Can NAC help with Cannabis Use Disorder?
Cannabis is one of the commonly used illicit substances. The use has increased further with multiple states legalizing cannabis use in the United States.
Cannabis use disorder is described as a problematic pattern of cannabis leading to clinically significant impairment or distress, with at least two of the following occurring within 12 months period:
- Cannabis is taken in either a large amount OR over a longer period than was intended.
- Persistent desire OR unsuccessful efforts to cut down.
- Great deal of time is spent in obtaining, using, or recovering from its effects.
- Craving present.
- failure to fulfill major role obligations: work, school, or home.
- Persistent cannabis use despite persistent or recurrent social or interpersonal problems.
- Important social, occupational, or recreational activities are either given up or reduced.
- Recurrent cannabis use in physically hazardous situations.
- Recurrent cannabis use despite knowledge of its physical or psychological effects.
- Tolerance
- Withdrawal
There is clearly a need for an effective treatment for cannabis use disorder.
Psychological treatments are first-line and a combination of cognitive-behavioral therapy (CBT), motivational enhancement therapy (MET), and contingency management (CM) has the best evidence base.
These psychosocial treatments have less than optimal responses and will need an augmentation with pharmacological treatment, but none is FDA approved at this time.
To date, the most promising medication for the treatment of cannabis use disorders is N-acetylcysteine (NAC).
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Answer: 2400 mg/day.
Psychiatry Education Forum Academy’s next video discussion will focus on this clinical topic:
This 15 min video discussion will be summarized in the following sections:
- Mechanism behind NAC efficacy for addiction?
- NAC: Dosing and Duration of treatment for cannabis use disorder.
- Which population group can get more benefit from NAC treatment?
- Adverse events with NAC treatment for cannabis use disorder.
- Can NAC alone help with cannabis use disorder?
Here is one of the slides from this presentation:
Mechanism Behind NAC Efficacy for Addiction:
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