Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial
•Cannabinoid medications hold promise in treating cannabis dependence, but outcomes post-treatment are unclear.•We examine outcomes after a 12-week RCT comparing nabiximols (containing equal parts THC & CBD) v placebo.•The nabiximols group reported less cannabis use 12 weeks after stopping treat...
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| Veröffentlicht in: | Drug and alcohol dependence 2020-10, Vol.215, p.108220, Article 108220 |
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| creator | Lintzeris, Nicholas Mills, Llewellyn Dunlop, Adrian Copeland, Jan Mcgregor, Iain Bruno, Raimondo Kirby, Adrienne Montebello, Mark Hall, Michelle Jefferies, Meryem Kevin, Richard Bhardwaj, Anjali |
| description | •Cannabinoid medications hold promise in treating cannabis dependence, but outcomes post-treatment are unclear.•We examine outcomes after a 12-week RCT comparing nabiximols (containing equal parts THC & CBD) v placebo.•The nabiximols group reported less cannabis use 12 weeks after stopping treatment.•A 12-week intervention of counselling with nabiximols is suggested.
Previous studies suggest cannabinoid agonist treatment is effective in reducing cannabis use in dependent treatment seekers, however few studies have reported on post-treatment outcomes. We examine cannabis use outcomes 12 weeks after cessation of treatment from a randomised placebo-controlled trial of nabiximols for the treatment of cannabis dependence.
128 participants received either nabiximols (n = 61) or placebo (n = 67) for 12 weeks, in combination with psychosocial interventions. Self-reported number of days of cannabis use in the previous 28 days was measured at baseline, 4, 8, and 12 weeks (end of treatment) and again at 24 weeks (3 months after treatment ceased). Urinalysis was used to confirm self-report data at Week 24 interview.
A factorial mixed-effects model for repeated measures regression revealed that the nabiximols group used cannabis on 6.8 fewer days in the previous 28 days at week 12 (end of treatment) than the placebo group (p = 0.002, CI: 2.1,11.4), and 6.7 fewer days in the previous 28 days at the week-24 follow-up than the placebo group (p = 0.006, CI: 1.4,12.1). A significantly higher proportion of the nabiximols group (14/61; 23 %) than the placebo group (6/67; 9%) reported abstinence from cannabis in the previous 28 days at the week-24 research interview OR=3.0, CI: 1.1, 9.1; p=0.035, NNT=8, CI: 4, 71).
The benefits of treatment incorporating nabiximols with psychosocial interventions in reducing cannabis use appears to persist for up to 3 months after the cessation of treatment. A stepped care model of treatment is proposed.
Australian New Zealand Clinical Trials Registry (ACTRN12616000103460) https://www.anzctr.org.au |
| doi_str_mv | 10.1016/j.drugalcdep.2020.108220 |
| format | Article |
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Previous studies suggest cannabinoid agonist treatment is effective in reducing cannabis use in dependent treatment seekers, however few studies have reported on post-treatment outcomes. We examine cannabis use outcomes 12 weeks after cessation of treatment from a randomised placebo-controlled trial of nabiximols for the treatment of cannabis dependence.
128 participants received either nabiximols (n = 61) or placebo (n = 67) for 12 weeks, in combination with psychosocial interventions. Self-reported number of days of cannabis use in the previous 28 days was measured at baseline, 4, 8, and 12 weeks (end of treatment) and again at 24 weeks (3 months after treatment ceased). Urinalysis was used to confirm self-report data at Week 24 interview.
A factorial mixed-effects model for repeated measures regression revealed that the nabiximols group used cannabis on 6.8 fewer days in the previous 28 days at week 12 (end of treatment) than the placebo group (p = 0.002, CI: 2.1,11.4), and 6.7 fewer days in the previous 28 days at the week-24 follow-up than the placebo group (p = 0.006, CI: 1.4,12.1). A significantly higher proportion of the nabiximols group (14/61; 23 %) than the placebo group (6/67; 9%) reported abstinence from cannabis in the previous 28 days at the week-24 research interview OR=3.0, CI: 1.1, 9.1; p=0.035, NNT=8, CI: 4, 71).
The benefits of treatment incorporating nabiximols with psychosocial interventions in reducing cannabis use appears to persist for up to 3 months after the cessation of treatment. A stepped care model of treatment is proposed.
Australian New Zealand Clinical Trials Registry (ACTRN12616000103460) https://www.anzctr.org.au</description><identifier>ISSN: 0376-8716</identifier><identifier>EISSN: 1879-0046</identifier><identifier>DOI: 10.1016/j.drugalcdep.2020.108220</identifier><identifier>PMID: 32768992</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Australia ; Cannabidiol ; Cannabinoid Receptor Agonists - therapeutic use ; Cannabinoid receptors ; Cannabis ; Clinical outcomes ; Dependence ; Diagnostic tests ; Dronabinol ; Drug Combinations ; Female ; Health services utilization ; Help seeking behavior ; Humans ; Interviews ; Male ; Marijuana ; Marijuana Abuse - therapy ; Marijuana Smoking ; Nabiximols ; Outcomes ; Psychosocial factors ; Psychosocial intervention ; Psychosocial therapy ; RCT ; Regression models ; Self report ; Substance-Related Disorders ; Treatment ; Treatment Outcome ; Urinalysis</subject><ispartof>Drug and alcohol dependence, 2020-10, Vol.215, p.108220, Article 108220</ispartof><rights>2020</rights><rights>Copyright © 2020. Published by Elsevier B.V.</rights><rights>Copyright Elsevier Science Ltd. Oct 1, 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-ea01d7e403041bfbee12cde5cbbdc0b79c3e420d6c79891860d731fc08b33303</citedby><cites>FETCH-LOGICAL-c402t-ea01d7e403041bfbee12cde5cbbdc0b79c3e420d6c79891860d731fc08b33303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.drugalcdep.2020.108220$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,30999,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32768992$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lintzeris, Nicholas</creatorcontrib><creatorcontrib>Mills, Llewellyn</creatorcontrib><creatorcontrib>Dunlop, Adrian</creatorcontrib><creatorcontrib>Copeland, Jan</creatorcontrib><creatorcontrib>Mcgregor, Iain</creatorcontrib><creatorcontrib>Bruno, Raimondo</creatorcontrib><creatorcontrib>Kirby, Adrienne</creatorcontrib><creatorcontrib>Montebello, Mark</creatorcontrib><creatorcontrib>Hall, Michelle</creatorcontrib><creatorcontrib>Jefferies, Meryem</creatorcontrib><creatorcontrib>Kevin, Richard</creatorcontrib><creatorcontrib>Bhardwaj, Anjali</creatorcontrib><creatorcontrib>For The Agonist Replacement For Cannabis Dependence Study Group. (Arc-D)</creatorcontrib><creatorcontrib>Agonist Replacement For Cannabis Dependence Study Group. (Arc-D)</creatorcontrib><title>Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial</title><title>Drug and alcohol dependence</title><addtitle>Drug Alcohol Depend</addtitle><description>•Cannabinoid medications hold promise in treating cannabis dependence, but outcomes post-treatment are unclear.•We examine outcomes after a 12-week RCT comparing nabiximols (containing equal parts THC & CBD) v placebo.•The nabiximols group reported less cannabis use 12 weeks after stopping treatment.•A 12-week intervention of counselling with nabiximols is suggested.
Previous studies suggest cannabinoid agonist treatment is effective in reducing cannabis use in dependent treatment seekers, however few studies have reported on post-treatment outcomes. We examine cannabis use outcomes 12 weeks after cessation of treatment from a randomised placebo-controlled trial of nabiximols for the treatment of cannabis dependence.
128 participants received either nabiximols (n = 61) or placebo (n = 67) for 12 weeks, in combination with psychosocial interventions. Self-reported number of days of cannabis use in the previous 28 days was measured at baseline, 4, 8, and 12 weeks (end of treatment) and again at 24 weeks (3 months after treatment ceased). Urinalysis was used to confirm self-report data at Week 24 interview.
A factorial mixed-effects model for repeated measures regression revealed that the nabiximols group used cannabis on 6.8 fewer days in the previous 28 days at week 12 (end of treatment) than the placebo group (p = 0.002, CI: 2.1,11.4), and 6.7 fewer days in the previous 28 days at the week-24 follow-up than the placebo group (p = 0.006, CI: 1.4,12.1). A significantly higher proportion of the nabiximols group (14/61; 23 %) than the placebo group (6/67; 9%) reported abstinence from cannabis in the previous 28 days at the week-24 research interview OR=3.0, CI: 1.1, 9.1; p=0.035, NNT=8, CI: 4, 71).
The benefits of treatment incorporating nabiximols with psychosocial interventions in reducing cannabis use appears to persist for up to 3 months after the cessation of treatment. A stepped care model of treatment is proposed.
Australian New Zealand Clinical Trials Registry (ACTRN12616000103460) https://www.anzctr.org.au</description><subject>Australia</subject><subject>Cannabidiol</subject><subject>Cannabinoid Receptor Agonists - therapeutic use</subject><subject>Cannabinoid receptors</subject><subject>Cannabis</subject><subject>Clinical outcomes</subject><subject>Dependence</subject><subject>Diagnostic tests</subject><subject>Dronabinol</subject><subject>Drug Combinations</subject><subject>Female</subject><subject>Health services utilization</subject><subject>Help seeking behavior</subject><subject>Humans</subject><subject>Interviews</subject><subject>Male</subject><subject>Marijuana</subject><subject>Marijuana Abuse - therapy</subject><subject>Marijuana Smoking</subject><subject>Nabiximols</subject><subject>Outcomes</subject><subject>Psychosocial factors</subject><subject>Psychosocial intervention</subject><subject>Psychosocial therapy</subject><subject>RCT</subject><subject>Regression models</subject><subject>Self report</subject><subject>Substance-Related Disorders</subject><subject>Treatment</subject><subject>Treatment Outcome</subject><subject>Urinalysis</subject><issn>0376-8716</issn><issn>1879-0046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkV-P1CAUxYnRuLOrX8GQ-NzZC3QK9U0n659kExOz74TC7S6TFipQo5_EryvN7OqjvEDI75wD9xBCGewZsO76tHdpvTeTdbjsOfDtWnEOz8iOKdk3AG33nOxAyK5RknUX5DLnE9TV9fCSXAguO9X3fEd-H00IZvCZrhmpD3QxxWMomQo6x1AeMjVjwUQtmuzDPd3gn36OU6ZjTLQ8IC0JTZmriMaR2ie_-jQMDoPFd_Qb5nWqnmOKMzV0mYzFITa2BqQ4TehoMsHF2ed6LMmb6RV5MZop4-vH_Yrcfby5O35ubr9--nJ8f9vYFnhp0ABzElsQ0LJhHBAZr0M52GFwFgbZW4EtB9dZ2aueqQ6cFGy0oAYhBIgr8vZsu6T4fcVc9CmuKdREzdtDe2BSybZS6kzZFHNOOOol-dmkX5qB3grRJ_2vEL0Vos-FVOmbx4B1mNH9FT41UIEPZwDrL394TDpbv03N-YS2aBf9_1P-ALQ3pGw</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Lintzeris, Nicholas</creator><creator>Mills, Llewellyn</creator><creator>Dunlop, Adrian</creator><creator>Copeland, Jan</creator><creator>Mcgregor, Iain</creator><creator>Bruno, Raimondo</creator><creator>Kirby, Adrienne</creator><creator>Montebello, Mark</creator><creator>Hall, Michelle</creator><creator>Jefferies, Meryem</creator><creator>Kevin, Richard</creator><creator>Bhardwaj, Anjali</creator><general>Elsevier B.V</general><general>Elsevier Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>20201001</creationdate><title>Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial</title><author>Lintzeris, Nicholas ; Mills, Llewellyn ; Dunlop, Adrian ; Copeland, Jan ; Mcgregor, Iain ; Bruno, Raimondo ; Kirby, Adrienne ; Montebello, Mark ; Hall, Michelle ; Jefferies, Meryem ; Kevin, Richard ; Bhardwaj, Anjali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c402t-ea01d7e403041bfbee12cde5cbbdc0b79c3e420d6c79891860d731fc08b33303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Australia</topic><topic>Cannabidiol</topic><topic>Cannabinoid Receptor Agonists - therapeutic use</topic><topic>Cannabinoid receptors</topic><topic>Cannabis</topic><topic>Clinical outcomes</topic><topic>Dependence</topic><topic>Diagnostic tests</topic><topic>Dronabinol</topic><topic>Drug Combinations</topic><topic>Female</topic><topic>Health services utilization</topic><topic>Help seeking behavior</topic><topic>Humans</topic><topic>Interviews</topic><topic>Male</topic><topic>Marijuana</topic><topic>Marijuana Abuse - therapy</topic><topic>Marijuana Smoking</topic><topic>Nabiximols</topic><topic>Outcomes</topic><topic>Psychosocial factors</topic><topic>Psychosocial intervention</topic><topic>Psychosocial therapy</topic><topic>RCT</topic><topic>Regression models</topic><topic>Self report</topic><topic>Substance-Related Disorders</topic><topic>Treatment</topic><topic>Treatment Outcome</topic><topic>Urinalysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lintzeris, Nicholas</creatorcontrib><creatorcontrib>Mills, Llewellyn</creatorcontrib><creatorcontrib>Dunlop, Adrian</creatorcontrib><creatorcontrib>Copeland, Jan</creatorcontrib><creatorcontrib>Mcgregor, Iain</creatorcontrib><creatorcontrib>Bruno, Raimondo</creatorcontrib><creatorcontrib>Kirby, Adrienne</creatorcontrib><creatorcontrib>Montebello, Mark</creatorcontrib><creatorcontrib>Hall, Michelle</creatorcontrib><creatorcontrib>Jefferies, Meryem</creatorcontrib><creatorcontrib>Kevin, Richard</creatorcontrib><creatorcontrib>Bhardwaj, Anjali</creatorcontrib><creatorcontrib>For The Agonist Replacement For Cannabis Dependence Study Group. 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(Arc-D)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Drug and alcohol dependence</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lintzeris, Nicholas</au><au>Mills, Llewellyn</au><au>Dunlop, Adrian</au><au>Copeland, Jan</au><au>Mcgregor, Iain</au><au>Bruno, Raimondo</au><au>Kirby, Adrienne</au><au>Montebello, Mark</au><au>Hall, Michelle</au><au>Jefferies, Meryem</au><au>Kevin, Richard</au><au>Bhardwaj, Anjali</au><aucorp>For The Agonist Replacement For Cannabis Dependence Study Group. (Arc-D)</aucorp><aucorp>Agonist Replacement For Cannabis Dependence Study Group. (Arc-D)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial</atitle><jtitle>Drug and alcohol dependence</jtitle><addtitle>Drug Alcohol Depend</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>215</volume><spage>108220</spage><pages>108220-</pages><artnum>108220</artnum><issn>0376-8716</issn><eissn>1879-0046</eissn><abstract>•Cannabinoid medications hold promise in treating cannabis dependence, but outcomes post-treatment are unclear.•We examine outcomes after a 12-week RCT comparing nabiximols (containing equal parts THC & CBD) v placebo.•The nabiximols group reported less cannabis use 12 weeks after stopping treatment.•A 12-week intervention of counselling with nabiximols is suggested.
Previous studies suggest cannabinoid agonist treatment is effective in reducing cannabis use in dependent treatment seekers, however few studies have reported on post-treatment outcomes. We examine cannabis use outcomes 12 weeks after cessation of treatment from a randomised placebo-controlled trial of nabiximols for the treatment of cannabis dependence.
128 participants received either nabiximols (n = 61) or placebo (n = 67) for 12 weeks, in combination with psychosocial interventions. Self-reported number of days of cannabis use in the previous 28 days was measured at baseline, 4, 8, and 12 weeks (end of treatment) and again at 24 weeks (3 months after treatment ceased). Urinalysis was used to confirm self-report data at Week 24 interview.
A factorial mixed-effects model for repeated measures regression revealed that the nabiximols group used cannabis on 6.8 fewer days in the previous 28 days at week 12 (end of treatment) than the placebo group (p = 0.002, CI: 2.1,11.4), and 6.7 fewer days in the previous 28 days at the week-24 follow-up than the placebo group (p = 0.006, CI: 1.4,12.1). A significantly higher proportion of the nabiximols group (14/61; 23 %) than the placebo group (6/67; 9%) reported abstinence from cannabis in the previous 28 days at the week-24 research interview OR=3.0, CI: 1.1, 9.1; p=0.035, NNT=8, CI: 4, 71).
The benefits of treatment incorporating nabiximols with psychosocial interventions in reducing cannabis use appears to persist for up to 3 months after the cessation of treatment. A stepped care model of treatment is proposed.
Australian New Zealand Clinical Trials Registry (ACTRN12616000103460) https://www.anzctr.org.au</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>32768992</pmid><doi>10.1016/j.drugalcdep.2020.108220</doi></addata></record> |
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| ispartof | Drug and alcohol dependence, 2020-10, Vol.215, p.108220, Article 108220 |
| issn | 0376-8716 1879-0046 |
| language | eng |
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| subjects | Australia Cannabidiol Cannabinoid Receptor Agonists - therapeutic use Cannabinoid receptors Cannabis Clinical outcomes Dependence Diagnostic tests Dronabinol Drug Combinations Female Health services utilization Help seeking behavior Humans Interviews Male Marijuana Marijuana Abuse - therapy Marijuana Smoking Nabiximols Outcomes Psychosocial factors Psychosocial intervention Psychosocial therapy RCT Regression models Self report Substance-Related Disorders Treatment Treatment Outcome Urinalysis |
| title | Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial |
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