AccScience Publishing / JCTR / Volume 11 / Issue 1 / DOI: 10.36922/jctr.24.00066
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REVIEW ARTICLE

Assessing the efficacy of cannabinoids in managing cannabis use disorder: A systematic review of randomized controlled trials with pharmacological emphasis

Camila Mari Yamada1 ,  Fernanda Valeriano Zamora1* ,  Ana Clara Felix de Farias Santos2 ,  Patrícia Almeida Jacob Moreno3 ,  Nicole dos Santos Pimenta4 ,  Joao Pedro Costa Esteves Almuinha Salles4 ,  Lorhayne Kerley Capuchinho Scalioni Galvao1 ,  Vânio Antunes do Livramento Junior5 ,  Andres Villca Zamora1
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1 Department of Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
2 Department of Pharmacy, Faculty of Pharmacy, City University of São Paulo, São Paulo, Brazil
3 Department of Medicine, Faculty of Medicine, University Center Dom Pedro II, Bahia, Brazil
4 Department of Medicine, Faculty of Medicine, Federal University of the State of do Rio de Janeiro, Brazil
5 Department of Medicine, Faculty of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
JCTR 2025, 11(1), 4–14; https://doi.org/10.36922/jctr.24.00066
Submitted: 13 October 2024 | Revised: 3 December 2024 | Accepted: 7 January 2025 | Published: 3 March 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background: Cannabis is the most used illicit drug worldwide. The increasing prevalence of cannabis use has raised concerns about the development of cannabis use disorder (CUD) and cannabis withdrawal syndrome (CWS). Thus far, however, no medications have been proven effective for treating these conditions. In this context, several cannabinoid (CB) preparations are being investigated as potential treatments. Aim: This systematic review aims to provide an overview of the key findings from medical CBs in the management of CUD and CWS, focusing on the efficacy of and users’ tolerability to different CB formulations. Conclusion: The findings suggest that certain CB preparations, such as nabiximols and cannabidiol, may effectively reduce cannabis use and enhance abstinence rates, providing hope for patients struggling with CUD. Conversely, CB receptor agonists such as dronabinol and nabilone show limited therapeutic potential, indicating the need for further research to identify effective treatments for cannabis dependence. Relevance for patients: These findings offer potential treatment options to help patients reduce cannabis use and improve abstinence from cannabis dependence.

Graphical abstract
Keywords
Cannabis use disorder
Cannabinoids
Cannabis withdrawal syndrome
Funding
None.
Conflict of interest
All authors declare no relationships that could be considered conflicts of interest.
References
  1. UNODC. World Drug Report 2023. United Nations Publication; 2023. Available from: https://www.unodc.org/ unodc/en/data-and-analysis/world-drug-report-2023.html [Last accessed on 2024 Aug 1].

 

  1. Sherman BJ, McRae‐Clark AL. Treatment of cannabis use disorder: Current science and future outlook. Pharmacotherapy. 2016;36(5):511-535. doi: 10.1002/phar.1747

 

  1. American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2022.

 

  1. Leung J, Chan GCK, Hides L, Hall WD. What is the prevalence and risk of cannabis use disorders among people who use cannabis? A systematic review and meta-analysis. Addict Behav. 2020;109:106479. doi: 10.1016/j.addbeh.2020.106479

 

  1. Dawson D, Stjepanović D, Lorenzetti V, Cheung C, Hall W, Leung J. The prevalence of cannabis use disorders in people who use medicinal cannabis: A systematic review and meta-analysis. Drug Alcohol Depend. 2024;257:111263. doi: 10.1016/j.drugalcdep.2024.111263

 

  1. Hasin DS. US epidemiology of cannabis use and associated problems. Neuropsychopharmacology. 2018;43(1):195-212. doi: 10.1038/npp.2017.198

 

  1. Bahji A, Stephenson C, Tyo R, Hawken ER, Seitz DP. Prevalence of cannabis withdrawal symptoms among people with regular or dependent use of cannabinoids: A systematic review and meta-analysis. JAMA Netw Open. 2020;3(4):e202370. doi: 10.1001/jamanetworkopen.2020.2370

 

  1. Connor JP, Stjepanović D, Le Foll B, Hoch E, Budney AJ, Hall WD. Cannabis use and cannabis use disorder. Nat Rev Dis Primer. 2021;7(1):16. doi: 10.1038/s41572-021-00247-4

 

  1. Schlosburg JE, Carlson BLA, Ramesh D, et al. Inhibitors of endocannabinoid-metabolizing enzymes reduce precipitated withdrawal responses in THC-Dependent mice. AAPS J. 2009;11(2):342-352. doi: 10.1208/s12248-009-9110-7

 

  1. European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2023. Publications Office; 2023. Available from: https://data.europa.eu/doi/10.2810/161905 [Last accessed on 2024 Jun 22].

 

  1. Bahji A, Meyyappan AC, Hawken ER, Tibbo PG. Pharmacotherapies for cannabis use disorder: A systematic review and network meta-analysis. Int J Drug Policy. 2021;97:103295. doi: 10.1016/j.drugpo.2021.103295

 

  1. Lees R, Hines LA, D’Souza DC, et al. Psychosocial and pharmacological treatments for cannabis use disorder and mental health comorbidities: A narrative review. Psychol Med. 2021;51(3):353-364. doi: 10.1017/S0033291720005449

 

  1. Sterne JAC, Savović J, Page MJ, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. doi: 10.1136/bmj.l4898

 

  1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ. 2009;339:b2535. doi: 10.1136/bmj.b2535

 

  1. Harrison S, Jones HE, Martin RM, Lewis SJ, Higgins JPT. The albatross plot: A novel graphical tool for presenting results of diversely reported studies in a systematic review. Res Synth Methods. 2017;8(3):281-289. doi: 10.1002/jrsm.1239

 

  1. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to Meta‐Analysis. 1st ed. United States: John Wiley and Sons, Ltd; 2009. doi: 10.1002/9780470743386

 

  1. Levin FR, Mariani JJ, Pavlicova M, et al. Dronabinol and lofexidine for cannabis use disorder: A randomized, double-blind, placebo-controlled trial. Drug Alcohol Depend. 2016;159:53-60. doi: 10.1016/j.drugalcdep.2015.11.025

 

  1. Hill KP, Palastro MD, Gruber SA, et al. Nabilone pharmacotherapy for cannabis dependence: A randomized, controlled pilot study. Am J Addict. 2017;26(8):795-801. doi: 10.1111/ajad.12622

 

  1. Trigo JM, Soliman A, Quilty LC, et al. Nabiximols combined with motivational enhancement/cognitive behavioral therapy for the treatment of cannabis dependence: A pilot randomized clinical trial. PLoS One. 2018;13(1):e0190768. doi: 10.1371/journal.pone.0190768

 

  1. Levin FR, Mariani JJ, Brooks DJ, Pavlicova M, Cheng W, Nunes EV. Dronabinol for the treatment of cannabis dependence: A randomized, double-blind, placebo-controlled trial. Drug Alcohol Depend. 2011;116(1-3):142-150. doi: 10.1016/j.drugalcdep.2010.12.010

 

  1. Allsop DJ, Copeland J, Lintzeris N, et al. Nabiximols as an agonist replacement therapy during cannabis withdrawal: A randomized clinical trial. JAMA Psychiatry. 2014;71(3):281-291. doi: 10.1001/jamapsychiatry.2013.3947

 

  1. Freeman TP, Hindocha C, Baio G, et al. Cannabidiol for the treatment of cannabis use disorder: A phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial. Lancet Psychiatry. 2020;7(10):865-874. doi: 10.1016/S2215-0366(20)30290-X

 

  1. Lintzeris N, Bhardwaj A, Mills L, et al. Nabiximols for the treatment of cannabis dependence: A randomized clinical trial. JAMA Intern Med. 2019;179(9):1242. doi: 10.1001/jamainternmed.2019.1993

 

  1. Lintzeris N, Mills L, Dunlop A, et al. Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial. Drug Alcohol Depend. 2020;215:108220. doi: 10.1016/j.drugalcdep.2020.108220

 

  1. Stead LF, Perera R, Bullen C, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2012;11:CD000146. doi: 10.1002/14651858.CD000146.pub4

 

  1. Weiss RD. Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid dependence: A 2-phase randomized controlled trial. Arch Gen Psychiatry. 2011;68(12):1238. doi: 10.1001/archgenpsychiatry.2011.121

 

  1. Gottschling S, Ayonrinde O, Bhaskar A, et al. Safety considerations in cannabinoid-based medicine. Int J Gen Med. 2020;13:1317-1333. doi: 10.2147/IJGM.S275049

 

  1. Pergolizzi JV, Taylor R, LeQuang JA, Zampogna G, Raffa RB. Concise review of the management of iatrogenic emesis using cannabinoids: Emphasis on nabilone for chemotherapy-induced nausea and vomiting. Cancer Chemother Pharmacol. 2017;79(3):467-477. doi: 10.1007/s00280-017-3257-1

 

  1. Darkovska-Serafimovska M, Serafimovska T, Arsova- Sarafinovska Z, Stefanoski S, Keskovski Z, Balkanov T. Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases. J Pain Res. 2018;11:837-842. doi: 10.2147/JPR.S160556

 

  1. Pertwee RG. The pharmacology of cannabinoid receptors and their ligands: An overview. Int J Obes (Lond). 2006;30(S1):S13-S18. doi: 10.1038/sj.ijo.0803272

 

  1. Morgan CJ, Freeman TP, Schafer GL, Curran HV. Cannabidiol attenuates the appetitive effects of delta 9-tetrahydrocannabinol in humans smoking their chosen cannabis. Neuropsychopharmacology. 2010;35(9):1879-1885. doi: 10.1038/npp.2010.58

 

  1. Crippa JAS, Hallak JEC, Machado-de-Sousa JP, et al. Cannabidiol for the treatment of cannabis withdrawal syndrome: A case report. J Clin Pharm Ther. 2013;38(2):162-164. doi: 10.1111/jcpt.12018

 

  1. Hermann D, Sartorius A, Welzel H, et al. Dorsolateral prefrontal cortex N-acetylaspartate/total creatine (NAA/ tCr) loss in male recreational Cannabis users. Biol Psychiatry. 2007;61(11):1281-1289. doi: 10.1016/j.biopsych.2006.08.027

 

  1. Hermann D, Schneider M. Potential protective effects of cannabidiol on neuroanatomical alterations in cannabis users and psychosis: A critical review. Curr Pharm Des. 2012;18(32):4897-4905. doi: 10.2174/138161212802884825

 

  1. Pertwee RG. The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: Delta9‐tetrahydrocannabinol, cannabidiol and delta9‐tetrahydrocannabivarin. Br J Pharmacol. 2008;153(2):199-215. doi: 10.1038/sj.bjp.0707442

 

  1. Higgins JPT, Thomas J, Chandler J, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions Version 6.4. United Kingdom: Cochrane; 2023. Available from: https://www. training.cochrane.org/handbook [Last accessed on 2024 Aug 1].
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Journal of Clinical and Translational Research, Electronic ISSN: 2424-810X Print ISSN: 2382-6533, Published by AccScience Publishing
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