Cannabidiol as a treatment for craving and relapse in individuals with cocaine use disorder : a randomized placebo‐controlled trial

Abstract

Background and Aims 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. Design Single site double‐blind randomized controlled superiority trial comparing CBD with placebo. Setting Centre hospitalier de l'Université de Montréal, Canada. Participants Seventy‐eight adults (14 women) with moderate to severe CUD participated. Intervention 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. Measurements Primary outcomes were drug‐cue induced craving during detoxication and time‐to‐cocaine relapse during subsequent outpatient treatment. Findings During drug‐cue exposure, craving scores (mean ± 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 (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 to 2.20, p=0.51; Bayes factor = 0.152). CBD treatment was well tolerated and associated mainly with diarrhea. Conclusions Cannabidiol did not reduce cocaine craving or relapse among people being treated for cocaine use disorder.