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Cited by 157Substance Abuse Treatment and OutcomesCannabis and Cannabinoid ResearchOpioid Use Disorder Treatment

The DOI matches its Crossref record; 34 of the 35 references it cites were found in a registry or an index.

A randomized placebo-controlled trial of N-acetylcysteine for cannabis use disorder in adults.

Open access
Gray, Kevin M., Sonne, Susan C., McClure, Erin A., Ghitza, Udi E., Matthews, Abigail G., McRae-Clark, Aimee L., Carroll, Kathleen M., Potter, Jennifer S., Wiest, Katharina, Mooney, Larissa J., Hasson, Albert, Walsh, Sharon L., Lofwall, Michelle R., Babalonis, Shanna, Lindblad, Robert W., Sparenborg, Steven, Wahle, Aimee, King, Jacqueline S., Baker, Nathaniel L., Tomko, Rachel L., Haynes, Louise F., Vandrey, Ryan G., Levin, Frances R.·2017·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2017.04.020PMC PMC5535813
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Abstract

Background Cannabis use disorder (CUD) is a prevalent and impairing condition, and established psychosocial treatments convey limited efficacy. In light of recent findings supporting the efficacy of N-acetylcysteine (NAC) for CUD in adolescents, the objective of this trial was to evaluate its efficacy in adults.Methods In a 12-week double-blind randomized placebo-controlled trial, treatment-seeking adults ages 18-50 with CUD (N=302), enrolled across six National Drug Abuse Treatment Clinical Trials Network-affiliated clinical sites, were randomized in a 1:1 ratio to a 12-week course of NAC 1200mg (n=153) or placebo (n=149) twice daily. All participants received contingency management (CM) and medical management. The primary efficacy measure was the odds of negative urine cannabinoid tests during treatment, compared between NAC and placebo participants.Results There was not statistically significant evidence that the NAC and placebo groups differed in cannabis abstinence (odds ratio=1.00, 95% confidence interval 0.63-1.59, p=0.984). Overall, 22.3% of urine cannabinoid tests in the NAC group were negative, compared with 22.4% in the placebo group. Many participants were medication non-adherent; exploratory analysis within medication-adherent subgroups revealed no significant differential abstinence outcomes by treatment group.Conclusions In contrast with prior findings in adolescents, there is no evidence that NAC 1200mg twice daily plus CM is differentially efficacious for CUD in adults when compared to placebo plus CM. This discrepant finding between adolescents and adults with CUD may have been influenced by differences in development, cannabis use profiles, responses to embedded behavioral treatment, medication adherence, and other factors.

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Authors
Gray, K. M., Sonne, S. C., McClure, E. A., Ghitza, U. E., Matthews, A. G., McRae-Clark, A. L., Carroll, K. M., Potter, J. S., Wiest, K., Mooney, L. J., Hasson, A., Walsh, S. L., Lofwall, M. R., Babalonis, S., Lindblad, R. W., Sparenborg, S., Wahle, A., King, J. S., Baker, N. L., Tomko, R. L., Haynes, L. F., Vandrey, R. G., & Levin, F. R.
Affiliations
  • Medical University of South Carolina (US)
  • National Institutes of Health (US)
  • Emmes (United States) (US)
  • Yale University (US)
  • The University of Texas at San Antonio (US)
  • University of California, Los Angeles (US)
  • University of Kentucky (US)
  • National Institute on Drug Abuse (US)
  • Johns Hopkins University (US)
  • Columbia University Irving Medical Center (US)
Corresponding author
Gray, Kevin M.
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2017-08
Volume
177
Pages
249-257
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2017.04.020
PMC
PMC5535813
OpenAlex
W2624100118
Cited by
157
References
35
Citations by year
2026: 10 · 2025: 17 · 2024: 17 · 2023: 13 · 2022: 20 · 2021: 20 · 2020: 17 · 2019: 13 · 2018: 24 · 2017: 6
FWCI
12.85
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Drug and Alcohol Dependence (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • UKnowledge (University of Kentucky) (submittedVersion, cc-by-nc-nd)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
National Institutes of Health (UG1DA013727, UG1DA015831, UG1DA020024, UG1DA013714, UG1DA013732, U10DA013045, HHSN271201200017C)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
cannabis use disorder, N-acetylcysteine, contingency management, medication adherence, cannabis abstinence, adolescents versus adults, treatment-seeking patients
MeSH terms
Acetylcysteine, Adolescent, Adult, Cannabis, Marijuana Abuse, Double-Blind Method, Female, Humans, Male, Marijuana Smoking, Sulpiride, Free Radical Scavengers, Treatment Outcome, Medication Adherence, Young Adult

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