Bertrand Redonnet, Filiz Eren, Guillaume Avenin, Maria Melchior, Murielle Mary-Krause
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The objective of this umbrella review was to determine whether CBD alone or in combination with Δ-9-tetrahydrocannabinol (THC) is effective for managing and treating SUDs.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Following a registered protocol, we searched PubMed, Web of Science and Epistemonikos databases for SRs, with or without a meta-analysis, of randomized controlled trials focusing on interventions dispensing CBD, alone or in combination with THC, to treat SUDs, published from 1 January 2000 to 15 October 2024. Screening, data extraction and quality assessment with the AMSTAR 2 tool were performed by two researchers in parallel and duplicated.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>22 SRs were included, 5 of which performed a meta-analysis. We found mixed evidence regarding the efficacy of CBD to manage and treat SUDs. Findings were interpreted in light of the quality of the SRs. Nabiximols, which contains CBD and THC, demonstrated positive effects on cannabis withdrawal and craving symptoms. Evidence supporting the efficacy of CBD is limited and inconclusive for abstinence, reduction or cessation of use of cannabis, tobacco, alcohol, opiates and other psychoactive substances.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Cannabidiol (CBD) monotherapy does not appear to be efficacious for treatment of substance use disorders. CBD primarily exhibits effects on cannabis withdrawal and craving when combined with Δ-9-tetrahydrocannabinol (THC). 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引用次数: 0
摘要
背景和目的：物质使用障碍（SUD）导致高疾病负担，但治疗选择有限。由于其在内源性大麻素系统中的药理特性和作用方式，大麻二酚（CBD）作为一种潜在的治疗靶点正在被研究。最近关于CBD和sud的系统综述（SR）显示出不一致的结果。本综述的目的是确定CBD单独使用或与Δ-9-tetrahydrocannabinol （THC）联合使用是否有效地管理和治疗sud。方法：根据注册方案，我们检索PubMed， Web of Science和Epistemonikos数据库，检索2000年1月1日至2024年10月15日发表的随机对照试验的SRs，无论是否进行荟萃分析，这些随机对照试验的重点是单独或联合使用CBD来治疗sud。筛选、数据提取和使用AMSTAR 2工具进行质量评估由两名研究人员并行和重复进行。结果：纳入22例SRs，其中5例进行了meta分析。我们发现关于CBD管理和治疗sud的功效的证据不一。结果是根据SRs的质量来解释的。Nabiximols含有CBD和THC，对大麻戒断和渴望症状有积极作用。支持CBD在戒断、减少或停止使用大麻、烟草、酒精、阿片类药物和其他精神活性物质方面的功效的证据有限且不确定。结论：大麻二酚（CBD）单药治疗似乎对药物使用障碍无效。当与Δ-9-tetrahydrocannabinol （THC）结合使用时，CBD主要表现出对大麻戒断和渴望的影响。关于单独使用CBD对与物质使用障碍有关的其他结果的功效的现有数据是有限的。
Efficacy of cannabidiol alone or in combination with Δ-9-tetrahydrocannabinol for the management of substance use disorders: An umbrella review of the evidence
Background and Aims
Substance use disorders (SUD) lead to a high burden of disease, yet treatment options are limited. Cannabidiol (CBD) is being investigated as a potential therapeutic target due to its pharmacological properties and mode of action in the endocannabinoid system. Recent systematic reviews (SR) on CBD and SUDs have shown inconsistent results. The objective of this umbrella review was to determine whether CBD alone or in combination with Δ-9-tetrahydrocannabinol (THC) is effective for managing and treating SUDs.
Methods
Following a registered protocol, we searched PubMed, Web of Science and Epistemonikos databases for SRs, with or without a meta-analysis, of randomized controlled trials focusing on interventions dispensing CBD, alone or in combination with THC, to treat SUDs, published from 1 January 2000 to 15 October 2024. Screening, data extraction and quality assessment with the AMSTAR 2 tool were performed by two researchers in parallel and duplicated.
Results
22 SRs were included, 5 of which performed a meta-analysis. We found mixed evidence regarding the efficacy of CBD to manage and treat SUDs. Findings were interpreted in light of the quality of the SRs. Nabiximols, which contains CBD and THC, demonstrated positive effects on cannabis withdrawal and craving symptoms. Evidence supporting the efficacy of CBD is limited and inconclusive for abstinence, reduction or cessation of use of cannabis, tobacco, alcohol, opiates and other psychoactive substances.
Conclusion
Cannabidiol (CBD) monotherapy does not appear to be efficacious for treatment of substance use disorders. CBD primarily exhibits effects on cannabis withdrawal and craving when combined with Δ-9-tetrahydrocannabinol (THC). Existing data on the efficacy of CBD alone with regard to other outcomes related to substance use disorders are limited.
期刊介绍：
Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines.
Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries.
Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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