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Study breakdown

No FDA-Approved Treatment Exists for Cannabis Craving, but 22 Trials Show Several Promising Approaches

Systematic ReviewModerate evidence
The takeaway

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?
No treatment is FDA-approved for cannabis craving. This review of 22 trials found the most promising approaches include combinations involving THC with lofexidine, oxytocin, progesterone, and N-acetylcysteine, all used off-label.
What helps with quitting cannabis?
The review emphasizes that psychotherapy and behavioral treatments are essential alongside any medication. No single pharmacological approach has proven robust enough for approval.

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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