September 22, 2023

Experimental drug for marijuana addiction shows promise, small study finds

As marijuana use in the United States reaches record highs among young adults, there is a growing need to address the potential for addiction, experts say.

An experimental pill, the first in a new class of drugs, has shown promise in treating cannabis use disorders, according to results of a small trial published Thursday in Nature Medicine.

The drug, known as AEF-0117, was found to reduce the perceived “good effects” of cannabis by up to 38 percent in a double-blind, randomized, controlled Phase 2a trial led by Columbia University researchers. Phase 2a usually means that researchers determine the right dosage for the next phase of testing.

Meg Haney, the study’s lead author and director of the cannabis research lab at Columbia University, described the preliminary findings on the medication as “very encouraging.”

No drugs have yet been approved by the Food and Drug Administration to treat cannabis use disorder, which is estimated to affect up to 30 percent of marijuana users, according to the Centers for Disease Control and Prevention.

Cannabis use disorder is diagnosed as the inability to stop using marijuana, even when it causes significant disruptions to daily life, such as interfering with relationships or work.

According to a report by the Substance Abuse and Mental Health Services Administration, an estimated 14 million Americans will struggle with a cannabis use disorder by 2021.

“This is one of the few drugs I’ve tested that directly reduces the effects of cannabis,” Haney said. “The question I asked was, can I change the way people feel about this and thereby help them to abstain from cannabis?”

The drug was studied in 29 adult men and women diagnosed with a cannabis use disorder. They smoked an average of about 3 grams of marijuana a day, six days a week.

The doses of the drug studied were a low dose of 0.06 milligrams (mg) and a higher dose of 1 milligram.

Participants began the trial by first being given either the drug or a placebo for five days. They took the drug at 9 a.m. every day and smoked a controlled amount of cannabis 3.5 hours later.

They were then asked questions such as “I feel high” or “I feel a good effect” five times – from 20 minutes after smoking to two hours after smoking.

The lower dose reduced the subjective “good effects” of cannabis by 19 percent, while the higher dose reduced it by 38 percent.

Only the higher dose was able to significantly reduce the amount of cannabis the participants ended up using later in the day.

There were no significant side effects and the drug did not cause withdrawal symptoms.

The small study’s findings will need to be confirmed in larger trials in progress, Haney said, as about 300 patients nationwide are participating in a phase 2b trial. The results are expected early next year.

How cannabis affects the brain

The drug, developed by French biotech company Aelis Farma, is unique in the specific way it targets the brain, Haney said.

Cannabis primarily affects the brain through the psychoactive compound tetrahydrocannabinol, or THC, which binds to a receptor in the brain called CB1.

“This particular compound can only block certain actions of the receptor,” says Dr. Scott Hadland, an addiction specialist at Mass General Hospital for Children in Boston. “That way you can block the euphoric effects of cannabis without causing pain.” these adverse side effects.”

Ultimately, Hadland, who was not involved in the study, said this drug works best in patients who are motivated to quit.

“We have to remember that this is a drug that, because it blocks the rewarding effects of cannabis, patients really have to want to take it,” he said. “We need motivated patients who want to stop their cannabis use to take the medication to make it work.”

Potential harm from potent cannabis

Hadland said that while many people use marijuana without a problem, he worries that the public may not be aware of the potential harm.

“What is under-recognized in our society now that we have expanded access to cannabis is that some people have very serious problems with it,” he said.

Hadland said signs of a cannabis use disorder in young people could include:

  • Struggles at school, such as deteriorating grades.

  • Changes in relationships.

  • Giving up activities they used to love, such as being part of a sports team or a club at school.

Haney is saddened by the public health challenge posed by more states legalizing adult recreational use of marijuana.

“There’s no fair discussion about it,” she said. “I think the public is largely unaware of the risks of cannabis use, and it’s just been talked about in very favorable terms.”

Hadland, who works with teens and young adults struggling with marijuana addiction at his clinic, says there is a need for effective drugs.

“Our care has been really hampered by a lack of drugs that are effective for treatment,” he said. “This is different from other substances like opioids, nicotine and alcohol, for which we have effective drugs.”

Larger studies will be needed to confirm the new findings and learn more about possible side effects of the drug, Hadland said.

David Kroll, a toxicologist and co-director of the cannabis science and medicine education programs at the University of Colorado’s Skaggs School of Pharmacy, also called the drug promising, but noted that it appears to have been tested on products with lower potency than what is commonly believed. is used. available in the market. (He was also not involved in the investigation.)

The cannabis smokes tested contained 7 percent THC, which equates to about 67 mg of THC, a dose that is typically a third of what he sees in the joints available in Colorado today.

“The products available now are just amazing,” he said. “There is no connection to the cannabis your parents or grandparents may have smoked.”

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