• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia
    • Books
    • eBooks
    • ABPN SA Courses
    • Social Work Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
    • Psychiatry News Videos
    • Medication Guide Videos
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • FAQs
  • Med Fact Book App
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Good News for Smoking Cessation Drugs: Not as Scary as Once Thought
RESEARCH UPDATE

Good News for Smoking Cessation Drugs: Not as Scary as Once Thought

June 1, 2016
Bret A. Moore, PsyD, ABPP
From The Carlat Addiction Treatment Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue

Bret A. Moore, PsyD, ABPP                                    

Board-Certified Clinical Psychologist, San Antonio, TX.                                       

Dr. Moore has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Subject:
(Frances L et al, Drug and Alcohol Dependence, 2016;159:53–60)

Background:

Second only to alcohol, marijuana is the most common reason people enter substance abuse treatment. And unlike alcohol dependence, there are virtually no effective medications available for those addicted to it. It’s not from a lack of trying. A recent review of 14 drug studies for cannabis dependence revealed little benefit from antidepressants, anticonvulsants, or anxiolytics. The only glimmer of hope came from studies using tetrahydrocannabinol-based concoctions, which are effective in some studies that use it as substitution treatment. Researchers from Columbia University set out to test the effectiveness of combining dronabinol, a synthetic form of THC, and lofexidine. Lofexidone is an alpha 2 agonist, structurally similar to clonidine, that is available in the United Kingdom, where it is used both for hypertension and opiate withdrawal symptoms.

One hundred twenty two cannabis-dependent adults were randomized to receive dronabinol and lofexidine or placebo. Patients had used an average of 1.65 grams daily over the past month, which is roughly the equivalent of smoking 2 joints per day—an average joint contains 0.5 g to 1 g of marijuana (Inaba DS, Cohen WE. Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs, 8th ed. Medford, OR: CNS Productions, Inc; 2014). In addition to medications, all patients received weekly cognitive-behavioral therapy (CBT) related to their cannabis use; therapy focused on motivational enhancement and relapse prevention. Medications were gradually increased during the first 2 weeks of the study to an average dose of 55.6 mg/day for dronabinol and 1.28 mg/day for lofexidine. Once a stable dose was reached, patients were followed on the medications for an additional 6 weeks.

After an average of 6 weeks of treatment at a stable dose, there were no differences between groups with regard to abstinence, easing withdrawal symptoms, or the proportion of patients who finished treatment. Overall, half of patients decreased cannabis use by 50% or more. The authors attributed this improvement to CBT, which all subjects received. This is not surprising as CBT has been shown to be effective for cannabis use disorder (Copeland J et al, Journal of Substance Abuse Treatment, 2001;21:55–64).

CATR’s Take: We are no closer to finding a viable pharmacological answer to cannabis dependence. This is concerning since nearly 20 million Americans over the age of 12 used marijuana within the past month. Continuing the search is important, and with time, it’s likely that options will become available. In the meantime, for those patients who want or need to quit, referral for CBT appears to be the best choice. 

Addiction Treatment Research Update
KEYWORDS research_updates smoking_cessation_agents
    Bret a moore psyd abpp
    Bret A. Moore, PsyD, ABPP

    Synthetic THC and Antihypertensive Provide Little Benefit for Cannabis Dependence

    More from this author
    www.thecarlatreport.com
    Issue Date: June 1, 2016
    SUBSCRIBE NOW
    Table Of Contents
    Motivational Interviewing: Ten Tips
    Using Motivational Interviewing in Your Practice
    Psychedelic Mushrooms May Help Treatment Resistant Depression
    Good News for Smoking Cessation Drugs: Not as Scary as Once Thought
    DOWNLOAD NOW
    Featured Book
    • OUDFB1e_Cover_Binding.png

      Treating Opioid Use Disorder—A Fact Book (2024)

      All the tools you need to assess and treat patients struggling with opioid use disorder. 
      READ MORE
    Featured Video
    • KarXT (Cobenfy)_ The Breakthrough Antipsychotic That Could Change Everything.jpg
      General Psychiatry

      KarXT (Cobenfy): The Breakthrough Antipsychotic That Could Change Everything

      Read More
    Featured Podcast
    • shutterstock_2622607431.jpg
      General Psychiatry

      Should You Test MTHFR?

      MTHFR is a...
      Listen now
    Recommended
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report
    • The Carlat Psychotherapy Report

    Contact

    carlat@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2025 Carlat Publishing, LLC and Affiliates, All Rights Reserved.