Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.
Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.
Addiction. 2021 Sep;116(9):2431-2442. doi: 10.1111/add.15417. Epub 2021 Feb 9.
Cocaine use disorder (CUD) is a significant public health concern for which no efficacious pharmacological interventions are available. Cannabidiol (CBD) has attracted considerable interest as a promising treatment for addiction. This study tested CBD efficacy for reducing craving and preventing relapse in people with CUD.
Single-site double-blind randomized controlled superiority trial comparing CBD with placebo.
Centre Hospitalier de l'Université de Montréal, Canada. Seventy-eight adults (14 women) with moderate to severe CUD participated.
Participants were randomly assigned (1 : 1) by stratified blocks to daily 800 mg CBD (n = 40) or placebo (n = 38). They first underwent an inpatient detoxification phase lasting 10 days. Those who completed this phase entered a 12-week outpatient follow-up.
Primary outcomes were drug-cue-induced craving during detoxication and time-to-cocaine relapse during subsequent outpatient treatment.
During drug-cue exposure, craving scores [mean ± standard deviation (SD)] increased from baseline by 4.69 (2.89) versus 3.21 (2.78) points, respectively, in CBD (n = 36) and placebo (n = 28) participants [confidence interval (CI) = -0.33 to 3.04; P = 0.069; Bayes factor = 0.498]. All but three participants relapsed to cocaine by week 12 with similar risk for CBD (n = 34) and placebo (n = 27) participants (hazard ratio = 1.20, CI = 0.65-2.20, P = 0.51; Bayes factor = 0.152). CBD treatment was well tolerated and associated mainly with diarrhoea.
CBD did not reduce cocaine craving or relapse among people being treated for CUD.
可卡因使用障碍（CUD）是一个严重的公共卫生问题，目前尚无有效的药物干预措施。大麻二酚（CBD）作为一种有前途的成瘾治疗药物引起了广泛关注。本研究测试了 CBD 减少 CUD 患者的渴望和预防复发的疗效。
一项比较 CBD 与安慰剂的单中心、双盲、随机对照优效性试验。
加拿大蒙特利尔大学医疗中心。78 名成年人（14 名女性）患有中重度 CUD 参与了研究。
参与者按照分层块随机分配（1:1）接受每日 800mg CBD（n=40）或安慰剂（n=38）治疗。他们首先接受为期 10 天的住院戒毒期。完成这一阶段的参与者进入为期 12 周的门诊随访。
主要结果是戒毒期间药物线索引起的渴望和随后门诊治疗期间可卡因复发的时间。
在药物线索暴露期间，CBD（n=36）和安慰剂（n=28）参与者的渴望评分分别从基线增加了 4.69（2.89）和 3.21（2.78）点[均值±标准差（SD）]；置信区间（CI）为-0.33 至 3.04；P=0.069；贝叶斯因子=0.498]。除了三名参与者外，所有参与者在第 12 周时都复发了可卡因，CBD（n=34）和安慰剂（n=27）参与者的风险相似（风险比=1.20，CI=0.65-2.20，P=0.51；贝叶斯因子=0.152）。CBD 治疗耐受性良好，主要与腹泻有关。
在接受 CUD 治疗的人群中，CBD 并未减少可卡因的渴望或复发。
