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

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.

Systematic review following PRISMA guidelines with extensive database search. Included human RCTs examining drug effects on cannabis craving symptoms. 22 studies met inclusion criteria.

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 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.

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.