Prescription medication of cannabidiol can be used safely to treat cannabis use disorder and could help people to cut down on use of the drug, a new UK study claims.
An initial randomised controlled trial, published in The Lancet Psychiatry, is the first to report that daily prescribed medical-use CBD use can reduce cannabis use among people with cannabis use disorder.
Researchers found an optimal daily dose of between 400mg and 800mg of CBD, which is higher than concentrations found in over-the-counter CBD products.
Lead author Dr Tom Freeman, director of the addiction and mental health group at the University of Bath, said: “Our study provides the first causal evidence to support cannabidiol, or CBD, as a treatment for cannabis use disorders.
“This is encouraging, as there are currently no drug treatments for cannabis addiction. CBD products are widely available in many countries but we would not advise people to self-medicate with these products. People with concerns about their cannabis use should always speak to a healthcare professional in the first instance.”
Previous studies have suggested that taking CBD products could help to reduce withdrawal symptoms in people who are actively trying to stop using cannabis, but it has not yet been possible to determine if these effects were due to CBD, because the studies either used an open-label design or CBD was prescribed alongside THC.
In this study, all 82 participants had been diagnosed with a cannabis use disorder of at least moderate severity and had expressed a desire to stop, having tried and failed at least once before.
The participants were randomly assigned to treatment groups and asked to take two capsules of CBD twice daily for four weeks.
The placebo group were given capsules containing no CBD, while the others received a daily dose of 200mg, 400mg or 800mg CBD. All received six counselling sessions that were designed to help them stop using cannabis.
Weekly urine samples were tested for levels of THC to assess how much cannabis had been consumed in the past week and participants were asked to report how many days they had abstained from using cannabis that week.
In the first stage of the trial, 12 people per group were assigned to placebo, 200mg, 400mg or 800mg CBD.
After the first phase of the study, the 200mg dose was found to be ineffective and these participants were removed from the trial and a further 34 people were recruited to the second stage of the study, 11 of whom received the placebo, 12 400mg and 11 800mg.
Daily CBD doses of 400mg and 800mg were both found to reduce participants’ cannabis intake and abstinence from cannabis use increased by an average of 0.5 days per week in the group who received the 400mg daily dose of CBD and 0.3 days per week in the group who received 800mg CBD daily.
Professor Valerie Curran, senior author and director of the Clinical Psychopharmacology Unit at University College London, UK, said: “Our findings indicate that CBD doses ranging from 400mg to 800mg daily have the potential to reduce cannabis use in clinical settings, but higher doses are unlikely to bring any additional benefit. Larger studies are needed to determine the magnitude of the benefits of daily CBD for reducing cannabis use.”
The study was carried out over a four week treatment period with follow up extending to six months. The researchers say additional research is needed to investigate the extent to which their findings translate to different durations of treatment.
Freeman TP, Hindocha C, Baio G. Cannabidiol for the treatment of cannabis use disorder: a phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial. The Lancet Psychiatry 29 July 2020
http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30290-X/fulltext
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