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Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial.
Drug Alcohol Depend. 2020 10 01; 215:108220.DA

Abstract

INTRODUCTION AND AIMS

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.

METHOD

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.

RESULTS

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).

DISCUSSIONS AND CONCLUSIONS

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.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ACTRN12616000103460) https://www.anzctr.org.au.

Authors+Show Affiliations

Drug and Alcohol Services, South East Sydney Local Health District, NSW, Australia; Division Addiction Medicine, Faculty Medicine and Health, University of Sydney, NSW, Australia; NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Australia. Electronic address: Nicholas.lintzeris@health.nsw.gov.au.Drug and Alcohol Services, South East Sydney Local Health District, NSW, Australia; Division Addiction Medicine, Faculty Medicine and Health, University of Sydney, NSW, Australia; NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Australia.NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Australia; Drug and Alcohol Services, Hunter New England Local Health District, NSW, Australia; Priority Research Centre for Brain and Mental Health, School of Medicine and Public Health, University of Newcastle, NSW, Australia.University of New South Wales, NSW, Australia.Lambert Initiative Cannabinoid Therapeutics, University of Sydney, NSW, Australia.University of Tasmania, TAS, Australia.National Health and Medical Research Council, Clinical Trials Centre, Faculty Medicine and Public Health, University of Sydney, NSW, Australia.Drug and Alcohol Services, South East Sydney Local Health District, NSW, Australia; Division Addiction Medicine, Faculty Medicine and Health, University of Sydney, NSW, Australia; NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Australia; University of New South Wales, NSW, Australia.NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Australia; Drug and Alcohol Services, Hunter New England Local Health District, NSW, Australia.NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), Australia; Drug Health, Western Sydney Local Health District, NSW, Australia.Lambert Initiative Cannabinoid Therapeutics, University of Sydney, NSW, Australia.Drug and Alcohol Services, South East Sydney Local Health District, NSW, Australia; Division Addiction Medicine, Faculty Medicine and Health, University of Sydney, NSW, Australia; National Health and Medical Research Council, Clinical Trials Centre, Faculty Medicine and Public Health, University of Sydney, NSW, Australia.No affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32768992

Citation

Lintzeris, Nicholas, et al. "Cannabis Use in Patients 3 Months After Ceasing Nabiximols for the Treatment of Cannabis Dependence: Results From a Placebo-controlled Randomised Trial." Drug and Alcohol Dependence, vol. 215, 2020, p. 108220.
Lintzeris N, Mills L, Dunlop A, et al. Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial. Drug Alcohol Depend. 2020;215:108220.
Lintzeris, N., Mills, L., Dunlop, A., Copeland, J., Mcgregor, I., Bruno, R., Kirby, A., Montebello, M., Hall, M., Jefferies, M., Kevin, R., & Bhardwaj, A. (2020). Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial. Drug and Alcohol Dependence, 215, 108220. https://doi.org/10.1016/j.drugalcdep.2020.108220
Lintzeris N, et al. Cannabis Use in Patients 3 Months After Ceasing Nabiximols for the Treatment of Cannabis Dependence: Results From a Placebo-controlled Randomised Trial. Drug Alcohol Depend. 2020 10 1;215:108220. PubMed PMID: 32768992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cannabis use in patients 3 months after ceasing nabiximols for the treatment of cannabis dependence: Results from a placebo-controlled randomised trial. AU - Lintzeris,Nicholas, AU - Mills,Llewellyn, AU - Dunlop,Adrian, AU - Copeland,Jan, AU - Mcgregor,Iain, AU - Bruno,Raimondo, AU - Kirby,Adrienne, AU - Montebello,Mark, AU - Hall,Michelle, AU - Jefferies,Meryem, AU - Kevin,Richard, AU - Bhardwaj,Anjali, AU - ,, Y1 - 2020/08/01/ PY - 2020/02/23/received PY - 2020/06/29/revised PY - 2020/07/28/accepted PY - 2020/8/10/pubmed PY - 2021/3/13/medline PY - 2020/8/10/entrez KW - Cannabis KW - Dependence KW - Nabiximols KW - Outcomes KW - RCT KW - Treatment SP - 108220 EP - 108220 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 215 N2 - INTRODUCTION AND AIMS: 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. METHOD: 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. RESULTS: 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). DISCUSSIONS AND CONCLUSIONS: 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. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12616000103460) https://www.anzctr.org.au. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/32768992/Cannabis_use_in_patients_3_months_after_ceasing_nabiximols_for_the_treatment_of_cannabis_dependence:_Results_from_a_placebo_controlled_randomised_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(20)30385-9 DB - PRIME DP - Unbound Medicine ER -