Stimulant medication for ADHD reduced cannabis use days but did not significantly increase quit rates in dual-diagnosis adults

In a small pilot trial of 28 adults with both ADHD and cannabis use disorder, extended-release amphetamine salts significantly reduced weekly cannabis use days compared to placebo, though overall abstinence rates did not significantly differ.

Levin, Frances R et al.·Journal of attention disorders·2024·Preliminary Evidencerandomized controlled trial
RTHC-05471Randomized controlled trialPreliminary Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
randomized controlled trial
Evidence
Preliminary Evidence
Sample
N=28

What This Study Found

MAS-ER (80 mg) was well-tolerated. While ADHD symptom reduction was high in both groups (83.3% vs 71.4%, not significant) and abstinence rates were not significantly different (15.4% vs 0%, p = .27), the medication group showed a significant decrease in weekly cannabis use days over time compared to placebo (p < .0001).

Key Numbers

28 participants; MAS-ER 80 mg vs placebo; ADHD response: 83.3% vs 71.4% (not significant); abstinence: 15.4% vs 0% (p = .27); weekly cannabis use days significantly reduced over time with MAS-ER (p < .0001); well-tolerated

How They Did This

Twelve-week randomized, double-blind pilot feasibility trial of 28 adults with comorbid ADHD and cannabis use disorder. MAS-ER (up to 80 mg) vs placebo. All received computerized behavioral therapy and abstinence-based contingency management. Cannabis use confirmed by quantitative urine testing.

Why This Research Matters

ADHD and cannabis use disorder frequently co-occur but have no established pharmacological treatment. This pilot suggests treating the ADHD component may help reduce cannabis use even if it does not achieve full abstinence.

The Bigger Picture

The reduction in cannabis use days even without full abstinence is clinically meaningful, as harm reduction approaches recognize that reduced frequency may lower overall risk.

What This Study Doesn't Tell Us

Very small sample (28); pilot feasibility study not powered for efficacy; high placebo response for ADHD symptoms; treatment retention not detailed; cannot generalize to broader ADHD-CUD population

Questions This Raises

  • ?Would a larger trial confirm the reduction in use days?
  • ?Does treating ADHD reduce cannabis use motivation, or do the two respond to treatment independently?

Trust & Context

Key Stat:
Weekly cannabis use days significantly reduced (p < .0001)
Evidence Grade:
Small pilot RCT with biochemical verification, demonstrating feasibility but not adequately powered for definitive efficacy conclusions.
Study Age:
2024 study
Original Title:
Extended-Release Mixed Amphetamine Salts for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cannabis Use Disorder: A Pilot, Randomized Double-Blind, Placebo-Controlled Trial.
Published In:
Journal of attention disorders, 28(11), 1467-1481 (2024)
Database ID:
RTHC-05471

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Frequently Asked Questions

Can ADHD medication help with cannabis use disorder?

This small pilot study suggests it may reduce use frequency. Adults receiving extended-release amphetamine salts used cannabis on significantly fewer days per week compared to placebo. However, the study was too small to show a clear difference in complete abstinence (15.4% vs 0%).

Was the ADHD medication safe for people with cannabis use disorder?

Yes, the medication (MAS-ER at up to 80 mg daily) was generally well-tolerated. ADHD symptoms improved substantially in both groups, with 83% of the medication group showing at least 30% symptom reduction.

Read More on RethinkTHC

Cite This Study

RTHC-05471·https://rethinkthc.com/research/RTHC-05471

APA

Levin, Frances R; Mariani, John J; Pavlicova, Martina; Choi, C Jean; Basaraba, Cale; Mahony, Amy L; Brooks, Daniel J; Brezing, Christina A; Naqvi, Nasir. (2024). Extended-Release Mixed Amphetamine Salts for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cannabis Use Disorder: A Pilot, Randomized Double-Blind, Placebo-Controlled Trial.. Journal of attention disorders, 28(11), 1467-1481. https://doi.org/10.1177/10870547241264675

MLA

Levin, Frances R, et al. "Extended-Release Mixed Amphetamine Salts for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cannabis Use Disorder: A Pilot, Randomized Double-Blind, Placebo-Controlled Trial.." Journal of attention disorders, 2024. https://doi.org/10.1177/10870547241264675

RethinkTHC

RethinkTHC Research Database. "Extended-Release Mixed Amphetamine Salts for Comorbid Adult ..." RTHC-05471. Retrieved from https://rethinkthc.com/research/levin-2024-extendedrelease-mixed-amphetamine-salts

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.