In recent years, gabapentin, a GABA analogue, has been utilized in off-label applications in the treatment of some forms of anxiety. Gabapentin is not a narcotic. This drug has also been used to treat certain manifestations of neuropathic pain; gabapentin use in pain management is widespread. In the treatment of cannabis-dependent patients, some addiction medicine physicians have taken to using gabapentin as a means of reducing patients' symptoms of drug withdrawal. In many of those cases, the course of treatment progressed faster and involved fewer relapses. In all, it appeared that gabapentin possessed some real promise in helping cannabis addicts cope with the debilitating effects of withdrawal. To that end, researchers conducted a pilot study of gabapentin's effectiveness. In a 12-week randomized, placebo-controlled trial, 50 chronic and dependent cannabis users were enrolled in a careful study. All participants received motivational enhancement and counseling in the form of cognitive behavioral therapy[1].
Compared to placebo, those who were treated with gabapentin exhibited fewer days of cannabis use and lessened symptoms of withdrawal and drug cravings. The gabapentin-using patients also exhibited greater improvement in executive function and fewer systemic physical problems associated with their drug use. In this study, patients were treated with 1200 mg of the drug in three divided daily doses. The drug appeared to be well tolerated. With a broad spectrum of positive effects apparent in this study, gabapentin looks like a medication that can have immediate and beneficial effects on the symptoms and progression of recovering cannabis addicts. In related news, N-acetylcysteine (NAC) has also been evaluated for efficacy in the treatment of cannabis dependent teenagers[2].
NAC has been proffered as a potential benefit in the treatment of cocaine and nicotine cravings. It has also been ventured as helpful in reducing some symptoms of schizophrenia and bipolar disorder. A pro-drug of amino acid cysteine, the substance is available in a variety of different compounds and products. Researchers recently concluded a double blind, randomized- and placebo-controlled study of the effects of this substance in 116 cannabis dependent teenagers. Patients received 1200 mg of NAC, twice daily over an eight week course of therapy. In this study, the NAC treatment group had significantly more negative urine test results than those treated receiving placebo (NAC group 40.9% negative; placebo group 27.2% negative). But there were no differences between these groups when secondary measures of effectiveness were considered. Despite the lack of difference in secondary measures, experts opine that NAC may be a useful tool when combined with a contingency-based cannabis dependency treatment program and they argue for further careful study of the substance. Available as an over-the-counter supplement, NAC is well tolerated and is fairly affordable. Gabapentin and N-acetylcysteine both appear to have positive effects on the symptoms and course for recovery of addicted patients. Let's hope that follow-on studies corroborate these early findings. We could all use some good news in the battle against marijuana dependency.
