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Marijuana

  • No FDA approved treatment for marijuana use disorder
     
  • Some evidence that N-acetyl cysteine and gabapentin might help especially for adolescent brains although the jury remains out on the topic 
     
  • 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
  • If going to offer medication, both have some promise but no guarantees.​

     
  • N-acetyl-cysteine 1200 mg BID (two tabs of 600mg) - over the counter

    OR
     
  • Gabapentin 1200 mg PO BID
    • NOTE!!  Most patients CANNOT TOLERATE 1200mg BID unless they have a co-occurring sedative or alcohol use disorder.    Avoid if any safety concerns.   
    • Possible benefit if patient has co-occurring anxiety disorder
    • 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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