Against the backdrop of cannabis legalization and shifting social perceptions, cases of cannabis use disorder (CUD) are steadily increasing. However, to date, there is no FDA-approved medication specifically for the management of this condition. Scientific attention has turned toward varenicline, which acts on the same receptors in the brain’s “reward system” that are activated during cannabis use. Consequently, researchers aimed to determine whether this drug could reduce usage frequency and withdrawal symptoms.
Mechanism of Action of Varenicline
The drug acts on specific receptors in the brain—functioning as a partial agonist of nicotinic acetylcholine receptors and a full agonist of receptors—which are activated during substance use. By regulating dopamine release, the medication suppresses the pleasure or “reward” effect derived from harmful substances.
Since varenicline has already demonstrated positive results in the fight against tobacco and alcohol dependence, researchers attempted to utilize it for the treatment of cannabis dependency as well.
Study Details
In a study conducted between 2020 and 2023, active cannabis users (consuming at least 3 days per week) participated. Patients were randomly assigned to two groups: the first group received varenicline (up to 2 mg per day), and the second received a placebo.
Over twelve weeks, both groups underwent weekly medical consultations, during which researchers meticulously monitored usage frequency, laboratory urine markers, withdrawal symptoms (via the Cannabis Withdrawal Scale – CWS), and the degree of substance craving (via the Marijuana Craving Questionnaire – MCQ).
The study results indicated that, in the general population, varenicline did not demonstrate a significant advantage over placebo. However, when the data were analyzed by sex, a completely different picture emerged.
Men: The medication exhibited high therapeutic potential. Along with a sharp decrease in usage frequency, there was a proportional increase in negative urine toxicology results.
Women: A radically different outcome was observed. In addition to the drug’s lack of efficacy, the administration of varenicline increased anxiety and cravings, making the withdrawal period even more difficult.
It is also noteworthy that side effects in the varenicline group, such as nausea and abnormal dreams, were recorded at a higher frequency (83%) compared to the placebo group (56%).
Despite the gender specificity of the therapeutic effect, the results obtained in men suggest a new pathway for treating cannabis dependency. Future research will focus on studying the biological mechanisms responsible for the drug’s differing impact on women.
Source: SSA
