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大麻素治疗大麻使用障碍:接触和帮助青少年的新途径?

Cannabinoids for the treatment of cannabis use disorder: New avenues for reaching and helping youth?

机构信息

Centre for Alcohol and Drug Research, Department of Psychology and Behavioral Sciences, Aarhus University, Denmark.

Centre for Alcohol and Drug Research, Department of Psychology and Behavioral Sciences, Aarhus University, Denmark.

出版信息

Neurosci Biobehav Rev. 2022 Jan;132:169-180. doi: 10.1016/j.neubiorev.2021.11.033. Epub 2021 Nov 22.

Abstract

Cannabis use peaks during adolescence and emerging adulthood, and cannabis use disorder (CUD) is associated with a wide range of adverse outcomes. This is particularly pertinent in youth, because the developing brain may be more vulnerable to adverse effects of frequent cannabis use. Combining evidence-based psychosocial interventions with safe and effective pharmacotherapy is a potential avenue to improve youth outcomes, but we lack approved CUD pharmacotherapies. Here, we review new potential avenues for helping youth with CUD, with a particular focus on cannabinoid-based treatments. Evidence from placebo-controlled RCTs suggests synthetic delta-9-tetrahydrocannabinol (THC) decreases withdrawal symptoms, but not cannabis use, in adults with daily cannabis use/CUD, while findings regarding formulations containing THC combined with cannabidiol (CBD) are mixed. Preliminary evidence from two placebo-controlled RCTs in adults with CUD suggests that both Fatty Acid Amide Hydrolase inhibitors and CBD can reduce cannabis use. However, larger trials are needed to strengthen the evidence. Findings from adults point to cannabinoid-based treatments as a potential strategy that should be examined in youth with CUD.

摘要

大麻使用在青少年和成年早期达到高峰,大麻使用障碍(CUD)与广泛的不良后果相关。这在年轻人中尤为重要,因为发育中的大脑可能更容易受到频繁使用大麻的不良影响。将基于证据的心理社会干预与安全有效的药物治疗相结合,是改善年轻人结局的一种潜在途径,但我们缺乏批准的 CUD 药物治疗方法。在这里,我们回顾了帮助患有 CUD 的年轻人的新的潜在途径,特别关注基于大麻素的治疗方法。安慰剂对照 RCT 的证据表明,合成 delta-9-四氢大麻酚(THC)可减轻每日使用大麻/患有 CUD 的成年人的戒断症状,但不能减少大麻使用,而含有 THC 与大麻二酚(CBD)的配方的结果则喜忧参半。两项在患有 CUD 的成年人中进行的安慰剂对照 RCT 的初步证据表明,脂肪酸酰胺水解酶抑制剂和 CBD 均可减少大麻使用。然而,需要更大规模的试验来加强证据。成年人的研究结果表明,基于大麻素的治疗方法是一种潜在的策略,应该在患有 CUD 的年轻人中进行检查。

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