Counseling Plus Nabiximols Worked Best for Cannabis Use Disorder Treatment | Research

The takeaway

In a cannabis use disorder trial, counseling attendance was the strongest predictor of abstinence, while nabiximols reduced dropout and a 50%+ reduction in use was seen in patients with longer use histories.

Addiction medicine providers, people seeking treatment for cannabis use disorder

Counseling + nabiximols was the optimal combination

What the researchers found

Greater counseling attendance predicted both abstinence and 50%+ reduction in cannabis use. Nabiximols increased odds of 50%+ reduction, improved counseling attendance, and reduced treatment dropout. Longer duration of regular cannabis use predicted better outcomes. Males attended less counseling, and sleep problems predicted worse outcomes.

Why it matters

Understanding what predicts treatment success helps clinicians tailor cannabis use disorder treatment. The finding that counseling combined with agonist therapy is optimal mirrors approaches used for opioid use disorder.

The numbers in context

128 participants; 12-week trial; counseling predicted abstinence; nabiximols reduced dropout; longer use history predicted better outcomes; males attended less counseling

How the study worked

Secondary analysis of a 12-week randomized placebo-controlled trial of nabiximols for CUD (128 participants). Bayesian multiple regression examined the impact of client and treatment factors on engagement and outcomes.

What this study cannot tell us

Secondary analysis. Correlates of treatment success do not prove causal mechanisms. Sample size limits the number of predictors that can be reliably examined.

How to read the evidence

Secondary analysis of a well-designed RCT, but limited by sample size and exploratory nature of the analysis.

When this study was published

Published in 2022

The bigger picture

Just as methadone and buprenorphine plus counseling work for opioid use disorder, nabiximols plus counseling may represent an effective pharmacotherapy model for cannabis use disorder.

Questions still open

Would longer treatment duration improve outcomes further? Could digital counseling address the lower attendance among male patients?

Common questions

What is the best treatment for cannabis use disorder?

This study found the combination of counseling and nabiximols (a cannabinoid medication) produced the best outcomes. Counseling attendance was the strongest predictor of achieving abstinence.

Does nabiximols help with quitting cannabis?

Nabiximols improved odds of reducing cannabis use by 50%+, increased counseling attendance, and reduced treatment dropout. It appears to stabilize patients enough to engage with behavioral therapy.

Read the original research

Correlates of treatment engagement and client outcomes: results of a randomised controlled trial of nabiximols for the treatment of cannabis use disorder.

Substance abuse treatment, prevention, and policy, 17(1), 67

View on PubMed ↗Publisher’s paper ↗

Citation

Mills, Llewellyn; Dunlop, Adrian; Montebello, Mark; Copeland, Jan; Bruno, Raimondo; Jefferies, Meryem; Mcgregor, Iain; Lintzeris, Nicholas. (2022). Correlates of treatment engagement and client outcomes: results of a randomised controlled trial of nabiximols for the treatment of cannabis use disorder.. Substance abuse treatment, prevention, and policy, 17(1), 67. https://doi.org/10.1186/s13011-022-00493-z