British Pharmacology Guidelines for Treating Cannabis and Other Drug Dependencies | Research

The takeaway

International experts found no approved medications for cannabis or synthetic cannabinoid dependence, highlighting a major treatment gap — while medications exist for alcohol, opioid, and nicotine dependence.

Addiction psychiatrists and clinicians treating cannabis dependence, pharmacologists developing new treatments, policymakers evaluating substance use treatment resources.

What the researchers found

The British Association for Psychopharmacology convened international experts to produce evidence-based consensus guidelines for the pharmacological management of substance dependence across all major drug classes.

For cannabis and synthetic cannabinoid dependence, the guidelines revealed a stark gap: no medications have received regulatory approval for treatment. The expert panel reviewed available evidence and made recommendations for clinical decision-making, but the recommendations necessarily relied on off-label use and behavioral interventions rather than approved pharmacotherapies.

This contrasted with the more developed treatment landscapes for alcohol (multiple approved medications including naltrexone and acamprosate), opioids (methadone, buprenorphine, naltrexone), and nicotine (nicotine replacement, varenicline, bupropion). The guidelines also covered benzodiazepines, GHB, gabapentinoids, cocaine, amphetamines, and dissociative drugs.

For synthetic cannabinoids specifically — which produce more severe dependence and withdrawal than natural cannabis — the guidelines highlighted both the clinical urgency and the near-complete absence of evidence to guide treatment.

Why it matters

These guidelines from a major professional body formalize what clinicians treating cannabis dependence already know: they have no approved medications to offer. As cannabis potency increases and cannabis use disorder becomes more prevalent, this treatment gap becomes more consequential. The inclusion of synthetic cannabinoids acknowledges that this newer category requires its own clinical approach.

The numbers in context

11 substance classes covered: alcohol, benzodiazepines, z-drugs, GHB, gabapentinoids, opioids, nicotine, cannabis, synthetic cannabinoids, cocaine, amphetamine/methamphetamine, dissociative drugs. Zero approved medications for cannabis or synthetic cannabinoid dependence.

How the study worked

Consensus guidelines developed by the British Association for Psychopharmacology. International experts from multiple disciplines reviewed current evidence in their fields, assessed evidence strength, and discussed clinical implications at a consensus meeting. Covered pharmacological management of dependence on 11 substance classes.

Who was studied

Guidelines developed by a group of international experts in substance dependence management.

What this study cannot tell us

Consensus guidelines reflect expert opinion and available evidence, which may be limited or conflicting. The guidelines are UK-focused and may not account for regulatory or clinical differences in other countries. Cannabis products and potency vary widely, and guidelines may not address all product types. Rapidly evolving synthetic cannabinoid landscape means these recommendations may need frequent updating.

How to read the evidence

Expert consensus guidelines from a major professional organization — represents the current state of evidence-based recommendations but limited by the absence of high-quality treatment trials for cannabis dependence.

When this study was published

Published in 2026, providing the most current evidence-based consensus on pharmacological management across all major substance dependencies.

The bigger picture

The absence of approved cannabis dependence medications puts the H4 deep TMS pilot (RTHC-00259) and the CBD for opioid withdrawal research (RTHC-00252) in context — researchers are exploring non-traditional approaches precisely because the pharmacological cupboard is bare. The withdrawal literature (RTHC-00037, RTHC-00275) documents real clinical need, and the PTSD abstinence study (RTHC-00274) shows that quitting cannabis produces substantial benefits — yet there's no medication to help people achieve or maintain abstinence.

Replication

Not stated in abstract.

Funding

Not reported in abstract.

Conflicts of interest

Not reported in abstract.

Questions still open

What pharmacological targets are most promising for future cannabis dependence medications? Should the cannabis withdrawal syndrome be treated differently from synthetic cannabinoid withdrawal? Could repurposed medications from other substance use disorders (e.g., gabapentin, N-acetylcysteine) receive formal evaluation for cannabis dependence?

Read the original research

Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology.

Journal of psychopharmacology (Oxford, England), 2698811251399593

The Journal of Psychopharmacology is a well-respected peer-reviewed journal focusing on the effects of drugs on behavior and mental processes.

View on PubMed ↗Publisher’s paper ↗

Citation

Sinclair, Julia Ma; Kalk, Nicola J; Kaar, Stephen J; Agabio, Roberta; Arunogiri, Shalini; Bisaga, Adam; Chesney, Edward; Daly, Chris; Dewhurst, Jonathan; Freeman, Tom P; Ghosh, Abhishek; Hemrage, Sophia; Leggio, Lorenzo; Lingford-Hughes, Anne; Matheson, Catriona; McKetin, Rebecca; Paterson, Louise M; Roberts, Emmert; Robson, Deborah; Scott, Jenny; Welch, Sarah. (2026). Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology.. Journal of psychopharmacology (Oxford, England), 2698811251399593. https://doi.org/10.1177/02698811251399593