A PRISMA-guided review of 22 randomized controlled trials found no approved treatment for cannabis craving, but combinations of THC with lofexidine, oxytocin, progesterone, and N-acetylcysteine show promise.
Addiction psychiatrists, people trying to quit cannabis, cannabis treatment researchers.
Zero FDA-approved treatments exist for cannabis craving despite 22 RCTs testing various compounds
What the researchers found
Twenty-two RCTs investigated various compounds for cannabis craving. Most current treatments involve off-label drug use and cannabinoid-based medications. The most promising approaches include THC combined with lofexidine, oxytocin, progesterone, and N-acetylcysteine. No treatment has received regulatory approval for cannabis craving. Psychotherapy and behavioral treatments remain essential complements to any pharmacological approach.
Why it matters
Cannabis use disorder affects millions worldwide, and craving is a primary driver of relapse. The absence of any approved pharmacological treatment for cannabis craving is a major treatment gap, and identifying the most promising candidates is essential for advancing the field.
The numbers in context
22 RCTs included. No FDA-approved treatments for cannabis craving. Promising compounds: THC + lofexidine, oxytocin, progesterone, N-acetylcysteine. All current use is off-label.
How the study worked
Systematic review following PRISMA guidelines with extensive database search. Included human RCTs examining drug effects on cannabis craving symptoms. 22 studies met inclusion criteria.
What this study cannot tell us
Heterogeneous study designs and craving measurement tools. Small sample sizes in many trials. Short treatment durations. Different cannabis use patterns across studies make comparison difficult.
How to read the evidence
PRISMA-guided systematic review of 22 RCTs, providing the best available evidence on a topic with no approved treatments.
When this study was published
Published 2023.
The bigger picture
The cannabis treatment field is decades behind alcohol and opioid treatment in pharmacological options. While several compounds show promise, the field needs larger trials and regulatory pathways to bring approved treatments to patients.
Questions still open
- Which of the promising compounds will advance to phase 3 trials?
- Can combination pharmacotherapy plus behavioral treatment achieve better outcomes than either alone?
Common questions
Is there medication to help with cannabis cravings?
What helps with quitting cannabis?
Read the original research
Unravelling the landscape of Cannabis craving pharmacological treatments: a PRISMA-guided review of evidence.
International review of psychiatry (Abingdon, England), 35(5-6), 434-449
Citation
Preto, Mayra Cruz; Kortas, Guilherme Trevizan; Blaas, Israel Kanaan; Lassi, Dangela Layne Silva; Waisman Campos, Marcela; Torales, Julio; Ventriglio, Antonio; de Azevedo-Marques Périco, Cintia; de Andrade, Arthur Guerra; Castaldelli-Maia, João Mauricio. (2023). Unravelling the landscape of Cannabis craving pharmacological treatments: a PRISMA-guided review of evidence.. International review of psychiatry (Abingdon, England), 35(5-6), 434-449. https://doi.org/10.1080/09540261.2023.2231540
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