High-Dose Oral THC Reduced Cannabis Self-Administration in Daily Users

Daily cannabis users given dronabinol (oral THC) at doses up to 240 mg/day significantly reduced their self-administration of smoked cannabis compared to placebo, suggesting cannabinoid agonist therapy could treat cannabis use disorder.

Schlienz, Nicolas J et al.·Drug and alcohol dependence·2018·Moderate EvidenceRandomized Controlled Trial
RTHC-01828Randomized Controlled TrialModerate Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Chronic dronabinol dosing significantly reduced cannabis self-administration compared to placebo maintenance. Both low-dose (120 mg/day) and high-dose (180-240 mg/day) dronabinol reduced use equally, with no additional benefit from the higher dose. Dronabinol also suppressed withdrawal symptoms.

Key Numbers

13 daily cannabis users studied. Low-dose dronabinol: 120 mg/day (40 mg three times daily). High-dose: 180-240 mg/day (60-80 mg three times daily). 12-day maintenance periods per condition.

How They Did This

Residential within-subjects crossover study with 13 non-treatment-seeking daily cannabis users. Participants received placebo, low-dose (120 mg/day), or high-dose (180-240 mg/day) dronabinol for 12 days each. Cannabis self-administration was measured under forced-choice and progressive ratio conditions.

Why This Research Matters

There are currently no FDA-approved medications for cannabis use disorder. This study provides evidence that an agonist replacement approach (similar to methadone for opioids) could work for cannabis dependence.

The Bigger Picture

Agonist replacement therapy has been successful for opioid (methadone) and nicotine (patches/gum) dependence. This study suggests a similar approach could work for cannabis, though the high doses needed raise practical questions about real-world implementation.

What This Study Doesn't Tell Us

Small sample (n=13). Non-treatment-seeking participants may differ from those wanting to quit. Residential laboratory setting does not reflect real-world cannabis access. Short 12-day maintenance periods.

Questions This Raises

  • ?Could lower dronabinol doses still be effective in treatment-seeking individuals?
  • ?Would longer maintenance periods produce sustained reductions?
  • ?How would this work in an outpatient setting where cannabis is freely available?

Trust & Context

Key Stat:
Both low (120 mg/day) and high-dose (240 mg/day) dronabinol reduced cannabis self-administration equally compared to placebo.
Evidence Grade:
Moderate - randomized crossover design with controlled conditions, but small sample and artificial laboratory setting.
Study Age:
Published in 2018.
Original Title:
The effect of high-dose dronabinol (oral THC) maintenance on cannabis self-administration.
Published In:
Drug and alcohol dependence, 187, 254-260 (2018)
Database ID:
RTHC-01828

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

Can oral THC help people use less cannabis?

This study found that dronabinol (oral THC) at 120-240 mg/day significantly reduced how much cannabis daily users chose to smoke in a controlled setting. It also suppressed withdrawal symptoms.

Is there an agonist therapy for cannabis like methadone for opioids?

No medication is currently approved for cannabis use disorder, but this study provides evidence that dronabinol (oral THC) could work as an agonist replacement therapy, similar to how methadone works for opioid dependence.

Read More on RethinkTHC

Cite This Study

RTHC-01828·https://rethinkthc.com/research/RTHC-01828

APA

Schlienz, Nicolas J; Lee, Dustin C; Stitzer, Maxine L; Vandrey, Ryan. (2018). The effect of high-dose dronabinol (oral THC) maintenance on cannabis self-administration.. Drug and alcohol dependence, 187, 254-260. https://doi.org/10.1016/j.drugalcdep.2018.02.022

MLA

Schlienz, Nicolas J, et al. "The effect of high-dose dronabinol (oral THC) maintenance on cannabis self-administration.." Drug and alcohol dependence, 2018. https://doi.org/10.1016/j.drugalcdep.2018.02.022

RethinkTHC

RethinkTHC Research Database. "The effect of high-dose dronabinol (oral THC) maintenance on..." RTHC-01828. Retrieved from https://rethinkthc.com/research/schlienz-2018-the-effect-of-highdose

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.