The prescription synthetic cannabinoid nabilone showed extremely rare abuse potential after nearly 30 years of use | Research

The takeaway

A comprehensive search of scientific literature, internet forums, law enforcement, and medical professionals found extremely rare evidence of nabilone abuse despite being available since 1981.

Read this if you are interested in whether prescription cannabinoid medications carry addiction risk.

Extremely rare abuse reported after nearly 30 years of availability

What the researchers found

Researchers conducted a comprehensive evaluation of whether the synthetic cannabinoid nabilone (approved in Canada since 1981 for chemotherapy nausea) was being abused, particularly as off-label pain management prescribing increased.

The scientific literature and popular press contained very little reference to nabilone abuse. Internet searches revealed only rare, isolated instances of recreational use. Law enforcement database review showed some seizures and thefts in Canada (particularly Ontario) but most officers reported no encounters with nabilone abuse. The drug had no known street value.

Several factors limited abuse potential: nabilone produced more undesirable side effects than smoked cannabis, had a slower onset of action, and cost more. Medical professionals did not perceive nabilone as a concern for abuse.

Why it matters

The finding of negligible abuse potential after nearly 30 years of availability was reassuring for clinicians prescribing nabilone for pain management, while still recommending ongoing monitoring.

The numbers in context

Nabilone approved in Canada since 1981. Some seizures and thefts documented, primarily in Ontario. No known street value. Law enforcement and medical professionals reported minimal concern.

How the study worked

Multi-source investigation including systematic searches of scientific literature, popular press, and internet databases, plus focused interviews with medical professionals and law enforcement agencies across Canada.

What this study cannot tell us

Absence of evidence is not evidence of absence. Nabilone prescribing was relatively limited in 2010. Under-reporting of abuse is possible. The study predated the expansion of nabilone use for pain.

How to read the evidence

Multi-source investigation including literature, internet, law enforcement, and medical professional interviews providing a comprehensive abuse potential assessment.

When this study was published

Published in 2010. Nabilone prescribing patterns have evolved since, and ongoing vigilance was recommended.

The bigger picture

This evaluation helped distinguish between different cannabinoid formulations in terms of abuse liability, showing that the pharmaceutical properties of a cannabinoid (onset time, side effect profile, cost) strongly influence abuse potential.

Questions still open

As nabilone prescribing increases for pain management, will abuse patterns emerge? What pharmaceutical properties most effectively reduce the abuse potential of therapeutic cannabinoids?

Common questions

Can people get addicted to nabilone?

After nearly 30 years of availability, abuse reports were extremely rare. Nabilone's slower onset, more side effects, and higher cost compared to cannabis appeared to limit its appeal for recreational use.

What is nabilone used for?

Nabilone is a synthetic cannabinoid prescription drug approved for chemotherapy-induced nausea and vomiting. It has increasingly been used off-label for chronic pain management.

Read the original research

The abuse potential of the synthetic cannabinoid nabilone.

Addiction (Abingdon, England), 105(3), 494-503

View on PubMed ↗Publisher’s paper ↗

Citation

Ware, Mark A; St Arnaud-Trempe, Emmanuelle. (2010). The abuse potential of the synthetic cannabinoid nabilone.. Addiction (Abingdon, England), 105(3), 494-503. https://doi.org/10.1111/j.1360-0443.2009.02776.x