Gender differences among treatment-seeking adults with cannabis use disorder: Clinical profiles of women and men enrolled in the achieving cannabis cessation-evaluating N-acetylcysteine treatment (ACCENT) study.
OBJECTIVE
Recent evidence suggests that women may fare worse than men in cannabis trials with pharmacologic interventions. Identifying baseline clinical profiles of treatment-seeking cannabis-dependent adults could inform gender-specific treatment planning and development.


METHODS
The current study compared baseline demographic, cannabis use, and psychiatric factors between women (n = 86) and men (n = 216) entering the Achieving Cannabis Cessation-Evaluating N-acetylcysteine Treatment (ACCENT) study, a multi-site, randomized controlled trial conducted within the National Drug Abuse Treatment Clinical Trials Network.


RESULTS
Women reported greater withdrawal intensity (p = .001) and negative impact of withdrawal (p = .001), predominantly due to physiological and mood symptoms. Women were more likely to have lifetime panic disorder (p = .038) and current agoraphobia (p = .022), and reported more days of poor physical health (p = .006) and cannabis-related medical problems (p = .023). Women reporting chronic pain had greater mean pain scores than men with chronic pain (p = .006). Men and women did not differ on any measures of baseline cannabis use.


CONCLUSIONS
Cannabis-dependent women may present for treatment with more severe and impairing withdrawal symptoms and psychiatric conditions compared to cannabis-dependent men. This might help explain recent evidence suggesting that women fare worse than men in cannabis treatment trials of pharmacologic interventions. Baseline clinical profiles of treatment-seeking adults can inform gender-specific treatment planning and development.


CONCLUSIONS
Cannabis-dependent women may benefit from integrated treatment focusing on co-occurring psychiatric disorders and targeted treatment of cannabis withdrawal syndrome.(Am J Addict 2017;26:136-144).
Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina.
Brian J
BJ
Sherman
Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina.
Aimee L
AL
McRae-Clark
Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.
Nathaniel L
NL
Baker
Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina.
Susan C
SC
Sonne
Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina.
Therese K
TK
Killeen
CODA, Inc., Portland, Oregon.
Kasie
K
Cloud
Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina.
Kevin M
KM
Gray
D000111:Acetylcysteine / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D002186:Cannabinoids / Q000494:pharmacology*; D015897:Comorbidity; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000009:adverse effects; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010346:Patient Care Management / Q000379:methods; D012737:Sex Factors; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000517:prevention & control
D002186:Cannabinoids; D016166:Free Radical Scavengers; D000111:Acetylcysteine