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

The takeaway

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.

Addiction researchers, people trying to reduce cannabis use, pharmacotherapy developers.

Both low (120 mg/day) and high-dose (240 mg/day) dronabinol reduced cannabis self-administration equally compared to placebo.

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Moderate - randomized crossover design with controlled conditions, but small sample and artificial laboratory setting.

When this study was published

Published in 2018.

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.

Questions still open

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?

Common 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 the original research

The effect of high-dose dronabinol (oral THC) maintenance on cannabis self-administration.

Drug and alcohol dependence, 187, 254-260

View on PubMed ↗Publisher’s paper ↗

Citation

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