Evidence map›Paper›PMID 34062288›Full record

SynthesisThe International journal on drug policy2021

Pharmacotherapies for cannabis use disorder: A systematic review and network meta-analysis.

Anees Bahji, Arthi Chinna Meyyappan, Emily R Hawken, Philip G Tibbo

Open access · greenAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 6 pooled it
3.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 6 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Pharmacotherapies for cannabis use disorder.The Cochrane database of systematic reviews · 2025
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  7. N-acetylcysteine for youth cannabis use disorder: randomized controlled trial main findings.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Anees BahjiDepartment of Psychiatry, University of Calgary, Calgary, AB, Canada. Electronic address: anees.bahji1@ucalgary.ca.
Arthi Chinna MeyyappanDepartment of Psychiatry, Queen's University, Kingston, ON, Canada; Centre for Neurosciences, Queen's University, Kingston, ON, Canada; Providence Care Hospital, Kingston, ON, Canada.
Emily R HawkenDepartment of Psychiatry, Queen's University, Kingston, ON, Canada; Centre for Neurosciences, Queen's University, Kingston, ON, Canada; Providence Care Hospital, Kingston, ON, Canada.
Philip G TibboDepartment of Psychiatry, Dalhousie University, Halifax, NS, Canada; Nova Scotia Early Psychosis Program, Halifax, NS, Canada.
Queen's University · CADalhousie University · CAUniversity of Calgary · CA

Funding

Mentoring the next generation of addiction clinician scientists while responding to the opioid epidemicR25DA037756 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI FAIRBAIRN, NADIA · 2014 to 2023
$3.6M
NIDA NIH HHS R25 DA037756
6 · The paper itself

Abstract

objectiveThis study aimed to determine the efficacy and acceptability of pharmacotherapies for cannabis use disorder (CUD).

methodsWe conducted a systematic review and frequentist network meta-analysis, searching five electronic databases for randomized placebo-controlled trials of individuals diagnosed with CUD receiving pharmacotherapy with or without concomitant psychotherapy. Primary outcomes were the reduction in cannabis use and retention in treatment. Secondary outcomes were adverse events, discontinuation due to adverse events, total abstinence, withdrawal symptoms, cravings, and CUD severity. We applied a frequentist, random-effects Network Meta-Analysis model to pool effect sizes across trials using standardized mean differences (SMD, g) and rate ratios (RR) with their 95% confidence intervals.

resultsWe identified a total of 24 trials (n=1912, 74.9% male, mean age 30.2 years). Nabilone (d=-4.47 [-8.15; -0.79]), topiramate (d=-3.80 [-7.06; -0.54]), and fatty-acid amyl hydroxylase inhibitors (d=-2.30 [-4.75; 0.15]) reduced cannabis use relative to placebo. Dronabinol improved retention in treatment (RR=1.27 [1.02; 1.57]), while topiramate worsened treatment retention (RR=0.62 [0.42; 0.91]). Gabapentin reduced cannabis cravings (d=-2.42 [-3.53; -1.32], while vilazodone worsened craving severity (d=1.69 [0.71; 2.66]. Buspirone (RR=1.14 [1.00; 1.29]), venlafaxine (RR=1.78 [1.40; 2.26]), and topiramate (RR=9.10 [1.27; 65.11]) caused more adverse events, while topiramate caused more dropouts due to adverse events.

conclusionsBased on this review, some medications appeared to show promise for treating individual aspects of CUD. However, there is a lack of robust evidence to support any particular pharmacological treatment. There is a need for additional studies to expand the evidence base for CUD pharmacotherapy. While medication strategies may become an integral component for CUD treatment one day, psychosocial interventions should remain the first line given the limitations in the available evidence.

Indexed as

Marijuana AbuseAdultFemaleHumansMaleCannabinoidComparative effectivenessMeta-analysisOutcome assessment

Identifiers

PMID34062288
PMCPMC8881089
OpenAlexW3164437855

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.