Nicotine patch for cannabis withdrawal symptom relief: a randomized controlled trial

• Published in: Psychopharmacology 2020-05, Vol.237 (5), p.1507-1519
• Main Authors: Gilbert, David G., Rabinovich, Norka E., McDaniel, Justin T.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biomedical and Life Sciences; Biomedicine; Cannabis; Clinical trials; Emotions; Female; Hallucinogens - therapeutic use; Humans; Male; Marijuana; Marijuana Abuse - drug therapy; Marijuana Abuse - psychology; Marijuana Smoking - drug therapy; Marijuana Smoking - psychology; Neurosciences; Nicotine; Nicotine - administration & dosage; Original Investigation; Pharmacology/Toxicology; Psychiatry; Smokers; Smoking Cessation - methods; Smoking Cessation - psychology; Smoking cessation programs; Substance Withdrawal Syndrome - drug therapy; Substance Withdrawal Syndrome - psychology; Tetrahydrocannabinol; Tobacco; Tobacco Use Cessation Devices - trends; Transdermal medication; Young Adult
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s00213-020-05476-1

Rationale Given that tetrahydrocannabinol (THC) and nicotine have similar effects on negative affect (NA), we hypothesized that a 7-mg nicotine patch (NP) would reduce NA-related cannabis (CAN) withdrawal symptoms in cannabis-dependent (CD) individuals who were not nicotine dependent. Objective We sought to determine whether NP reduces NA across 15 days of CAN abstinence in two groups: non-tobacco smokers (NTS) and light tobacco smokers (LTS). Methods CD participants ( N  = 127; aged 18–35) who used CAN at least 5 times/week for the past 12 + months were randomized to (1) NP or (2) a placebo patch (PP) and received $300 for sustained biochemically verified CAN abstinence. Of those randomly assigned, 52 of 63 NP, and 56 of 64 PP maintained biochemically verified CAN abstinence and 51 NP and 50 PP participants complied with all aspects of the study. Affect and other withdrawal symptoms were measured every 48 h across 15 days of CAN abstinence. Results After controlling for age, tobacco use, baseline THC concentration, and baseline measurements of the dependent variable, NP reduced NA symptoms across the 15-day treatment relative to PP. Differences in NA and CAN withdrawal symptoms were not moderated by tobacco user status. Conclusions The findings provide the first evidence that NP may be able to attenuate NA-related withdrawal symptoms in individuals with cannabis use disorder who are not heavy users of tobacco or nicotine. Clinical trials registry NCT01400243 http://www.clinicaltrials.gov