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Marijuana
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No FDA approved treatment for marijuana use disorder
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Some evidence that N-acetyl cysteine and gabapentin might help especially for adolescent brains although the jury remains out on the topic
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Cochrane database unimpressed with pharmacotherapy results. Nielsen S, Gowing L, Sabioni P, Le Foll B. Pharmacotherapies for cannabis dependence. Cochrane Database Syst Rev. 2019 Jan 28;1(1):CD008940. doi: 10.1002/14651858.CD008940.pub3. PMID: 30687936; PMCID: PMC6360924
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If going to offer medication, both have some promise but no guarantees.
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N-acetyl-cysteine 1200 mg BID (two tabs of 600mg) - over the counter
OR
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Gabapentin 1200 mg PO BID
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NOTE!! Most patients CANNOT TOLERATE 1200mg BID unless they have a co-occurring sedative or alcohol use disorder. Avoid if any safety concerns.
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Possible benefit if patient has co-occurring anxiety disorder
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Most patients will need to start at much lower dose e.g. 300mg BID-TID and then can be increased if tolerating at followup appointment
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