Cannabinoid Medications Show Promise for Treating Cannabis Withdrawal Symptoms | Research

The takeaway

A systematic review of 10 trials found that dronabinol, nabilone, and nabiximols all showed promise in reducing cannabis withdrawal symptoms with good safety and tolerability, potentially in a dose-dependent manner.

Addiction medicine specialists, people experiencing cannabis withdrawal, pharmacotherapy researchers.

30-95% of cannabis users experience withdrawal symptoms, and three cannabinoid medications (dronabinol, nabilone, nabiximols) show promise for treatment.

What the researchers found

Dronabinol, nabilone, and nabiximols, used alone or in combination with other drugs, showed promise in reducing cannabis withdrawal symptoms. The effect appeared dose-dependent. These medications were considered safe with good tolerability and few adverse effects. About 30% of regular cannabis users experience withdrawal, rising to 50-95% among highly dependent/treatment-seeking users.

Why it matters

Cannabis withdrawal was only recognized as a formal diagnosis in 2013 (DSM-5). With high relapse rates often driven by withdrawal symptoms, having effective treatments could significantly improve outcomes for people trying to quit.

The numbers in context

30% of regular cannabis users experience withdrawal. 50-95% of highly dependent users experience withdrawal. 10 trials included in review. Three medications studied: dronabinol, nabilone, nabiximols.

How the study worked

Systematic review searching PubMed, Web of Science, and PsycINFO through September 2017. 243 studies screened, 10 met inclusion criteria. Quality assessed using Cochrane tool. PROSPERO-registered protocol.

What this study cannot tell us

Only 10 studies available with methodological differences. No meta-analysis was performed. Most studies were small. Different cannabinoid medications make comparison difficult. Limited data on long-term outcomes.

How to read the evidence

Moderate - registered systematic review with appropriate methodology, though only 10 studies were available and no meta-analysis was performed.

When this study was published

Published in 2018. Cannabis withdrawal treatment research has continued to expand.

The bigger picture

Cannabinoid agonist replacement therapy for cannabis use disorder mirrors the successful approach used for opioid (methadone, buprenorphine) and nicotine (patches, gum) dependence. The evidence is building that this strategy works for cannabis as well.

Questions still open

Which cannabinoid medication is most effective and at what dose? How long should agonist replacement therapy continue? Can withdrawal treatment alone prevent relapse, or is behavioral therapy also needed?

Common questions

Is there medication for cannabis withdrawal?

This systematic review found that three cannabinoid medications - dronabinol, nabilone, and nabiximols - show promise for reducing withdrawal symptoms like irritability, insomnia, decreased appetite, and anxiety. None are FDA-approved for this use yet.

How common is cannabis withdrawal?

About 30% of regular cannabis users experience withdrawal symptoms when they stop. Among highly dependent or treatment-seeking users, the rate is much higher at 50-95%. Symptoms include irritability, insomnia, decreased appetite, depressed mood, and restlessness.

Read the original research

A Systematic Review of the Efficacy of Cannabinoid Agonist Replacement Therapy for Cannabis Withdrawal Symptoms.

CNS drugs, 32(12), 1113-1129

View on PubMed ↗Publisher’s paper ↗

Citation

Werneck, Maira Aguiar; Kortas, Guilherme Trevizan; de Andrade, Arthur Guerra; Castaldelli-Maia, João Mauricio. (2018). A Systematic Review of the Efficacy of Cannabinoid Agonist Replacement Therapy for Cannabis Withdrawal Symptoms.. CNS drugs, 32(12), 1113-1129. https://doi.org/10.1007/s40263-018-0577-6