A comprehensive assessment found no evidence that prescription dronabinol (Marinol) was being abused, diverted, or sold on the street, with cannabis-dependent individuals showing no interest in the pharmaceutical form.
Read this if you want to understand why prescription THC has not become a drug of abuse despite containing the same active ingredient as marijuana.
Zero evidence of abuse, diversion, or street market for prescription THC
What the researchers found
Researchers investigated the abuse potential of dronabinol (Marinol), a prescription oral THC product, through literature review, surveys, and interviews with addiction specialists, oncologists, HIV researchers, and law enforcement.
The findings were consistently negative across all measures of abuse potential. No evidence of abuse or diversion was found. Prescription tracking showed patients stayed within therapeutic dose ranges over time. Healthcare professionals detected no "scrip-chasing" or "doctor-shopping." Cannabis-dependent populations showed no interest in abusing dronabinol.
The explanation was pharmacological: dronabinol has a slow, gradual onset of action, is at most weakly reinforcing, and most users described its effects as dysphoric and unappealing. There was no street market for dronabinol and no evidence of diversion for sale as a street drug.
Why it matters
This study directly addressed concerns that pharmaceutical THC would become a drug of abuse. The finding that even cannabis-dependent individuals had no interest in dronabinol demonstrated that the pharmaceutical formulation's slow onset and dysphoric effects made it fundamentally different from smoked cannabis in terms of abuse potential.
The numbers in context
Zero evidence of abuse or diversion across all data sources. Prescription tracking confirmed therapeutic-range dosing over time. No street market detected. Most users reported dysphoric, unappealing effects.
How the study worked
Multi-method assessment including literature review, surveys, and interviews with addiction medicine specialists, oncologists, cancer and HIV researchers, and law enforcement. Prescription tracking data was also reviewed.
What this study cannot tell us
The study was conducted among legitimate patients and healthcare providers. Surveillance systems may not capture all forms of diversion. The relatively small patient population using dronabinol at the time may have limited detection of rare abuse events.
How to read the evidence
A multi-method assessment with data from multiple professional groups and prescription tracking. Thorough methodology but funded in a context where negative abuse findings would support continued marketing.
When this study was published
Published in 1998. Dronabinol was rescheduled from Schedule II to Schedule III in 1999, partly based on evidence like this.
The bigger picture
This study explained why pharmaceutical THC did not generate the abuse concerns some predicted. The key insight is that abuse potential depends heavily on pharmacokinetics: drugs that reach the brain slowly are less reinforcing than those with rapid onset. This principle has informed subsequent cannabinoid drug development.
Questions still open
- Would faster-acting THC formulations have higher abuse potential? Has dronabinol abuse emerged as its use has expanded? Do these findings support keeping THC in a lower drug schedule?
Common questions
Why don't people abuse prescription THC?
Did cannabis users want to use Marinol?
Read the original research
Abuse potential of dronabinol (Marinol).
Journal of psychoactive drugs, 30(2), 187-96
Citation
Calhoun, S R; Galloway, G P; Smith, D E. (1998). Abuse potential of dronabinol (Marinol).. Journal of psychoactive drugs, 30(2), 187-96.
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