Cannabinoids to Treat Cannabis Use Disorders

Abstract

As with treatment development for other substance use disorders, there has been great interest in exploring the clinical use of cannabinoid agonists and antagonists for the treatment of cannabis use disorder (CUD). While there are no clearly efficacious medication treatments for CUD, 20 years of committed and high-quality research in the human laboratory and clinical settings has resulted in evidence demonstrating medications with cannabinoid receptor-1 (CB-1) activity are effective in the treatment of cannabis withdrawal, reduction of cannabis use, and prevention of relapse (in the human lab model) and hold a great promise for future work. As with other controlled prescriptions, off-label clinical use of cannabinoid agonists should be considered in the context of potential misuse, overuse, and diversion. While the antagonist medication rimonabant demonstrated early promise in the human lab, safety concerns and withdrawal of its use from the US market preclude further investigation of this agent. However, development of antagonists with different properties may have clinical utility, though they are in the earliest stages of preclinical investigation.