“The concept of prescribing patients a safer form of the drug they are dependent on is not novel; it is routinely used to treat tobacco and heroin addiction,” explains Nicholas Lintzeris, a researcher at New South Wales University, Australia, and part of a team that hopes to apply the same logic to cannabis dependency (1). “The process can encourage behavioral ‘lifestyle’ change, which is necessary to stopping addiction.”
A previous study (2), conducted over a period of 28 days, had already demonstrated promising results with nabiximols (Sativex) – an oromucosal spray, containing THC, CBD and specific minor cannabinoids, which has been approved in “over 25 countries outside the USA for the treatment of spasticity (muscle stiffness/spasm) due to muscular sclerosis (3)”
“We found that a short course of nabiximols was effective in helping patients’ complete withdrawal and minimize discomfort,” says Lintzeris. “However, most patients relapsed within several weeks, returning to regular cannabis use. Hence, we wanted to determine if a longer exposure to nabiximols would produce longer term benefits.”
In the randomized, double-blind, controlled trial, patients received either nabiximols or placebo, dispensed weekly and with individually adjusted doses. In addition, patients were provided access to counseling, nursing and medical input to address other health and social issues. The aim? To mimic real life experience as much as possible. “Patients in both the nabiximols and placebo groups reduced their cannabis use, but those that received nabiximols demonstrated significantly greater reductions,” says Lintzeris. “The medication was well tolerated with few side effects, and patients did not report significant intoxication when using nabiximols.”
In these rapidly changing times, who dares predict the scale of need for so-called “drug replacement therapy” for cannabis dependence – or what form it may eventually take? Lintzeris remains confident in their work: “Our findings indicate considerable promise in this treatment approach – and we might one day consider this a routine part of treatment for cannabis dependence.”
- N Lintzeris et al., “Nabiximols for the Treatment of Cannabis Dependence: A Randomized Clinical Trial”, JAMA Intern Med, [Epub ahead of print] (2019). PMID: 31305874.
- DJ Allsop et al., “Nabiximols as an agonist replacement therapy during cannabis withdrawal: a randomized clinical trial”, JAMA Psychiatry, 71, 281 (2014). PMID: 24430917.
- GW Pharmaceuticals, “Sativex” (2019). Accessed July 22, 2019.
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