Is There a Pill to Help You Quit Cannabis? The Cochrane Review Says Not Yet | Research

The takeaway

The most comprehensive review of medications for cannabis use disorder found no pharmacotherapy with strong evidence for promoting abstinence or reliably reducing withdrawal symptoms.

Clinicians treating cannabis use disorder, patients considering medication-assisted treatment, and researchers developing candidate pharmacotherapies.

What the researchers found

This is the gold standard of evidence synthesis: a Cochrane systematic review, now in its second update since 2014. The question is simple—is there a medication that helps people quit cannabis or reduces withdrawal? The answer, despite years of additional research, remains: not yet.

The review searched for randomized controlled trials comparing medications to placebo, other medications, or no pharmacotherapy for treating cannabis dependence. The critical outcomes were: abstinence at end of treatment, withdrawal intensity including craving, adverse events, and severe adverse events.

Multiple medication classes have been tested over the years—antidepressants, anxiolytics, mood stabilizers, cannabinoid agonists (like dronabinol and nabilone), N-acetylcysteine, gabapentin, and others. None has emerged with strong, consistent evidence for promoting cannabis abstinence or meaningfully reducing withdrawal symptoms across trials.

This doesn't mean no medication will ever work—it means the evidence to date hasn't identified one. Some agents showed promise in individual trials but failed to replicate, or showed modest effects on secondary outcomes without achieving the primary goal of abstinence.

The practical implication is that psychosocial treatments (cognitive-behavioral therapy, motivational enhancement, contingency management) remain the first-line approach for cannabis use disorder, without a pharmacological adjunct that's proven to help.

Why it matters

Cannabis use disorder affects a meaningful minority of cannabis users, and the absence of approved pharmacotherapy is a significant gap. Alcohol has naltrexone and acamprosate; nicotine has varenicline and NRT; opioids have buprenorphine and methadone. Cannabis has nothing. This Cochrane review confirms that gap and provides a rigorous benchmark for evaluating future candidates.

The numbers in context

Cochrane Review, second update since 2014. Searched through May 2024. Critical outcomes: abstinence, withdrawal intensity, adverse events. No medication showed strong evidence for abstinence or consistent withdrawal relief.

How the study worked

Cochrane systematic review (second update, originally published 2014). Searched CENTRAL, MEDLINE, Embase, and PsycINFO through May 2024. Included RCTs and quasi-RCTs of medications for cannabis withdrawal and/or cessation/reduction vs. other medications, placebo, or no medication in cannabis-dependent participants.

Who was studied

37 RCTs (N=3,201 participants), mainly adults aged 22-41 years, with a majority male population (56-92%) from the USA, Australia, Israel, Canada, and the UK.

What this study cannot tell us

A null result from a systematic review doesn't prove no medication can work—it means none tested so far has shown consistent efficacy. Some trials may have been underpowered. Cannabis use disorder severity varies widely, and some medications might work for specific subgroups. The search through May 2024 means very recent trials may not be included.

How to read the evidence

Cochrane systematic review—the highest level of evidence synthesis. The null finding is itself strong evidence of the absence of proven pharmacotherapy.

When this study was published

Published in 2025, second update of a review first published in 2014, with searches through May 2024.

The bigger picture

This is the pharmacotherapy counterpart to the behavioral evidence. RTHC-00154 and RTHC-00156 showed that behavioral interventions (varenicline, text-based support) can help with co-occurring nicotine/cannabis use. RTHC-00157 tested integrated therapy for PTSD + CUD. RTHC-00176 explored app-based vs. face-to-face cessation. All of these are psychosocial or behavioral—because no medication has proven effective for cannabis specifically. The search continues, but for now, therapy is the evidence-based approach.

Replication

Not stated in abstract.

Funding

Received funding from the National Institute for Health and Care Research.

Conflicts of interest

Not reported in abstract.

Questions still open

Will any of the medications showing early promise in individual trials prove effective in larger replications? Could combinations of medications work where single agents haven't? Should research focus on withdrawal-specific medications (making quitting more comfortable) rather than abstinence-promoting ones?

Read the original research

Pharmacotherapies for cannabis use disorder.

The Cochrane database of systematic reviews, 9(9), CD008940

The Cochrane Database of Systematic Reviews is a highly respected source for systematic reviews in healthcare.

View on PubMed ↗Publisher’s paper ↗

Citation

Spiga, Francesca; Parkhouse, Thomas; Tang, Victor M; Savović, Jelena; Le Foll, Bernard; Nielsen, Suzanne. (2025). Pharmacotherapies for cannabis use disorder.. The Cochrane database of systematic reviews, 9(9), CD008940. https://doi.org/10.1002/14651858.CD008940.pub4