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Millions of Americans develop cannabis use disorder, which requires treatment to prevent numerous associated adverse outcomes. There are several evidence-based behavioral interventions, including motivational interviewing, motivational enhancement therapy, cognitive behavioral therapy, contingency management, and multidimensional family therapy, all with moderate effectiveness. None of the behavioral interventions are clearly superior to any of the others, whether in combination or alone. Thus, individual patient and therapist factors, such as patient preference and therapist expertise, should determine which is used. Currently, there are no FDA-approved medications for treatment of cannabis use disorder. Some pharmacologic agents have shown promise in early studies, most notably n-acetylcysteine and gabapentin, but none have been replicated. Given that gabapentin and buspirone have been widely used in psychiatric populations and have relatively few side effects, either could be considered as an augmenting agent to behavioral interventions, but neither should be continued for more than 12 weeks unless there is clear evidence of reduction in use. Evidence suggests venlafaxine and naltrexone are not effective in reducing use.

Behavioral Interventions and Pharmacotherapies for Cannabis Use Disorder