continues.
- Original Title:
- The effects of dronabinol during detoxification and the initiation of treatment with extended release naltrexone.
- Published In:
- Drug and alcohol dependence, 154, 38-45 (2015)
- Authors:
- Bisaga, Adam(5), Sullivan, Maria A(3), Glass, Andrew(5), Mishlen, Kaitlyn, Pavlicova, Martina, Haney, Margaret, Raby, Wilfrid N, Levin, Frances R, Carpenter, Kenneth M, Mariani, John J, Nunes, Edward V
- Database ID:
- RTHC-00923
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
Can THC help with opioid withdrawal?
In this study, synthetic THC (dronabinol) significantly reduced the severity of opioid withdrawal symptoms during detoxification. However, it did not increase the likelihood of completing a full course of naltrexone treatment.
Does marijuana use help people stay in opioid treatment?
A post hoc finding suggested participants who used marijuana during the outpatient phase had lower anxiety and insomnia and were more likely to complete treatment, but this was not a pre-planned comparison and needs dedicated study.
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Cite This Study
https://rethinkthc.com/research/RTHC-00923APA
Bisaga, Adam; Sullivan, Maria A; Glass, Andrew; Mishlen, Kaitlyn; Pavlicova, Martina; Haney, Margaret; Raby, Wilfrid N; Levin, Frances R; Carpenter, Kenneth M; Mariani, John J; Nunes, Edward V. (2015). The effects of dronabinol during detoxification and the initiation of treatment with extended release naltrexone.. Drug and alcohol dependence, 154, 38-45. https://doi.org/10.1016/j.drugalcdep.2015.05.013
MLA
Bisaga, Adam, et al. "The effects of dronabinol during detoxification and the initiation of treatment with extended release naltrexone.." Drug and alcohol dependence, 2015. https://doi.org/10.1016/j.drugalcdep.2015.05.013
RethinkTHC
RethinkTHC Research Database. "The effects of dronabinol during detoxification and the init..." RTHC-00923. Retrieved from https://rethinkthc.com/research/bisaga-2015-the-effects-of-dronabinol
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.