Cannabis use is increasing in the US with some state laws permitting medicinal and/or recreational use. The incidence of cannabis use disorder (CUD) has also increased, but there are currently no FDA-approved pharmacologic treatments for CUD among adults. Cannabidiol is a cannabinoid that has effects different from D-9-tetrahydrocannabinol (THC) and more medicinal value. This randomized clinical trial among adults with CUD assessed the effect of various doses of oral cannabidiol* on cannabis use measured self-reported average days of cannabis use and urine drug screen (urinary THC:creatinine ratio).
- The 200mg dose of cannabidiol was not associated with cannabis use reduction.
- Compared with placebo, participants receiving 400mg of cannabidiol reduced cannabis use by 0.48 days per week, and their urinary THC:creatinine ratio decreased by -94·21 ng/mL.
- Compared with placebo, participants receiving 800mg of cannabidiol reduced cannabis use by 0.27 days per week, and their urinary THC:creatinine ratio decreased by -72·02 ng/mL.
- No serious side effects were noted.
* In the first phase of this adaptive Bayesian trial, participants received placebo or 1 of 3 different doses of oral cannabidiol (200mg, 400mg, or 800mg). In the second phase, new participants were randomized to placebo or the doses deemed most efficacious in the first phase (400mg and 800mg).
Comments: There are currently no pharmacologic treatment options for treating cannabis use disorder in adults. In this randomized trial, cannabidiol showed promise as a possible treatment.
Melissa B. Weimer, DO, MCR
Reference: Freeman TP, Hindocha C, Baio G, et al. Cannabidiol for the treatment of cannabis use disorder: a phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial. Lancet Psychiatry. 2020;7(10):865–874.