The search for medications to treat cannabis dependence | Research

The takeaway

As of 2011, buspirone was the only medication showing efficacy for cannabis dependence in a controlled trial, with dronabinol, entacapone, and lithium warranting further study.

Read this if you are trying to quit cannabis and want to know what medications have been studied.

Zero medications were approved for cannabis dependence

What the researchers found

This review surveyed the landscape of pharmacological treatments for cannabis dependence, a condition with rising treatment admissions but no approved medications. Three categories of medications had been studied: those targeting withdrawal symptoms, those acting on cannabinoid receptors, and those with efficacy for other addictions or psychiatric conditions.

Buspirone, an anti-anxiety medication, was the only drug that had shown efficacy in a controlled clinical trial. Dronabinol (oral THC), the COMT inhibitor entacapone, and lithium showed promise in smaller studies or laboratory settings.

Preclinical research suggested newer targets including FAAH inhibitors like URB597, endocannabinoid-metabolizing enzymes, and nicotinic alpha-7 receptor antagonists, but none had reached clinical trials.

Why it matters

The majority of people entering treatment for cannabis dependence struggled to achieve and maintain abstinence. Without effective medications, treatment relied entirely on behavioral interventions, which have limited success rates for substance use disorders.

The numbers in context

Buspirone: only medication with controlled trial efficacy. Dronabinol, entacapone, lithium: promising in smaller studies. No medications approved by any national regulatory authority for cannabis dependence.

How the study worked

Narrative review of clinical trials, human laboratory studies, open-label trials, and preclinical research on medications for cannabis dependence. Covered both published and emerging data.

What this study cannot tell us

Narrative review without systematic search methodology. The field was young with mostly small studies. Many promising preclinical findings had not yet been tested in humans.

How to read the evidence

Narrative review of a sparse literature. Reflects the state of knowledge accurately but draws from mostly small or preliminary studies.

When this study was published

Published in 2011. Research on medications for cannabis use disorder has expanded since, though no universally effective medication has emerged.

The bigger picture

The lack of approved medications for cannabis dependence stood in contrast to treatment options for alcohol, opioid, and nicotine dependence. This gap became more pressing as cannabis potency increased and more people sought treatment.

Questions still open

Would buspirone hold up in larger trials? Could FAAH inhibitors transition safely from animal models to human treatment? Is combination therapy more effective than single medications?

Common questions

Is there a medication to help quit cannabis?

As of this review, no medication was officially approved for cannabis dependence. Buspirone showed the most promise in controlled trials. Since 2011, research has continued but no breakthrough medication has been approved.

Does oral THC help with cannabis dependence?

Dronabinol (oral THC) showed some promise as a replacement therapy, similar to how nicotine patches help with cigarette cessation. The idea is to provide controlled THC to reduce withdrawal while gradually tapering, but evidence was limited.

Read the original research

Pharmacological treatment of cannabis dependence.

Current pharmaceutical design, 17(14), 1351-8

View on PubMed ↗

Citation

Weinstein, A M; Gorelick, David A. (2011). Pharmacological treatment of cannabis dependence.. Current pharmaceutical design, 17(14), 1351-8.