Cannabinoids for the treatment of cannabis use disorder: New avenues for reaching and helping youth?
Cannabinoids for the treatment of cannabis use disorder: New avenues for reaching and helping youth?
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DOI：
10.1016/j.neubiorev.2021.11.033
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发表时间：
2021-11
影响因子：
8.2
通讯作者：
Kristine Rømer Thomsen;B. Thylstrup;Emily A. Kenyon;R. Lees;L. Baandrup;Sarah W. Feldstein Ewing;T. Freeman
中科院分区：
文献类型：
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作者：
Kristine Rømer Thomsen;B. Thylstrup;Emily A. Kenyon;R. Lees;L. Baandrup;Sarah W. Feldstein Ewing;T. Freeman
大麻使用在青春期和成年初期达到高峰，大麻使用障碍（CUD）与各种不良后果有关。这在青少年中尤其重要，因为发育中的大脑可能更容易受到频繁使用大麻的不利影响。将循证心理社会干预与安全有效的药物治疗相结合是改善青少年预后的潜在途径，但我们缺乏经批准的CUD药物治疗。在这里，我们回顾了帮助青少年CUD的新的潜在途径，特别关注基于大麻素的治疗。来自安慰剂对照随机对照试验的证据表明，在每日使用大麻/CUD的成年人中，合成的德尔塔-9-四氢大麻酚（THC）减少了戒断症状，但没有减少大麻的使用，而关于含有四氢大麻酚和大麻二酚（CBD）的配方的发现则是混合的。两项针对成年CUD患者的安慰剂对照随机对照试验的初步证据表明，脂肪酸酰胺水解酶抑制剂和CBD都可以减少大麻的使用。然而，需要更大规模的试验来加强证据。成年人的研究结果表明，大麻素为基础的治疗是一种潜在的策略，应该在青少年CUD中进行研究。
Cannabis use peaks during adolescence and emerging adulthood, and cannabis use disorder (CUD) is associated with a wide range of adverse outcomes. This is particularly pertinent in youth, because the developing brain may be more vulnerable to adverse effects of frequent cannabis use. Combining evidence-based psychosocial interventions with safe and effective pharmacotherapy is a potential avenue to improve youth outcomes, but we lack approved CUD pharmacotherapies. Here, we review new potential avenues for helping youth with CUD, with a particular focus on cannabinoid-based treatments. Evidence from placebo-controlled RCTs suggests synthetic delta-9-tetrahydrocannabinol (THC) decreases withdrawal symptoms, but not cannabis use, in adults with daily cannabis use/CUD, while findings regarding formulations containing THC combined with cannabidiol (CBD) are mixed. Preliminary evidence from two placebo-controlled RCTs in adults with CUD suggests that both Fatty Acid Amide Hydrolase inhibitors and CBD can reduce cannabis use. However, larger trials are needed to strengthen the evidence. Findings from adults point to cannabinoid-based treatments as a potential strategy that should be examined in youth with CUD.