Short answer
No medication holds FDA approval for cannabis dependence. Behavioral therapy is the first-line treatment. The options with the most trial evidence are cognitive behavioral therapy (CBT), motivational enhancement therapy (MET), contingency management, and mutual-help groups such as Marijuana Anonymous or SMART Recovery.
What cannabis dependence means
The DSM-5 uses the term cannabis use disorder. It lists 11 criteria, including tolerance, withdrawal, craving, failed attempts to quit, and use that damages work or school. A diagnosis needs at least 2 criteria within 12 months. Severity is graded by count: 2 to 3 criteria is mild, 4 to 5 is moderate, 6 or more is severe.
Federal survey data put past-year cannabis use disorder at about 19 million people aged 12 and older in the US for 2022.
Behavioral treatments
- CBT targets triggers and coping skills. Standard courses run 6 to 12 weekly sessions.
- MET is a 1 to 4 session interview. It builds motivation and addresses mixed feelings about quitting.
- Contingency management pays vouchers or cash for negative urine tests. Meta-analyses rank it as the strongest single method for short-term abstinence.
- Combined MET and CBT was tested in the Marijuana Treatment Project, a 9-session program. It cut use days at 4 months compared with a delayed-treatment group.
- Couples or family therapy helps when a partner or parent supports abstinence.
Relapse after treatment is common. Outcomes improve when treatment runs 6 weeks or longer and includes follow-up contact.
Cannabis Addiction Therapy: How Treatment for Cannabis Use Disorder Works
Medication research
No drug is FDA approved for cannabis use disorder. Trials have tested N-acetylcysteine, gabapentin, topiramate, buspirone, varenicline, and nabilone. Results are mixed. Several trials found no difference from placebo. Gabapentin and nabilone showed some effect on withdrawal symptoms in small studies.
Withdrawal
Daily heavy use followed by a stop can cause withdrawal. DSM-5 lists irritability, anger, insomnia, reduced appetite, restlessness, depressed mood, and physical symptoms such as headache or sweating. Symptoms start within 1 to 3 days and fade over 1 to 2 weeks. No medication is approved for cannabis withdrawal. Sleep problems can last longer than the rest.
Where to get help
- SAMHSA National Helpline: 1-800-662-4357. Free, 24 hours, confidential.
- 988 Suicide and Crisis Lifeline: call or text 988.
- Marijuana Anonymous and SMART Recovery run free meetings online and in person.
CBD and cannabis dependence
CBD is not an approved treatment for cannabis dependence. Randomized trials tested CBD at 200 mg to 800 mg per day in adults with cannabis use disorder. Results were mixed, and each trial enrolled fewer than 100 people. CBD products sold online are not FDA approved to treat cannabis use disorder. Anyone taking prescription medication should speak with a prescriber before adding CBD.
Questions for a clinician
- Which therapy has the best record for my pattern of use?
- How long will treatment last, and how often will we meet?
- What withdrawal symptoms should I expect, and when do they end?
- Are any medications worth trying off label?
- What is the plan if I use again?