Varenicline as a Treatment for Cannabis Use Disorder

Varenicline as a Treatment for Cannabis Use Disorder

Marijuana is the most commonly used illicit drug, and there is a high demand for effective treatments for cannabis use disorder, yet few specific pharmacological treatments have been developed. This study will evaluate the efficacy and safety of varenicline for reducing marijuana use in adults who use marijuana frequently. Participants will be randomized to receive either varenicline or placebo for 12 weeks, along with computerized cognitive behavioral therapy. Cannabis use, medication adherence, and safety outcomes will be assessed throughout treatment and at a follow-up visit.

Inclusion Criteria:

• Age ≥ 18 years
• DSM-5 diagnosis of cannabis use disorder
• Cannabis use ≥ 3 days per week in past 30 days
• Ability to read English and provide informed consent
• Willingness to comply with medication and study procedures
• Agreement to use acceptable contraception if of childbearing potential

Exclusion Criteria:

• Pregnant, breastfeeding, or planning pregnancy
• Severe renal impairment (CrCl < 30 mL/min)
• Lifetime bipolar I or II disorder, schizophrenia, or other psychotic disorder
• Suicidal ideation or behavior within 6 months
• Use of excluded psychotropic medications (e.g., bupropion, nortriptyline)
• Moderate or severe non-cannabis substance use disorder (except nicotine)
• Clinically significant cardiovascular or cerebrovascular disease in past 6 months
• Hypersensitivity to varenicline
• Participation in another investigational drug study within 30 days