Marijuana dependence: not just smoke and mirrors.
Divya Ramesh, Joel E Schlosburg, Jason M Wiebelhaus, Aron H Lichtman
ILAR Journal 2011 DOI: 10.1093/ilar.52.3.295 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Addiction Cannabis |
| Key findings | The authors argue that chronic exposure to cannabinoids produces physical dependence and a clinically relevant withdrawal syndrome, supported by preclinical and clinical research, and that this dependence may contribute to continued drug use in cannabis-dependent individuals. They note that no medications are approved to treat cannabis dependence or withdrawal and review potential pharmacotherapies such as THC, antidepressants, and lithium, as well as emerging endocannabinoid targets. |
Abstract
Marijuana (Cannabis sativa) is the most commonly used illicit drug worldwide as well as in the Unites States. Prolonged use of marijuana or repeated administration of its primary psychoactive constituent, Δ9-tetrahydrocannabinol (THC), can lead to physical dependence in humans and laboratory animals. The changes that occur with repeated cannabis use include alterations in behavioral, physiological, and biochemical responses. A variety of withdrawal responses occur in cannabis-dependent individuals: anger, aggression, irritability, anxiety and nervousness, decreased appetite or weight loss, restlessness, and sleep difficulties with strange dreams. But the long half-life and other pharmacokinetic properties of THC result in delayed expression of withdrawal symptoms, and because of the lack of contiguity between drug cessation and withdrawal responses the latter are not readily recognized as a clinically relevant syndrome. Over the past 30 years, a substantial body of clinical and laboratory animal research has emerged supporting the assertion that chronic exposure to cannabinoids produces physical dependence and may contribute to drug maintenance in cannabis-dependent individuals. However, no medications are approved to treat cannabis dependence and withdrawal. In this review, we describe preclinical and clinical research that supports the existence of a cannabinoid withdrawal syndrome. In addition, we review research evaluating potential pharmacotherapies (e.g., THC, a variety of antidepressant drugs, and lithium) to reduce cannabis withdrawal responses and examine how expanded knowledge about the regulatory mechanisms in the endocannabinoid system may lead to promising new therapeutic targets.
Comparable studies
Other narrative reviews on cannabis for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The neuropsychopharmacology of cannabis: A review of human imaging studies | 2018 | Review | |
| Substance-Induced Psychoses: An Updated Literature Review General (substance-induced psychosis) | 2021 | Narrative review | |
| New psychoactive substances of natural origin: A brief review | 2017 | Review | |
| New Psychoactive Substances (NPS) – a Challenge for the Addiction Treatment Services | 2017 | Review | |
| Classic Psychedelics in Addiction Treatment: The Case for Psilocybin in Tobacco Smoking Cessation | 2022 | Review |
Citations in the library
Cited by 4
- Chronic exposure to inhaled vaporized cannabis high in Δ9-THC suppresses Adderall-induced brain activity. Frontiers in Pharmacology 2024
- Single and combined effects of plant-derived and synthetic cannabinoids on cognition and cannabinoid-associated withdrawal signs in mice. British Journal of Pharmacology May 2019
- The Pharmacology of Delta-9-Tetrahydrocannabinol (THC) The Science of Marijuana 2019
- Peripheral and Central Effects of THC The Science of Marijuana 2019
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and 10 more in the library