Oral THC (dronabinol) suppressed cannabis withdrawal in a dose-dependent manner

Dronabinol (oral THC) at doses up to 120 mg per day dose-dependently reduced cannabis withdrawal symptoms with few side effects and no meaningful cognitive impairment.

Vandrey, Ryan et al.·Drug and alcohol dependence·2013·Moderate EvidenceRandomized Controlled Trial

Withdrawal (166)Medical Cannabis (1546)Tolerance (75)Quitting (221)

Quick Facts

Study Type

Randomized Controlled Trial

Evidence

Moderate Evidence

Sample

Not reported

What This Study Found

Thirteen daily cannabis smokers completed a within-subject crossover study receiving 0, 30, 60, and 120 mg dronabinol per day for five consecutive days each. Dronabinol dose-dependently reduced cannabis withdrawal symptoms, with higher doses providing greater relief.

The medication produced few adverse side effects and did not cause significant cognitive impairment at any dose tested, including the highest 120 mg dose. On the fifth day of each dosing period, participants smoked cannabis. Dronabinol did not alter the subjective effects of smoked cannabis, though the 60 and 120 mg doses reduced the heart rate increase normally caused by smoking.

The finding that dronabinol did not block the subjective effects of smoked cannabis distinguishes it from substitution therapies like methadone, which reduce the rewarding effects of the target drug.

Key Numbers

13 daily cannabis users tested. Four dose levels: 0, 30, 60, 120 mg/day. Five-day dosing periods separated by nine-day washouts. Withdrawal was dose-dependently suppressed. No significant cognitive impairment at any dose.

How They Did This

Within-subject crossover study with 13 daily cannabis smokers. Each participant received all four dose levels (0, 30, 60, 120 mg/day) for five consecutive days in counterbalanced order, separated by nine-day washout periods of ad libitum cannabis use. Withdrawal symptoms, craving, sleep quality, vital signs, and cognitive performance were assessed.

Why This Research Matters

Cannabis use disorder currently has no FDA-approved pharmacotherapy. Demonstrating that oral THC can suppress withdrawal symptoms safely at doses up to 120 mg/day supports continued development of agonist replacement strategies similar to those used for opioid and nicotine dependence.

The Bigger Picture

Agonist replacement therapy has been successful for opioid (methadone, buprenorphine) and nicotine (patch, gum) dependence. This study contributes to evidence that a similar approach could work for cannabis, using oral THC to manage the transition away from smoked cannabis.

What This Study Doesn't Tell Us

Very small sample of 13 participants. Five-day dosing periods may not reflect the longer durations needed clinically. The nine-day ad libitum cannabis use between conditions complicates interpretation. Real-world treatment involves more variables than this controlled setting.

Questions This Raises

?Would longer treatment with dronabinol during a complete quit attempt improve abstinence rates?
?Is 120 mg the ceiling dose, or could higher doses be more effective?
?Would combining dronabinol with behavioral therapy improve outcomes beyond either alone?

Trust & Context

Key Stat:: Dronabinol up to 120 mg/day suppressed withdrawal with no cognitive impairment
Evidence Grade:: Controlled crossover design with within-subject comparisons, but very small sample size limits generalizability.
Study Age:: Published in 2013. Dronabinol continues to be studied for cannabis use disorder treatment.
Original Title:: The dose effects of short-term dronabinol (oral THC) maintenance in daily cannabis users.
Published In:: Drug and alcohol dependence, 128(1-2), 64-70 (2013)
Authors:: Vandrey, Ryan(49), Stitzer, Maxine L(3), Mintzer, Miriam Z, Huestis, Marilyn A, Murray, Jeannie A, Lee, Dayong
Database ID:: RTHC-00749

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 with cannabis withdrawal?

In this small study, dronabinol (oral THC) dose-dependently reduced withdrawal symptoms at doses up to 120 mg/day, with few side effects. Larger clinical trials are needed to confirm these findings.

Does dronabinol block the high from smoking cannabis?

No. In this study, dronabinol did not alter the subjective effects of smoked cannabis. It reduced withdrawal but did not prevent users from feeling the effects of smoking.

Cite This Study

RTHC-00749·https://rethinkthc.com/research/RTHC-00749

APA

Vandrey, Ryan; Stitzer, Maxine L; Mintzer, Miriam Z; Huestis, Marilyn A; Murray, Jeannie A; Lee, Dayong. (2013). The dose effects of short-term dronabinol (oral THC) maintenance in daily cannabis users.. Drug and alcohol dependence, 128(1-2), 64-70. https://doi.org/10.1016/j.drugalcdep.2012.08.001

MLA

Vandrey, Ryan, et al. "The dose effects of short-term dronabinol (oral THC) maintenance in daily cannabis users.." Drug and alcohol dependence, 2013. https://doi.org/10.1016/j.drugalcdep.2012.08.001

RethinkTHC

RethinkTHC Research Database. "The dose effects of short-term dronabinol (oral THC) mainten..." RTHC-00749. Retrieved from https://rethinkthc.com/research/vandrey-2013-the-dose-effects-of

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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.

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