Tuesday, April 24, 2012

A Drug For Marijuana Withdrawal?


Researchers get good results with gabapentin.

Marijuana, as researchers and pundits never tire of pointing out, is the most widely used illegal drug in the world, by a serious margin. And while the argument still rages, for some years now drug researchers have been migrating to the camp that sees marijuana as an addictive drug for a minority of people who exhibit a propensity for addiction. The scientific literature supporting the contention of marijuana as addictive for some users is robust and growing, as is the body of anecdotal evidence.  It’s also clear that in many countries, cultures, and subcultures, combining cannabis with tobacco is a common practice that increases health risks all around.

Ongoing work at the Scripps Research Institute’s Pearson Center for Alcoholism and Addiction Research in La Jolla, California, has focused in part on the lack of FDA-approved medical therapies for treating marijuana addiction. Barbara J. Mason and ResearchBlogging.orgcoworkers at Scripps have reported preliminary success in a 12-week, double-blind, placebo-controlled pilot study with 50 treatment-seeking volunteers, using the anti-seizure drug gabapentin. Gabapentin, sold as Neurontin, pops up as a possible treatment for various forms of pain and anxiety, and sharp-eyed readers will recall that gabapentin was one of the ingredients in the now-defunct addiction drug Prometa.

Marijuana addiction numbers are hard to come by, and often inflated, since many small-time pot offenders end up in mandatory treatment programs, where they tend to be classified as marijuana addicts, whether or not that is objectively the case. Nonetheless, there are plenty of people seeking treatment on their own for cannabis dependence. For people strongly addicted to pot, the problems are very real, and withdrawal and abstinence pose serious challenges. People for whom marijuana poses no addictive threat should bear this in mind, the way casual drinkers bear in mind the existence of alcoholism in others.

The study, published recently in Neuropsychopharmacology, says that “activation of brain stress circuitry caused by chronic heavy marijuana use” can lead to withdrawal symptoms that persist “for weeks or even months, as in the case of marijuana craving and sleep disturbances.” A variety of existing medications have been tested in recent years, including buspirone, an anti-anxiety medication; Serzone, an antidepressant; and Wellbutrin, an antidepressant commonly used for smoking cessation. None of these treatments has shown any effect on cannabis use or withdrawal, according to Mason.

Gabapentin, as the name suggests, was modeled after the neurotransmitter GABA, and works via a transporter protein to raise GABA levels. Effective only for partial-onset seizures, common side effects include drowsiness, dizziness, and possible weight gain. It is a popular anti-epileptic drug, because it is relatively safe, with a low side-effect profile, compared to many of the medications in its class. For the same reasons, it is a common treatment for neuropathic pain. In addition to neuralgia, it has found some use as a migraine preventative.

Gabapentin normalizes GABA activation caused by corticotrophin-releasing factor, or CRF. CRF is a major player in the brain’s stress responses. As it turns out, withdrawal from both cannabis and alcohol ramp up anxiety levels by increasing CRF release in the amygdala, animal studies have shown. “Gabapentin had a significant effect in decreasing marijuana use over the course of treatment, relative to placebo,” the authors report. In addition, gabapentin produced “significant reductions in both the acute symptoms of withdrawal as well as in the more commonly persistent symptoms involving mood, craving, and sleep.”

As a bonus, the researchers discovered that “overall improvement in performance across cognitive measures was significantly greater for gabapentin-treated subjects compared with those receiving placebo.” Gabapentin was associated with improvement in “tasks related to neurocognitive executive functioning”—things like attention, concentration, visual-motor functioning, and inhibition. Counseling alone, represented by the placebo group, “resulted in less effective treatment of cannabis use and withdrawal, and no improvement in executive function.”

As in the case of Chantix for cigarette cessation, a treatment, which now requires additional caveats about possible suicidal ideation, researchers looking for a treatment for drug withdrawal, must weigh the benefits of pharmacological treatment against the possible side effects of the treatment itself. Does gabapentin for marijuana withdrawal pass the “Do No Harm” test? According to Mason, it does. “Gabapentin was well tolerated and without significant side effects” in the admittedly small trial study. The two groups did not differ in the number of adverse medical events reported in the first two weeks, when dropout rates due to side effects are highest in these kinds of studies. The investigators were not relying solely on self-reporting, either. They used urine drug screens, and verified that only 3% of the study sample tested positive for other drugs.

In short, the authors report that gabapentin reduced cannabis use and eased withdrawal with an acceptable safety profile and no signs of dependence. Gabapentin, the authors conclude, “may offer the most promising treatment for cannabis withdrawal and dependence studied to date.” Further clinical research is needed, of course, but the positive results of this proof-of-concept study should make funding a bit easier.

Mason, B., Crean, R., Goodell, V., Light, J., Quello, S., Shadan, F., Buffkins, K., Kyle, M., Adusumalli, M., Begovic, A., & Rao, S. (2012). A Proof-of-Concept Randomized Controlled Study of Gabapentin: Effects on Cannabis Use, Withdrawal and Executive Function Deficits in Cannabis-Dependent Adults Neuropsychopharmacology DOI: 10.1038/npp.2012.14

Photo Credit: http://pep3799.hubpages.com/

19 comments:

Kevin said...

If it can help withdrawals I think its a good idea. There are drugs for alcoholism and opiate withdrawals so why not for pot?

Tommi Hanley said...

I am not sure about using drugs to withdraw from drugs, it seems a little counter-productive. As an alcoholic who was equally addicted to marijuana for 30 years, I think I would be hard-pressed to give up the "helper" drug because I would still believe I could not do it on my own.

I can totally relate to the practice of mixing the pot with the tobacco. When I tried to take the tobacco out of the mix, I was not nearly as interested in the effects. Despite the fact I already smoked cigarettes, I found it impossible to give up the combination of tobacco and marijuana while in my addiction.

INTP said...

As someone who experienced a month-long cannabis withdrawal syndrome, I truly hope this drug gets approved if it is as effective as the study makes it out to be. I was fortunate enough to get a prescription for Mirtazapine, which alleviated my insomnia and lack of appetite, but did nothing for my cravings and associated depression. Anyone who found this page because they are experiencing marijuana withdrawals, know that it gets better every day, even if you can't feel it. Time heals all wounds.

MichaelPasha said...

I was prescribed Gabapentin to help me deal with Marijuana Withdrawal. Wow! I feel great...almost NO withdrawal symptoms...and I have not smoked any in 5 days. Normally, the withdrawal gets to me after a full day or two. So far so good. I was tempted to smoke tonight (Full Moon!) but am holding back...to see how many days I can go without, using the Gabapentin.

Anonymous said...

What strength of gabapentin and how much and how many times a day? did u take it

Anonymous said...

To the person on gabapentin how what was the strength and dose given daily?

Anonymous said...

i have been a heavy pot user for about a decade now. i also use gabapentin for my sciatica. will gabapentin still work for withdrawals with marijuana if i use both together on the daily?

Anonymous said...

I take gabapentin for marijuana withdraw symptoms. My dose is 300mg capsules 4 times a day. I believe it to be working, but I also was in an intensive outpatient rehab program. Getting the whole enchilada was good for me, but hard to pinpoint what is working where. Together they've gotten me to 50 days sober and counting...One day at a time!

Anonymous said...

I have been a consistent cannabis user for about 8 years. I have been using it now for about 4 years daily.

I can go about 3 hours without smoking before having withdrawl symptoms. Nausea, craving, sweating and even to the point of vomiting on several occasions.

About 2 weeks ago my doctor put me on Gabapentin, and it it doing an amazing job. I am on 300mg, 3 times a day. It does take away the more "mental" aspects of addiction for me, but not the physical which, so far I have not found a solution for, so I am still smoking.

I am not sure if my story is a success one or not, but I can say that Gabapentin helps.

Dirk Hanson said...

It appears that some doctors are willing to give gabapentin a try. And that it might be useful for some, but not all, withdrawal effects. Anyone else had experience with gabapentin?

Anonymous said...

I have been smoking daily 2-3 blunts a day for about 15 years. After reading this article I got a prescription. I'm going to start tomorrow. Wish me luck

Anonymous said...

Can one get a prescription for this yet? I am very interested. No matter how many times I try to quit I always fail and I'm sick of it.

Rodney Knight said...

Marijuana addiction is so strong that overcoming it and coming out triumphantly is a matter of hard toil. This is all the more difficult as popular drugs that can treat other forms of addiction fall flat against marijuana.However, with Gabapentin researchers have seen a ray of hope. Read More

ryan wright said...

For that reason, except if you wish to go all the way down the direction of trying to change human nature, isn't it better to tax and regulate? This would better protect children and the vulnerable, ensure that users have access to safe, quality controlled, product, properly labelled with cannabinoid content. It would also enable us to realise the enormous therapeutic benefits of cannabis or spice incense which are validated by scientific evidence more conclusively than many pharmaceutical products.

mrdeamon said...

Gabapentin is carcinogenic

J.M. female said...

@ mrdeamon....how the heck are u gonna make a statement like "gabapentin is carcinogenic" without backing it up...if u really cared enough to warn people, why not tell them why and how u know this and where u found it out, so others can look into it. Gosh, I have really bad marijuana addiction, and have struggled for years, my withdrawal is really bad, im on here looking for something to help me, and from what ive read gabapentin looks like a good option to try. I also have other family members who have taken it for other types of withdrawal and have had success. But DONT post something discouraging like "gabapentin is carcinogenic" with out explaining!!!!!!!! there are SOME of us who need help and who are taking it seriously and comments like that piss me oFFFFF!!!!!...yeah im irritable cuz im withdrawing right noW!!!!!!

Anonymous said...

Gabapentin has helped me, in that it takes away the nightmares, waking up several times a night in a pile a sweat, etc., that I always experienced after stopping pot use.

I don't find it helps me sleep much longer, though, just better. For me, it's not perfect but it's really helpful nonetheless.

Anonymous said...

Tried the gabapentin for marijuana withdrawal. Did not help at all. Did not feel better. Yes I have been chronic. Maybe that is why it simply does not work for me.

Al P said...

Tried gabapentin after smoking for 5yr and it works great for me I take 100 milligrams 2 times daily very satisfied with this product

Related Posts Plugin for WordPress, Blogger...
 
Real Time Web Analytics