Cannabidiol as a Treatment for Craving and Relapse in Individuals with Cocaine Use Disorder: a Randomized Placebo-Controlled Trial.

Background and aims: Cocaine use disorder (CUD) is a significant public health concern for which no efficacious pharmacological interventions are available. Cannabidiol (CBD) has attracted considerable interest as a promising treatment for addiction. This study tested CBD efficacy for reducing craving and preventing relapse in people with CUD.

Design: Single site double-blind randomized controlled superiority trial comparing CBD with placebo.

Setting: Centre hospitalier de l’Université de Montréal, Canada.

Participants: Seventy-eight adults (14 women) with moderate to severe CUD participated.

Intervention: Participants were randomly assigned (1:1) by stratified blocks to daily 800 mg CBD (n=40) or placebo (n=38). They first underwent an inpatient detoxification phase lasting 10 days. Those who completed this phase entered a 12-week outpatient follow-up.

Measurements: Primary outcomes were drug-cue induced craving during detoxication and time-to-cocaine relapse during subsequent outpatient treatment.

Findings: During drug-cue exposure, craving scores (mean ± SD) increased from baseline by 4.69 (2.89) versus 3.21 (2.78) points respectively in CBD (n=36) and placebo (n=28) participants (CI = -0.33 to 3.04; p = 0.069; Bayes factor = 0.498). All but three participants relapsed to cocaine by week 12 with similar risk for CBD (n=34) and placebo (n=27) participants (Hazard Ratio =1.20, CI=0.65 to 2.20, p=0.51; Bayes factor = 0.152). CBD treatment was well tolerated and associated mainly with diarrhea.

Conclusions: Cannabidiol did not reduce cocaine craving or relapse among people being treated for cocaine use disorder.