Marijuana Dependence Clinical Trial
Official title:
Nicotine for Marijuana Withdrawal
The purpose of this 3-year trial is to test the efficacy of transdermal nicotine patch versus placebo patch on marijuana withdrawal symptoms in cannabis-dependent individuals, using a randomized, double-blind, and placebo-controlled design. This proposal is in response to RFA-DA-10-016(R01) Medications Development for Cannabis-Related Disorders. Consistent with the goals of this RFA, the overall goal of the proposed project is to assess the impact of transdermal nicotine patch (TNP) on marijuana (MJ) withdrawal (negative affect and craving motivated by negative affect) symptoms in MJ-dependent individuals.
The aim of this proposal is to accurately assess the effects of TNP on MJ withdrawal
symptoms across 15 days of biochemically confirmed MJ abstinence using a placebo-controlled,
double-blind, randomly assigned treatment design, while closely monitoring any potential
adverse effects, including changes in nicotine use and dependence.
To achieve these goals, 116 carefully screened cannabis-dependent individuals (58 female)
will be randomly assigned to one of two doses (0 mg or 7mg nicotine) of TNP (transdermal
nicotine patch) while they abstain from MJ for 15 days. Subjects will be administered a
follow-up phone interview 30 days after the termination of treatment to assess the effects
of nicotine-patch treatment on: 1) frequency of nicotine and tobacco smoking intake, 2)
Fagerstrom Test of Nicotine Dependence (FTND)-assessed nicotine dependence, 3) new use of
nicotine during the time since completion of the study, and 4) marijuana and other drug use
patterns. Large financial contingencies will be used to provide a high degree of abstinence
and study completion. This will be the first adequately powered study to assess the effects
of TNP on MJ negative affect-related withdrawal symptoms and urges to use MJ. Withdrawal
patterns and abstinence will be assessed in two groups of MJ-dependent individuals: 1) those
who rarely or never smoke tobacco, and 2) those who smoke four or fewer tobacco cigarettes
per day (very-light tobacco smokers). A stratified randomization method will be used to
control for gender and tobacco-smoker status. It is hypothesized that MJ withdrawal symptoms
will be less severe in the group assigned to the 7 mg patch than in the group assigned to
the placebo. It is also hypothesized that individuals high in anxiety/neuroticism and those
high in aggression/hostility will exhibit greater benefits from TNP than those low in these
traits. Given that no gender differences were observed in our preliminary study, gender
differences are not predicted. The over-the-counter availability, minimal abuse risks, and
minimal adverse side-effects associated with TNP would make it an ideal and highly
implementable treatment for MJ dependence if it can be demonstrated to be efficacious in
reducing MJ withdrawal symptoms.
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Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Basic Science
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