The Prescription Drug Nabilone Felt Like THC to Cannabis Users, Supporting Its Potential as a Quit-Aid
In 6 cannabis users trained to identify THC, nabilone produced THC-like subjective effects and substituted for THC at doses of 1-5 mg, while methylphenidate (Ritalin) did not, supporting nabilone as a potential agonist replacement therapy.
Quick Facts
What This Study Found
Six cannabis users learned to identify 25 mg oral THC under double-blind conditions. They were then tested with multiple doses of nabilone (a synthetic cannabinoid prescription drug), THC, and methylphenidate.
Nabilone shared discriminative-stimulus effects with THC: participants identified it as feeling like their training dose. It also produced comparable subjective effects and increased heart rate.
Methylphenidate (a dopamine stimulant) did not produce THC-like effects, serving as a negative control.
The authors noted that since agonist replacement therapy has been relatively successful for opioid (methadone), tobacco (nicotine replacement), and stimulant dependence, nabilone could potentially serve as a similar replacement therapy for cannabis use disorders.
Key Numbers
6 participants. Nabilone: 1, 2, 3, 5 mg tested. THC: 5, 10, 15, 25 mg. Methylphenidate: 5, 10, 20, 30 mg. Nabilone substituted for THC. Methylphenidate did not.
How They Did This
Double-blind drug discrimination study. Six cannabis users learned to discriminate 25 mg oral THC from placebo. Multiple doses of nabilone (1-5 mg), THC (5-25 mg), and methylphenidate (5-30 mg) were tested for THC substitution, subjective effects, and physiological measures.
Why This Research Matters
No FDA-approved medication exists for cannabis dependence. If nabilone feels like THC to users, it could serve as a controlled substitute during treatment, similar to how methadone is used for opioid dependence.
The Bigger Picture
Agonist replacement (giving a controlled version of the same drug class) is the most successful pharmacological approach for several addictions. Extending this principle to cannabis dependence using nabilone could provide the first effective pharmacotherapy for this condition.
What This Study Doesn't Tell Us
Very small sample (6 participants). Drug discrimination measures subjective similarity, not treatment efficacy. Whether nabilone actually reduces cannabis use has not been tested in this study. The analogy to methadone may not hold for cannabis dependence.
Questions This Raises
- ?Would clinical trials confirm nabilone reduces cannabis use?
- ?At what dose does nabilone optimally substitute for cannabis?
- ?Could nabilone itself become a drug of abuse?
- ?Is partial agonist therapy (like buprenorphine for opioids) a better model?
Trust & Context
- Key Stat:
- Nabilone felt like THC to users; methylphenidate did not, supporting agonist replacement potential
- Evidence Grade:
- Very small drug discrimination study (n=6). Demonstrates subjective similarity but not clinical efficacy for treating cannabis dependence.
- Study Age:
- Published in 2010. Nabilone has since been studied in small clinical trials for cannabis dependence with mixed but somewhat promising results.
- Original Title:
- Substitution profile of the cannabinoid agonist nabilone in human subjects discriminating δ9-tetrahydrocannabinol.
- Published In:
- Clinical neuropharmacology, 33(5), 235-42 (2010)
- Authors:
- Lile, Joshua A(5), Kelly, Thomas H(2), Hays, Lon R(2)
- Database ID:
- RTHC-00428
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
What is agonist replacement therapy?
It involves giving a controlled, pharmaceutical version of the same drug class to reduce craving and withdrawal while allowing supervised tapering. Methadone for heroin and nicotine patches for tobacco are successful examples. Nabilone could potentially fill this role for cannabis.
Is nabilone the same as THC?
Nabilone is a synthetic cannabinoid that activates CB1 receptors like THC. It is FDA-approved for chemotherapy-induced nausea. This study showed it feels similar to THC to experienced users, which is the first requirement for an effective agonist replacement therapy.
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Cite This Study
https://rethinkthc.com/research/RTHC-00428APA
Lile, Joshua A; Kelly, Thomas H; Hays, Lon R. (2010). Substitution profile of the cannabinoid agonist nabilone in human subjects discriminating δ9-tetrahydrocannabinol.. Clinical neuropharmacology, 33(5), 235-42. https://doi.org/10.1097/WNF.0b013e3181e77428
MLA
Lile, Joshua A, et al. "Substitution profile of the cannabinoid agonist nabilone in human subjects discriminating δ9-tetrahydrocannabinol.." Clinical neuropharmacology, 2010. https://doi.org/10.1097/WNF.0b013e3181e77428
RethinkTHC
RethinkTHC Research Database. "Substitution profile of the cannabinoid agonist nabilone in ..." RTHC-00428. Retrieved from https://rethinkthc.com/research/lile-2010-substitution-profile-of-the
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.