Can Varenicline help treat Cannabis Use Disorder?
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New Research Reveals a Surprising Sex-Specific Breakthrough
As cannabis use continues to rise across the globe, so does the prevalence of Cannabis Use Disorder (CUD). Despite the growing number of people seeking help to reduce or quit their use, clinicians have long faced a major hurdle: there are currently no FDA-approved medications specifically for CUD.
However, a new study published in the journal Addiction offers a glimmer of hope—though with a fascinating twist. Researchers at the Medical University of South Carolina (MUSC) found that varenicline (a medication commonly known as Chantix used for quitting tobacco) can effectively reduce cannabis use, but only in men.
The Study: Repurposing a Proven Tool
Varenicline works by targeting nicotinic receptors in the brain, which play a role in the “reward” system that keeps people hooked on substances. Because tobacco and cannabis are often used together—and share similar neural pathways—researchers hypothesized that varenicline might help break the cycle of cannabis dependence.
The Trial Setup:
Participants: 174 adults with CUD who used cannabis at least three days per week.
Method: A 12-week, double-blind, randomized controlled trial.
Treatment: Participants received either varenicline (1 mg twice daily) or a placebo, combined with weekly medical management sessions.
The Results: A Tale of Two Genders:
When the researchers looked at the group as a whole, the results appeared modest. However, when they broke the data down by sex, a “significant interaction” appeared.
1. For Men: A Significant Reduction
Men who took varenicline saw a substantial drop in their cannabis use compared to those on a placebo.
Sessions per week: Men on varenicline averaged 7.9 sessions, compared to over 12 sessions for those on the placebo.
Days of use: Men on the medication reduced their use to an average of 3.8 days per week, significantly lower than the placebo group.
2. For Women: A Different Story
Surprisingly, the medication did not show the same benefits for women. In fact, women in the varenicline group reported:
Higher levels of withdrawal and cravings.
Increased anxiety compared to other groups.
Lower medication adherence, likely due to these side effects.
Why the Difference?
Lead author Dr. Aimee McRae-Clark noted that while varenicline works equally well for both men and women when quitting tobacco, the biological or psychological interaction with cannabis seems to differ.
One theory is that women may experience more intense withdrawal symptoms or anxiety when using varenicline for CUD, making it harder to stay with the treatment.Â
Clinical Relevance
This trial is important because it investigates a pharmacotherapy where none is currently approved. Behavioral therapies remain the mainstay for CUD, but many patients struggle with cravings and relapse. The possibility that varenicline — already approved and familiar to clinicians — could help reduce cannabis use in some people expands the toolbox for treating CUD.
However, the sex-specific response highlights the need for further research before widespread clinical adoption — especially understanding why women may not benefit similarly and whether different dosing or combined behavioral strategies could improve outcomes.
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Reference: McRae-Clark AL, Gray KM, Baker NL, Sherman BJ, Tolliver B, Burt J, Steplight A, Chapman E, Wagner A. Varenicline for cannabis use disorder: A randomized controlled trial. Addiction. 2026 Jan 14. doi: 10.1111/add.70296. Epub ahead of print. PMID: 41536001.
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