Despite evidence that some active substances in cannabis may support certain aspects of health, many people who use the drug — particularly those who smoke it — develop symptoms of dependence. A new clinical trial suggests that a safer, cannabis-based medication may help counter this dependence.

 

The National Institute on Drug Abuse notes that about 30% of recreational cannabis users in the United States may experience some degree of marijuana use disorder, which is often characterized by symptoms of dependence.

 

Dependence causes individuals to compulsively seek the drug and experience withdrawal symptoms when they cannot access it. These symptoms may include irritability, sleep disturbances, and a reduced appetite.

 

Researchers from the University of Sydney and the New South Wales Ministry of Health in Australia point out that existing treatments for cannabis dependence are not always effective.

 

To address this issue, the research team tested a new medicinal drug designed to be more effective at treating cannabis dependence than currently available therapies.

 

In a clinical trial, the results of which were published in JAMA Internal Medicine, the researchers assessed the drug’s safety and effectiveness in humans. The medication is a cannabinoid agonist consisting of a cannabis extract that interacts with cannabinoid receptors in the brain.

 

These receptors are part of the endocannabinoid system, whose main role is to produce substances similar to those found in cannabis. By targeting these receptors, the researchers hope to reduce relapse rates among people seeking treatment for cannabis dependence.

 

“We have never had evidence before that medication can be effective in treating cannabis dependency — this is the first large study to show that this is a safe and effective approach,” says lead author Professor Nick Lintzeris.

 

“The principles are very similar to nicotine replacement therapy. You are providing patients with a medicine that is safer than the drug they are already using, while linking it with medical and counseling support to help people address their illicit cannabis use,” Prof. Lintzeris explains.

 

The therapeutic compound used in the study contains nabiximols, which consist of equal parts cannabidiol (CBD) and tetrahydrocannabinol (THC), the primary psychoactive ingredient in cannabis.

 

Prof. Lintzeris and his team tested the medication on 128 volunteers — 30 women and 98 men — with an average age of 35 years. All participants were recreational cannabis users who had sought treatment for dependence but had previously been unsuccessful in quitting their drug use.

 

Participants received the nabiximols medication over a 12-week period. The drug was administered as an oral spray under the tongue. On average, participants used 18 sprays per day, with each spray measuring 0.1 milliliters and containing 2.7 milligrams of THC and 2.5 milligrams of CBD.

 

The researchers monitored participants at the beginning of the trial and again after 2, 4, 8, and 12 weeks. Throughout the study, participants also received cognitive-behavioral therapy (CBT) and additional therapeutic support when necessary.

 

The results showed that participants who received nabiximols significantly reduced their use of illicit recreational cannabis compared with the control group that received a placebo.

 

According to the researchers, this replacement strategy also benefits individuals by helping them break their usual patterns of recreational drug use.

 

“Worldwide, we are seeing medicinal cannabis patients transition away from the traditional smoked route of cannabis administration. This new study complements this trend by showing that an oral spray can be an effective substitute for smoked cannabis in heavy recreational users seeking treatment for their cannabis use.”

 

These results follow another study conducted by the same research team, which found that nabiximols effectively reduced cannabis withdrawal symptoms during a short-term, hospital-based treatment program.

 

However, the latest research is particularly significant because it demonstrates that nabiximols may help patients achieve longer-term changes in their cannabis use.

 

“Our study is an important step in addressing the lack of effective treatments,” Prof. Lintzeris says. “Currently, four in five patients relapse to regular cannabis use within six months after medical or psychological interventions.”