Nabilone Reduced Both Marijuana Withdrawal Symptoms and Relapse in a Lab Study | Research

The takeaway

The synthetic THC analog nabilone reduced marijuana withdrawal symptoms including irritability, sleep disruption, and appetite changes, and also decreased marijuana self-administration during a relapse phase, outperforming the existing medication dronabinol.

Read this if you experience withdrawal symptoms when stopping cannabis and are interested in medication options.

Nabilone reduced both withdrawal and relapse, an improvement over dronabinol

What the researchers found

Eleven daily marijuana smokers (averaging 8.3 joints/day) completed a within-subjects study testing three nabilone doses (0, 6, 8 mg/day). Each phase included a withdrawal period (3 days without marijuana) and a relapse period (4 days with active marijuana available).

Both nabilone doses (6 and 8 mg/day) significantly reduced marijuana relapse and reversed withdrawal-related irritability, sleep disruption, and food intake changes. Neither dose increased ratings of capsule "liking" or desire to take capsules, suggesting low abuse potential. The 8 mg dose modestly worsened psychomotor performance. Notably, nabilone achieved these effects with once-daily dosing, making it practical for clinical use.

Why it matters

Dronabinol (oral THC) reduces withdrawal symptoms but does not reduce marijuana self-administration. Nabilone did both, making it a more promising medication candidate. Its better bioavailability and clearer dose-linearity compared to dronabinol may explain its superior efficacy.

The numbers in context

11 participants, 8.3 joints/day. Nabilone 6 and 8 mg/day both effective. Reduced: relapse, irritability, sleep disruption, food intake changes (p<0.05). No increased capsule liking. 8 mg: modest psychomotor impairment. Once-daily dosing sufficient.

How the study worked

Within-subjects, double-blind, placebo-controlled inpatient study. 11 participants (8 men, 3 women) using 8.3 joints/day. Three 8-day phases with different nabilone doses (0, 6, 8 mg/day, counterbalanced). Days 2-4: placebo marijuana (withdrawal). Days 5-8: active marijuana available (relapse).

What this study cannot tell us

Very small sample (11 participants). Non-treatment-seeking volunteers may differ from treatment seekers. Inpatient laboratory setting does not replicate real-world conditions. Only two active doses tested. Short treatment duration (7 days) does not address long-term outcomes.

How to read the evidence

Within-subjects controlled trial; moderate evidence despite small sample, with practical dosing advantage.

When this study was published

Published in 2013. Nabilone and other agonist replacement therapies for cannabis dependence continue to be studied.

The bigger picture

This study represents a meaningful advance in cannabis pharmacotherapy. While dronabinol showed limited efficacy, nabilone achieved the dual goal of reducing both withdrawal and relapse. This follows the agonist replacement model successful for opioid dependence (methadone, buprenorphine).

Questions still open

Would nabilone be effective in outpatient treatment settings? What is the optimal dose and duration? Could nabilone serve as a transition medication for people gradually reducing cannabis use? How does nabilone compare to other emerging pharmacotherapies?

Common questions

What is nabilone?

Nabilone is a synthetic molecule similar to THC that is FDA-approved for chemotherapy-induced nausea. It has better bioavailability (the body absorbs and uses it more effectively) and more predictable dose-response than dronabinol (oral THC). This study tested it for a new purpose: treating marijuana dependence.

How is nabilone different from dronabinol?

Both are cannabinoid agonists, but they differ pharmacologically. Dronabinol (oral THC) reduces withdrawal symptoms but does not reduce marijuana self-administration in lab studies. Nabilone reduced both withdrawal and relapse. Its better bioavailability and dose-linearity may explain why it outperformed dronabinol. It also worked with once-daily dosing.

Read the original research

Nabilone decreases marijuana withdrawal and a laboratory measure of marijuana relapse.

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 38(8), 1557-65

View on PubMed ↗Publisher’s paper ↗

Citation

Haney, Margaret; Cooper, Ziva D; Bedi, Gillinder; Vosburg, Suzanne K; Comer, Sandra D; Foltin, Richard W. (2013). Nabilone decreases marijuana withdrawal and a laboratory measure of marijuana relapse.. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 38(8), 1557-65. https://doi.org/10.1038/npp.2013.54