A review of randomized controlled trials found multiple medications, including CBD, gabapentin, nabiximols, and others, showed superiority over placebo for cannabis use disorder, though all need further validation.
Addiction medicine specialists, psychiatrists, and CUD researchers
10 medications showed some benefit for CUD across RCTs
What the researchers found
Across multiple pharmacological systems, CBD, gabapentin, galantamine, nabilone plus zolpidem, nabiximols, naltrexone, PF-04457845 (FAAH inhibitor), quetiapine, varenicline, and topiramate all showed some superiority over control conditions in RCTs for CUD. All were reported as safe and tolerable.
Why it matters
There is currently no FDA-approved medication for cannabis use disorder, despite the condition affecting roughly one in five cannabis users. This review maps the entire landscape of pharmacological candidates that have reached the RCT stage.
The numbers in context
About 1 in 5 cannabis users develop CUD, rising to 1 in 2 for daily users. CUD accounts for 0.69 million disability-adjusted life years globally. Ten medication classes showed some benefit across eight neurotransmitter systems.
How the study worked
Narrative review of randomized controlled trials examining pharmacological interventions for cannabis use disorder, organized by mechanism of action across cannabinoid, glutamatergic, GABAergic, serotonergic, noradrenergic, dopaminergic, opioidergic, and cholinergic systems.
What this study cannot tell us
Narrative review without formal meta-analysis. Individual RCTs varied in sample size, follow-up duration, and outcome measures. Many trials had small samples. "Superiority over control" ranged from modest to meaningful effects.
How to read the evidence
Narrative review synthesizing RCT evidence, which provides a broad overview but lacks the rigor of a systematic review or meta-analysis.
When this study was published
2024 review
The bigger picture
The diversity of promising targets across multiple neurotransmitter systems suggests CUD is not a single-mechanism disorder. The field is moving toward combining pharmacotherapy with psychotherapy, and drug repurposing offers faster paths to clinical availability than new drug development.
Questions still open
- Which of these medications will prove most effective in larger confirmatory trials? Can combinations of medications targeting different systems produce better outcomes? Will personalized approaches based on patient characteristics improve treatment matching?
Common questions
Are there medications for cannabis use disorder?
What is the best treatment approach for CUD?
Read the original research
Emerging pharmacotherapy for the treatment of cannabis use disorder.
Expert opinion on pharmacotherapy, 25(6), 695-703
Citation
Shamabadi, Ahmad; Arabzadeh Bahri, Razman; Karimi, Hanie; Heidari, Ehsan; Akhondzadeh, Shahin. (2024). Emerging pharmacotherapy for the treatment of cannabis use disorder.. Expert opinion on pharmacotherapy, 25(6), 695-703. https://doi.org/10.1080/14656566.2024.2353638
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