"There is no doubt that cannabis is addictive."
By Emma Betuel
If you want to quit smoking cigarettes, there’s an entire industry ready to sell you ways to wean yourself off them. But for people who want to stop smoking marijuana, the options are far more limited. In a recent trial, a team of scientists in Australia, armed with a THC- and CBD-laced mouth spray, is hoping to change that by using marijuana’s own components to help users control their habit.
In
a series of experiments in Australia and Canada, teams of scientists
have been testing the effects of a drug called nabiximols on cannabis dependency, which is one way to describe an addiction to marijuana (more on that later).
A paper on the Australian study was published Monday in JAMA Internal Medicine
and concluded that regular smokers who used nabiximols smoked 18.6
fewer days than those who took a placebo medication over the course of a
12-week experiment. This finding suggests it might be able to help
people wean themselves off a weed habit.
Nabiximols
is actually a cannabis extract that’s been formulated to contain equal
parts THC, marijuana’s psychoactive component, and CBD, a minimally
psychoactive, loosely regulated molecule sold in chill-out seltzers for millennials and treats for pets. Nabiximols, which patients take by spraying under their tongue, is sold under the brand name Sativex for the treatment of multiple sclerosis symptoms, but it’s not yet approved in the United States.
Right
now, nabiximols isn’t approved to treat marijuana dependency anywhere
in the world. But maybe one day it could be, says lead study author Nicholas Lintzeris, Ph.D., an addiction medicine specialist at the University of Sydney School of Medicine.
“Ultimately
— we would like to see the use of cannabinoid based medicines become a
routine part of treatment for cannabis dependence —linked to counseling
and other psychosocial approaches,” he tells Inverse
Can You Be “Addicted” To Weed?
Nabiximols,
if licensed, isn’t a treatment for a casual weed smoker who may want to
smoke a little less. It’s for people who have a relationship with
marijuana that qualifies as “marijuana use disorder”.
The NIH describes
marijuana use disorder as a feeling of dependency — or problematic use
that in some cases can rise to the level of addiction. When the supply
is cut off, people with marijuana use disorder tend to feel
irritability, sleeplessness, or physical discomfort that peaks within
the first week of quitting. That discomfort, the NIH states, is
partially because the brain adapts to the influx of cannabinoids, and as
a result reduces the amount of endocannabinoids that the body produces
naturally.
Bernard Le Foll, Ph.D.,
the head of translational addiction research at Toronto’s Center for
Addiction and Mental, health agrees that these symptoms qualify as
addictive. Le Foll isn’t associated with this study, but has done past research on nabiximols for marijuana dependency.
“There is no doubt that cannabis is addictive,” he tells Inverse.
“It is estimated that 9% of users lifetime will develop cannabis
dependence. A larger fraction will develop a loss of control on their
use at some point of their life.”
Both
Le Foll and Lintzeris note that dependency on cannabis is not the same
as being addicted to another drug, like cocaine. From a clinical
standpoint, addictions manifest differently depending on what drug
you’re talking about, so it’s hard to compare them directly. But even if
you do compare them, the harms from cannabis dependency, says
Lintzeris, tend to be minor compared to those that stem from, say,
opioid addiction, which has been responsible for tens of thousands of deaths in the United States.
“I
would summarize cannabis dependence as very common (estimated at 10% of
cannabis users), but that most people experience minor levels of harms.
But nevertheless, it can be difficult for some people to stop or
control their use,” he says.
That’s why his lab taking a look at how cannabinoids may be able to help ease the transition.
Nabaximols and Cannabis Dependency
This
most recent study was a double blind, placebo-controlled trial on 128
smokers in Australia who had smoked at least 2-3 grams daily and had
expressed interest in stopping, mostly because of social and health
problems as a result of their habit.
Each day, they got a dose of nabiximols and
performed a total of six courses in cognitive behavioral therapy, a
method that has shown past promise for addiction treatment. The
volunteers in the study got an average of 9.5 sprays of nabiximols each
day, which amounted to 47.5 milligrams of THC and 44 milligrams of CBD.
In
terms of using cannabinoids to wean someone off of cannabis, this spray
functions slightly more like a nicotine gum might for a smoker. Give
someone small, controlled doses, and along with therapy, they might be
able to quit the habit over time.
Notably, this
trial didn’t measure total abstinence, which is the goal of smoking
cessation programs. But it did show promise in helping people back off
of a weed habit, which adds to growing interest around cannabinoids’
medicinal applications.
Cannabinoids like CBD do seem to have wider applications in medicine, and even addiction science.
For example, both CBD and THC are being explored
as treatments for opioid addiction — particularly, because they both
seem to affect dopamine, the brain’s pleasure-related neurotransmitter
that’s hijacked in opioid-addicted patients.
“There
is so much potential for the use of THC, CBD, and other cannabinoids in
the treatment of not just cannabis dependence — but also alcohol,
opioid, and stimulant dependence,” says Lintzeris.
“Cannabinoids are
likely to have a big impact upon the practice of addiction medicine.”
If
his team’s results hold up, another one of marijuana’s future forays
into medicine might be to help people who have become dependent on the
plant itself. The right combination of cannabinoids, ironically, may be
just the thing to help wean people off of them.
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