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Nabilone decreases marijuana withdrawal and a laboratory measure of marijuana relapse.

Abstract

Few individuals seeking treatment for marijuana use achieve sustained abstinence. The cannabinoid receptor agonist, Δ(9)-tetrahydrocannabinol (THC; dronabinol), decreases marijuana withdrawal symptoms, yet does not decrease marijuana use in the laboratory or clinic. Dronabinol has poor bioavailability, which may contribute to its poor efficacy. The FDA-approved synthetic analog of THC, nabilone, has higher bioavailability and clearer dose-linearity than dronabinol. This study tested whether nabilone administration would decrease marijuana withdrawal symptoms and a laboratory measure of marijuana relapse relative to placebo. Daily, nontreatment-seeking marijuana smokers (8 men and 3 women), who reported smoking 8.3±3.1 marijuana cigarettes/day completed this within-subject study comprising three, 8-day inpatient phases; each phase tested a different nabilone dose (0, 6, 8 mg/day, administered in counter-balanced order on days 2-8). On the first inpatient day, participants took placebo capsules and smoked active marijuana (5.6% THC) at six timepoints. For the next 3 days, they had the opportunity to self-administer placebo marijuana (0.0% THC; withdrawal), followed by 4 days in which active marijuana was available for self-administration (5.6% THC; relapse). Both nabilone dose conditions decreased marijuana relapse and reversed withdrawal-related irritability and disruptions in sleep and food intake (p<0.05). Nabilone (8 mg/day) modestly worsened psychomotor task performance. Neither dose condition increased ratings of capsule 'liking' or desire to take the capsules relative to placebo. Thus, nabilone maintenance produced a robust attenuation of marijuana withdrawal symptoms and a laboratory measure of relapse even with once per day dosing. These data support testing of nabilone for patients seeking marijuana treatment.

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  • Authors+Show Affiliations

    ,

    Division on Substance Abuse, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA. mh235@columbia.edu

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    MeSH

    Adult
    Dose-Response Relationship, Drug
    Dronabinol
    Female
    Humans
    Male
    Marijuana Abuse
    Marijuana Smoking
    Psychomotor Performance
    Secondary Prevention
    Self Administration
    Substance Withdrawal Syndrome
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    23443718

    Citation

    Haney, Margaret, et al. "Nabilone Decreases Marijuana Withdrawal and a Laboratory Measure of Marijuana Relapse." Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, vol. 38, no. 8, 2013, pp. 1557-65.
    Haney M, Cooper ZD, Bedi G, et al. Nabilone decreases marijuana withdrawal and a laboratory measure of marijuana relapse. Neuropsychopharmacology. 2013;38(8):1557-65.
    Haney, M., Cooper, Z. D., Bedi, G., Vosburg, S. K., Comer, S. D., & Foltin, R. W. (2013). Nabilone decreases marijuana withdrawal and a laboratory measure of marijuana relapse. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, 38(8), pp. 1557-65. doi:10.1038/npp.2013.54.
    Haney M, et al. Nabilone Decreases Marijuana Withdrawal and a Laboratory Measure of Marijuana Relapse. Neuropsychopharmacology. 2013;38(8):1557-65. PubMed PMID: 23443718.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Nabilone decreases marijuana withdrawal and a laboratory measure of marijuana relapse. AU - Haney,Margaret, AU - Cooper,Ziva D, AU - Bedi,Gillinder, AU - Vosburg,Suzanne K, AU - Comer,Sandra D, AU - Foltin,Richard W, Y1 - 2013/02/26/ PY - 2013/2/28/entrez PY - 2013/2/28/pubmed PY - 2014/2/14/medline SP - 1557 EP - 65 JF - Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology JO - Neuropsychopharmacology VL - 38 IS - 8 N2 - Few individuals seeking treatment for marijuana use achieve sustained abstinence. The cannabinoid receptor agonist, Δ(9)-tetrahydrocannabinol (THC; dronabinol), decreases marijuana withdrawal symptoms, yet does not decrease marijuana use in the laboratory or clinic. Dronabinol has poor bioavailability, which may contribute to its poor efficacy. The FDA-approved synthetic analog of THC, nabilone, has higher bioavailability and clearer dose-linearity than dronabinol. This study tested whether nabilone administration would decrease marijuana withdrawal symptoms and a laboratory measure of marijuana relapse relative to placebo. Daily, nontreatment-seeking marijuana smokers (8 men and 3 women), who reported smoking 8.3±3.1 marijuana cigarettes/day completed this within-subject study comprising three, 8-day inpatient phases; each phase tested a different nabilone dose (0, 6, 8 mg/day, administered in counter-balanced order on days 2-8). On the first inpatient day, participants took placebo capsules and smoked active marijuana (5.6% THC) at six timepoints. For the next 3 days, they had the opportunity to self-administer placebo marijuana (0.0% THC; withdrawal), followed by 4 days in which active marijuana was available for self-administration (5.6% THC; relapse). Both nabilone dose conditions decreased marijuana relapse and reversed withdrawal-related irritability and disruptions in sleep and food intake (p<0.05). Nabilone (8 mg/day) modestly worsened psychomotor task performance. Neither dose condition increased ratings of capsule 'liking' or desire to take the capsules relative to placebo. Thus, nabilone maintenance produced a robust attenuation of marijuana withdrawal symptoms and a laboratory measure of relapse even with once per day dosing. These data support testing of nabilone for patients seeking marijuana treatment. SN - 1740-634X UR - https://www.unboundmedicine.com/medline/citation/23443718/Nabilone_decreases_marijuana_withdrawal_and_a_laboratory_measure_of_marijuana_relapse_ L2 - http://dx.doi.org/10.1038/npp.2013.54 DB - PRIME DP - Unbound Medicine ER -