Pregabalin Shows Early Promise for Treating Cannabis and Other Drug Withdrawal Symptoms | Research

The takeaway

A comprehensive review found limited but promising evidence that pregabalin may help manage withdrawal symptoms from cannabis, opioids, benzodiazepines, nicotine, and alcohol.

Read this if you are interested in medical options for managing cannabis withdrawal symptoms.

Limited but promising evidence for pregabalin across five substance withdrawal categories

What the researchers found

This review examined evidence for using pregabalin, a nerve pain medication, to treat physical dependence and withdrawal symptoms across multiple substance categories including cannabinoids.

The available evidence was limited, with few randomized controlled studies. However, the findings that did exist were promising across several substance types, suggesting pregabalin may help manage the anxiety, sleep disturbance, and other discomfort associated with withdrawal.

The authors noted an important caveat: pregabalin itself carries potential for misuse or abuse, particularly in people with a history of substance use disorders. This creates a paradox where the population most likely to benefit may also be most vulnerable to developing problems with the treatment itself.

Why it matters

Cannabis withdrawal is increasingly recognized as a clinically meaningful syndrome that can derail quit attempts. Currently, there are no FDA-approved medications specifically for cannabis withdrawal. If pregabalin proves effective, it could fill an important treatment gap.

The numbers in context

The review covered withdrawal from five substance categories: opioids, benzodiazepines, nicotine, cannabinoids, and alcohol. Randomized controlled data were described as sparse across all categories.

How the study worked

Literature search of MEDLINE and Cochrane Library databases through December 2015. Search terms combined dependence or withdrawal with pregabalin. Cross-referencing of cited works and personal archives. Article selection based on expert opinion of the authors.

What this study cannot tell us

Randomized controlled data were sparse. The review included studies selected based on expert opinion rather than systematic criteria, introducing potential selection bias. The risk of pregabalin misuse in substance-dependent populations limits its practical application.

How to read the evidence

Narrative review with expert-selected studies rather than systematic methodology. Underlying evidence is sparse, particularly randomized controlled data.

When this study was published

Published in 2016. Additional studies on pregabalin for substance withdrawal may have been conducted since.

The bigger picture

The search for medications to ease cannabis withdrawal reflects the broader shift in understanding cannabis dependence as a treatable condition. As cannabis use increases with legalization, effective withdrawal management becomes more important for people who want to reduce or stop their use.

Questions still open

Can pregabalin be used safely in people with cannabis use disorders given its own abuse potential? Would short-term use during acute withdrawal minimize the misuse risk? What specific cannabis withdrawal symptoms does pregabalin address most effectively?

Common questions

Is there a medication for cannabis withdrawal?

No medications are specifically approved for cannabis withdrawal, but this review found early promising evidence that pregabalin may help manage withdrawal symptoms across multiple substances including cannabis.

What are the risks of using pregabalin for withdrawal?

Pregabalin itself carries potential for misuse or abuse, particularly in people with substance use histories, creating a challenge for its use in the very population that might benefit most.

Read the original research

Pregabalin for the Treatment of Drug and Alcohol Withdrawal Symptoms: A Comprehensive Review.

CNS drugs, 30(12), 1191-1200

View on PubMed ↗

Citation

Freynhagen, Rainer; Backonja, Miroslav; Schug, Stephan; Lyndon, Gavin; Parsons, Bruce; Watt, Stephen; Behar, Regina. (2016). Pregabalin for the Treatment of Drug and Alcohol Withdrawal Symptoms: A Comprehensive Review.. CNS drugs, 30(12), 1191-1200.