Marijuana neurobiology and treatment.
Marijuana is the number one illicit drug of abuse worldwide and a major public health problem, especially in the younger population. The objective of this article is to update and review the state of the science and treatments available for marijuana dependence based on a pre-meeting workshop that was presented at ISAM 2006. At the workshop, several papers were presented addressing the neurobiology and pharmacology of marijuana and treatment approaches, both psychotherapy and medications, for marijuana withdrawal. Medicolegal and ethical issues concerning marijuana medical use were also discussed. Concise summaries of these presentations are incorporated in this article, which is meant to be an updated review of the state of the science. Major advances have been made in understanding the underpinning of marijuana dependence and the role of the CNS cannabinoid system, which is a major area for targeting medications to treat marijuana withdrawal and dependence, as well as other addictions. Behavioral therapies are efficacious for facilitating abstinence from marijuana. Nefazadone, Marinol, and buspirone are showing early positive signals for efficacy in ameliorating marijuana withdrawal symptoms. Effective psychotherapeutic approaches are available and promising medications studies need to be confirmed in outpatient trials. The next few years looking promising for translational research efforts to make treatment widely accessible to patients with marijuana dependence.
Elkashef
Ahmed
A
Clinical Medical Branch, Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA. ae8a@nih.gov
Vocci
Frank
F
Huestis
Marilyn
M
Haney
Margaret
M
Budney
Alan
A
Gruber
Amanda
A
el-Guebaly
Nady
N
D001921:Brain / Q000187:drug effects*; D002065:Buspirone / Q000627:therapeutic use*; D002188:Cannabis / Q000009:adverse effects*; D015928:Cognitive Behavioral Therapy; D013759:Dronabinol / Q000627:therapeutic use*; D006801:Humans; D002189:Marijuana Abuse / Q000534:rehabilitation* / Q000628:therapy; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010879:Piperazines; D012932:Social Facilitation; D014230:Triazoles / Q000627:therapeutic use*
D009292:Narcotic Antagonists; D010879:Piperazines; D014230:Triazoles; C051752:nefazodone; D013759:Dronabinol; D002065:Buspirone