Counseling Plus Nabiximols Worked Best for Cannabis Use Disorder Treatment

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.

Mills, Llewellyn et al.·Substance abuse treatment·2022·Moderate EvidenceRandomized Controlled Trial
RTHC-04066Randomized Controlled TrialModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
N=128

What This Study 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.

Key Numbers

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

How They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

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

Trust & Context

Key Stat:
Counseling + nabiximols was the optimal combination
Evidence Grade:
Secondary analysis of a well-designed RCT, but limited by sample size and exploratory nature of the analysis.
Study Age:
Published in 2022
Original Title:
Correlates of treatment engagement and client outcomes: results of a randomised controlled trial of nabiximols for the treatment of cannabis use disorder.
Published In:
Substance abuse treatment, prevention, and policy, 17(1), 67 (2022)
Database ID:
RTHC-04066

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

Frequently Asked 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 More on RethinkTHC

Cite This Study

RTHC-04066·https://rethinkthc.com/research/RTHC-04066

APA

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

MLA

Mills, Llewellyn, et al. "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, 2022. https://doi.org/10.1186/s13011-022-00493-z

RethinkTHC

RethinkTHC Research Database. "Correlates of treatment engagement and client outcomes: resu..." RTHC-04066. Retrieved from https://rethinkthc.com/research/mills-2022-correlates-of-treatment-engagement

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.