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大麻使用障碍和戒断的药物治疗现状。

The Current State of Pharmacological Treatments for Cannabis Use Disorder and Withdrawal.

机构信息

Division of Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA.

Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA.

出版信息

Neuropsychopharmacology. 2018 Jan;43(1):173-194. doi: 10.1038/npp.2017.212. Epub 2017 Sep 6.

Abstract

Cannabis use disorder (CUD) commonly occurs and carries a notable economic and functional burden at both individual and societal levels. While there are no clearly efficacious medication treatments for CUD, 20 years of committed and high-quality research in the human laboratory and clinical settings have resulted in medications with demonstrated effectiveness in the treatment of cannabis withdrawal, the ability to reduce cannabis use, and results that point to promising future work. The current state of pharmacology research for CUD highlights the need to consider particular characteristics of patients, such as gender, impulsivity, and severity of cannabis use, when selecting a medication in the off-label treatment of CUD or cannabis withdrawal. As a field, the body of work also exposes some areas in need of improvement in study design, selection of outcome measures, interpretation of results, and the overall process of evaluating candidate medications. Coming to a consensus as a field and addressing these gaps in future research will likely lend itself to further advances in improving the lives of patients with CUD.

摘要

大麻使用障碍(CUD)在个人和社会层面都普遍存在,并带来显著的经济和功能负担。虽然目前没有针对 CUD 的明确有效药物治疗方法,但在人类实验室和临床环境中进行了 20 年的坚定和高质量研究,已经产生了一些在治疗大麻戒断、减少大麻使用方面具有显著效果的药物,并且这些药物的研究结果也为未来的工作指明了方向。目前,针对 CUD 的药理学研究强调了在选择药物治疗 CUD 或大麻戒断的标签外治疗时,需要考虑患者的特定特征,例如性别、冲动性和大麻使用的严重程度。作为一个领域,该领域的工作还暴露了一些在研究设计、选择结果衡量标准、解释结果以及评估候选药物的整体过程中需要改进的领域。作为一个领域达成共识,并在未来的研究中解决这些差距,可能有助于进一步提高 CUD 患者的生活质量。

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