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Study Examines New Treatment for Marijuana Dependence


A new potential treatment for marijuana dependence, and the success of network therapy, which engages family and friends in a patient’s substance abuse treatment, were two of the topics discussed at the recent annual meeting of the New York Society of Addiction Medicine. This is the second of a two-part report on the meeting, “Addiction Medicine 2013: Emerging Problems, Current Treatment.”

Researchers at Columbia University in New York are studying a new treatment for marijuana dependence.

Margaret Haney, PhD, led a study of 11 people, which has not yet been published, of a synthetic version of THC—the active ingredient in marijuana—called nabilone. Marijuana-dependent patients received either a placebo or one of two doses of nabilone.

Nabilone decreased marijuana withdrawal symptoms, such as increasing sleep and appetite, and decreased marijuana self-administration, in a laboratory model of relapse. Patients did not experience a “high” from nabilone, indicating it does not have a high abuse potential. The study was funded by the National Institute on Drug Abuse.

Dr. Haney’s colleague, Ziva Cooper, PhD, of Columbia University, Department of Psychiatry, New York State Psychiatric Institute, noted that while many people do not regard marijuana dependence as a major problem, it can lead to significant impairment or distress. “Marijuana dependence is likely to become more common as marijuana becomes legal in more states,” she said at the recent New York Society of Addiction Medicine meeting.

Marijuana potency has been increasing over the last 40 to 50 years, Dr. Cooper said. There is currently no medication approved by the U.S. Food and Drug Administration for treatment of marijuana dependence. Of people who do seek treatment for marijuana dependence, many are unable to stay abstinent, Dr. Cooper observed. In one study, 71 percent returned to marijuana use within six months.

Another treatment that has shown potential for marijuana dependence is a combination of oral THC and lofexidine, a drug used in the United Kingdom for opiate withdrawal, which is not approved in the United States. In a small study, patients who took the combination treatment had decreased cravings for marijuana and cigarettes, decreased relapse rate and improved sleep compared with either THC or lofexidine alone.

Network Therapy: Involving Family and Friends in Substance Abuse Treatment

Engaging close family and friends in substance abuse counseling—a process called network therapy—can help improve abstinence rates while providing much-needed support, according to an expert at New York University School of Medicine.

Marc Galanter, MD, a psychiatrist who originated network therapy, says including family and friends provides a valuable resource for patients if they relapse, while keeping them accountable. The therapy also provides support to those affected by patients’ substance use disorders.

Dr. Galanter conducted a study, published in 2004, that found substance abuse patients who engaged in network therapy were twice as likely to be abstinent compared with those who did not engage in the treatment.

“Participants in network therapy should have a close, ongoing relationship with the patient, and should not have a substance use disorder, so they don’t undermine the course of treatment,” Dr. Galanter said at the recent annual meeting of the New York Society of Addiction Medicine.

He continues treating patients separately in addition to seeing them as part of network therapy. The friends and family members who agree to be part of network therapy must agree to be available if the patient needs help. “They secure compliance—such as making sure the patient doesn’t go to a bar,” says Dr. Galanter. They also can suggest solutions to help the patient achieve and maintain abstinence.

Patients who know their drug test results will be shared with their network will be more motivated to pass the test, because they won’t want to let their family and friends down, Dr. Galanter observed.

Network therapy can help enforce patient agreements for future behavior, he added. “For instance, a patient may agree that if he can’t become abstinent within a few weeks, he will go into residential treatment. If he backs down, it’s harder for him to dismiss what he initially agreed to if he did so in front of his network.”

23 Responses to this article

  1. Avatar of Dari
    Dari / January 3, 2014 at 1:41 am

    I’m a 22 year old female college student from new york. I been smoking for 2 years straight everyday. I quit as a new years resolution. I’m also a psych major,work at mental disability school and had family members in and out of rehab(thankfully they’re all clean and happy). So I know what addiction is what’s it like. Marijuana is not chemically addictive. It’s a psychological thing. I mean I did it like 3 times high school but I think it was my addiction to cigarettes that triggered it. And cigs was triggered by stress and rebellion(against ex bf not parents lol) and before all that. Growing up I had an addiction to food which I stopped with my own determination by 14. Aka people who are “addicted” to weed aren’t actually addicted to the substance it’s more of an internal issue. My issue is my anxiety and strong oral fixation. ALSO for people who don’t realize when you smoke it’s almost the same as relaxation breathing. Try hardcore breathing exercises and see what I mean. For those who say its addictive and its bad obviously never smoked it. So it would be nice if non smokers would keep their two cents to themselves and leave this conversation UNLESS they are a professional in the subject matter and don’t have a bias against it. I stopped because I was too dependent on it and draining my money.i started spiraling downward when I got my new full time job this fall while still attending my full time school schedule. So my day was from 6am and get home at 1030-1130pm. The bad thing was there would be days I went all the way home just to smoke and would become late for my class by like 10-20 min or just plain cut it because of the anxiety I get from a class staring at me coming late. so it obviously affected my schooling, if not destroyed this semesters grades and now I’m scared of being rejected by new school. I have always been a good student and used to A- to Bs as a grade. I got a B, C, C- and D+ just from lateness and absences.this semester I’m actually an awesome test taker but even my 90s couldn’t help my overall average. I’m very hurt because those were such easy A classes and I did bad right before applying for my new college so they’re gonna look at this semester. The ironic this is that c when I smoke I’m very real and have unbiased views of the world. I would tell myself that I need to stop depending on weed and to find the source of inner issues. So as of new years I’m finally taking the advice of my high self. And after days of research it’s been my untreated ADHD that’s been the root of all my “evil”(I been diagnosed since high school but didn’t think it was that bad. In my mind its what made me into the artist and gamer that I am today.) Anyways I’ve been 4 days “clean” , I had to go cold turkey cause if not I’ll just go to back into my routine because I know myself. It’s been 2 years of the same v thing. Its similar to caffeine addiction. Aka if you’re determined and find the root of your “evil” you’ll eliminate you’re dependency. Also develop a hobby to distract your over active mind or bored mind. Also telling friends or ppl you trust helps a lot. My boyfriend had been a great support system. He even lets me unleash my mood swings on him cause he knows it’s part of the irritability. Maybe cause he knows I don’t mean it lol. Anyways good luck on your goals, you can do it. Remember it’s just weed not heroin” You got this ;-)

  2. Avatar of Jimmy Free
    Jimmy Free / August 6, 2013 at 12:41 pm

    All the anti pot stuff I read say: Marijuana potency has been increasing over the last 40 to 50 years. But it’s just not true. Just as a for instance. When I stated using Cannabis in 1967, east cost, right away I was introduced to Hash, from all the middle eastern countries, including Israel. This stuff was more potent then anything before or after, it’s as strong as it can get. and it all disappeared from the US black market in the early 1970′s. We called the Mexican stuff dirt weed. you could spent more on “fine Columbian” or “DaKine” from the Pacific islands, this and other products, just as strong as today’s grown in USA skunk weed. Now finally Hash has appeared in the marked, also made in the use. Still I remember(fondly) Afgani hash… the best.
    When is see: “Marijuana potency has been increasing over the last 40 to 50 years” It says to me: you really don’t know what you are talking about.

  3. Ben House / March 20, 2013 at 11:08 pm

    In June 1971 “Tricky Dick” signed papers starting the war on drugs and my orders to Vietnam to work in a heroin detox program. We still do not have a common definition of addiction, abuse, etc. and myth still outweighs science regarding THC.
    On topic to the original article AA has functioned as an effective peer or “network” support system for years. And in other than severe overdoses with some of the new intensely potent weed I struggle understanding the value of using medication to soften the fall. A solid detox plan is critical, and must be tailored to the individual. Providing accurate information on what to expect including physical responses and system resistances seems to help my clients.

  4. JZ / March 19, 2013 at 1:22 pm
    One of the toughest challenges to marijuana addiction recovery is the growing perception that pot is harmless, and that somehow cannabis has civil rights. Radical thinking of the worst kind. Stinkin’ thinkin’. The unintended consequence is more lost potential and more addiction.

  5. Avatar of Proud Patient
    Proud Patient / March 9, 2013 at 2:59 pm

    I love how it’s ok to take this synthetic capsule but treat your’ self with a plant, you’d better not – you criminal, PLEASE!

  6. BRENDA / March 8, 2013 at 6:33 pm

    I agree with John Thompson. I am just a parent, who has never smoked marijuana, raised 2 kids, and found out that “almost everyone” does. I also witnessed 2 kiddos with great potential in life throw it all away because of their addiction to marijuana. Some people are “wired” for addiction and some are not. But those who are, they are the ones who lose, even if it is “only” marijuana.

  7. docbarry / March 8, 2013 at 5:33 pm

    It’s too bad that some of the best minds of science neglect getting at the causal factors of use/abuse/dependence. If one has the Opportunity to Read Courtwright’s book, “Forces of Habit’, I believe that you will realize that this kind of work is just like a dog chasing it’s tail. There will be a new drug shortly, and our capital will try to develop new ways of treating abuse of it.
    I would just like to postulate that Fear, the way most humans are wired, creates anxiety. If we could nurture our infants and toddlers, so they did not see adults has giants, that may or not be nice, perhaps that type of change, coupled with methods of teaching the development of coping skills that work, maybe there will be no desire to escape or change this reality, but rather to thrive in it.
    Please consider what a change in social policy could really do?

  8. Avatar of David Schnee
    David Schnee / March 8, 2013 at 3:47 pm

    I am outraged by those who are trivializing or denying Cannabis Addiction. Competent clinicians or those in recovery that provide services to cannabis, alcohol or any other drug addict would never get into the soft drug/hard drug nonsense or think that an addict can control or moderate his or her using. Most people can drink or get high and not develop the symptoms of addiction. These include those who abuse substances now and then. Addiction is not about a habit, it is about significant impairment and/or distress like any other illness. I agree with Mr. John Thompson who commented above when he said, “Shame on you”

  9. Dave / March 8, 2013 at 2:49 pm

    As a dual diagnosis counselor, I find people who are suffering from symptoms that can be aggravated by cannabis use (anxiety, depression,psychosis, irritability) and yet are unable to conduct the simple experiment of stopping use for a few months to see if they improve.
    They often use the argument that it is “harmless” and therefore cannot be contributing to their problem, but are not able to take the rational step of stopping use to see if symptoms improve. If this is not addiction, what is it?

  10. Avatar of John thompson
    John thompson / March 8, 2013 at 12:36 pm

    I have provided chemical dependency treatment in inpatient, and IOP for more than twenty-five yrs and anyone who says they have never met a marijuana addict is either blind or just not honest. The withdrawal symptoms have been clearly documented in the literature as the same as tobacco and I have worked with hundreds of chronic marijuana users who when they try to quit report the same withdrawal symptoms… As well hundreds report that they want to stop smoking and find it very difficult or they give up and relapse back into using – this my friends is addiction… If a person is willing to carry someone else’s urine in their underpants, go to juvenile or jail for positive UAs, sacrifice important relationships and activities – these are all symptoms of addiction and thousands of chronic marijuana abusers fit this description – stop the denial! Just like alcohol it might be harmless to some but life destroyer for others. The ones who suffer the most are adolescents who damage their developing brains and squander their potential and future while you all tell them NO PROBLEM – not even a drug or some “Soft drug”! Shame on you!

  11. Avatar of todd sign
    todd sign / March 7, 2013 at 8:59 am

    The reason why people that go into rehab for marijuana use is usually a state or court appointed marijuana “treatment” program. They have a choice to go to jail or do an expensive treatment program. I would rather do treatment than go to jail. That is why the majority go back to using marijuana. Marijuana does not have the same ‘brain activity’ addiction reaction than any other addiction compared to coffee, heroin, or cigarettes. Habit forming and addiction are two different things.

  12. Avatar of James Morris
    James Morris / March 6, 2013 at 5:57 pm

    Firstly cannabis/marijuana is less physically addictive than caffeine, far less than alcohol, and barely even comparable to nicotine.

    ‘Marijuana dependence is likely to become more common as marijuana becomes legal in more states’ – That is absurd! If cannabis/marijuana dependence really is a problem, then through legalization, it can finally be seen and treated as a medical problem, as appose to a criminal problem, reducing the harm of dependence.

    ‘Marijuana potency has been increasing over the last 40 to 50 years’ – Why could this be? Maybe it has something to do with the fact that the drug has been in control of the black market for around the same length of time. Cannabis has gotten stronger because dealers will grow it to be as potent as possible, in order to make as much money as possible… In the hands of responsible, licensed outlets, they could choose to grow weaker strains if they see fit.

    Finally, cannabis/marijuana is likely to be any safer than any synthetic treatment for it.

  13. Avatar of James
    James / March 6, 2013 at 9:57 am

    I’ve worked with substance users of all kinds, I’m yet to come across people with addictions to Cannabis, or any soft drug for that matter, particularly when they use that one substance exclusively. I stand by that vulnerable people are in need of help if any activity in their life destabilises their livelihood or opportunities in life, but that is usually very closely linked with criminalising people for possession in the first place.

    Most people use drugs recreationally, and they are simply not problem drug users, they do not have addictions, they carry on with their lives, and their enjoyment of a substance does not interfere in their lives. Alcohol is the most popular, then Cannabis.

    Vulnerable people who may use Cannabis as a means of escape would be better off with opportunities to progress in life. Many of the young people who I’ve worked with in the past have not been solely Cannabis users, they have been Diazepam, Alcohol, Cocaine, Mephedrone, Codeine, “Legal High”, and Heroin users, and use Synthetic Cannabis to boost their high as it is stronger than Cannabis (and theres no tell tale smell as they may be excluded from services through judgemental Government policies if discovered). This is problematic use. Cannabis rarely factors into it, and is by far the safest substance they are taking.

    Recreational harder drugs from the Benzo family (Diazepam, Temazepam, etc), the Opiate/Opioid family (Codeine, Methadone, Heroin), and Cocaine pose actual risks of addiction, coupled with a massive increase risk taking behaviour and chance of overdose.

    So let me get this straight, you want to medicate these people for “Cannabis addiction” with another, more dangerous substance that mimics Cannabis, and has never been tested in the long-term for detrimental effects on the human mind and body, nevermind the social harms it may cause? I find this hard to believe.

    It cannot be compared to Opiate substitution programmes. Cannabis is not Heroin. The primary purpose of Opiate substitution programmes are to reduce the harm of Heroin tolerance lows and highs which can drop dramatically after about 18 hours of last use, and a better “batch” could cause overdose and to gradually reduce use over a long period of time to also stop withdrawal.

    You can’t overdose on Cannabis, you don’t go through withdrawals.

    The use of the term “addiction” simply doesn’t apply. Poor “science”.

    • Peter Byrne / September 8, 2014 at 6:11 pm

      James your talking through your hole when you say you dont go through withdrawals. Im smoking cannabis for the past 20 years dude bog hits for the past five and let me tell you when I run out its rough really rough.. my mood totally changes.. the fact that you said that means you havnt been working with people who have addiction to cannabis

  14. Avatar of Declan
    Declan / March 6, 2013 at 6:27 am

    the problem with any kind of “soft drug” rehabilitation, is they always insist on a blanket “just say no” policy. which means if someone on the program relapses, they see it as a failure and they may feel shame from this, which doesn’t actually help their mental well being, which is what rehab is suppose to do – if we are not improving their mental wellbeing – what exactly is the point in getting them off drugs. I think nowdays the focus of rehabilitation should be on harm reduction and moderation. most habitual weed smokers know how bad it is for them to smoke all the time, but at the same time not one of them wants to never smoke again. rehab should be about learning self control, to use substances occasional with discipline, which should allow a user to enjoy a good night occasional, but then not be dependent on their drug of choice for everyday life.

  15. Avatar of steven
    steven / July 18, 2013 at 1:24 pm

    I am an everyday cannabis smoker I smoke 2-4grams a day and really struggeling to get off it it is a horrible addiction my body and mind has now got used to the HIGH life I started to smoke it at 14yo I am now 22 and can say ive had about 3 weeks in total without the drug but my mind and body is used to having it In the system. Now im trying yo come off the drug and feel terrible anyone got got any suggestions??

  16. Sandra / August 29, 2013 at 2:13 pm

    You are making arguments for the wrong subject. This article is about studies to help users. Not why it should be legal. Not everyone want to remaina user. Some people do realize that THC is a conrolled substance and it DOES affect you brain, reactions and other systems in your body.

  17. Avatar of Sandra
    Sandra / August 29, 2013 at 2:08 pm

    You have not worked with someone with a real Cannabis addiction because it is people like you telling them they don’t have a problem. If you do truly work in the realm of addicts you should know that there are people out there that wake up and have to smoke before they can eat, can’t get a job because they would rather get high every day and will spend their last ten dollars on a dime bag. This is addiction, point blank period. This article is about Marijuana not all the other drugs you are naming how about focusing on the subject at hand.

  18. Avatar of asia
    asia / September 12, 2013 at 3:15 pm

    Well said.

  19. asia / September 12, 2013 at 3:19 pm

    FACTS!!!!! Well said!

  20. asia / September 12, 2013 at 3:28 pm

    Just like me, your best bet is to sign up for rehab outpatient or inpatient. That is exactly what I plan to do, which is what brought me to this page in the first place. Marijuanna is addictive, especially to those who have addictive personalities in the first place. No matter WHAT the adddiction is, it is going to affect your life as you and I both know, being that we are heavy marijuanna users. So let’s let God lead us and go to rehab and get our lives in order. We have to take that 1st step to get to the next one, so it’s no time like the present. God Bless you <3

  21. Avatar of Jeffrow
    Jeffrow / October 20, 2013 at 10:05 pm

    Couldn’t of said it any better

  22. David / September 8, 2014 at 6:28 pm

    I’d leave the god bit out but fully agree with you 100% on what you said I tried an outpatient thing it didnt work im now awaiting an assessment for a 4-5 week detox program from Cannabis..Im just coming into my 21st year of smoking it almost every day when I run out I go through hell but here’s the thing im taking small doses of anti anxiety drug called Lyrica for help with withdrawals and they do help some bit but I dont want to be cross addicting so thats why I think I should at least for assessment… any thoughts???

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