Cannabis dependence

These prevalence estimates, however, obscure an ongoing controversy surrounding the nature of the cannabis dependence syndrome. Specifically, the studies cited earlier, which were designed to examine the prevalence of abuse... 

Research on CBl knockout mice demonstrated the pivotal role of CBl receptors in cannabis dependence knockout mice have been shown not to self-administer cannabinoids (Ledent et al. 1999) and also to fail to exhibit symptoms ofSRl417l6A-precipitated withdrawal (Ledent et al. 1999 Lichtman et al. 2001). Although the research summarized earlier is consistent in reporting the occurrence of a variety of withdrawal symptoms following cessation of exposure to cannabinoids (which were injected), precipitated withdrawal in mice following chronic exposure to marijuana smoke was more recently reported (Lichtman and Martin 2002). 

Although their results were encouraging, these studies demonstrated how difficult it is to treat cannabis dependence. Experience with treating tobacco dependence has revealed that a combination of various psychotherapeutic techniques and pharmacotherapies is more effective than either approach alone in producing and maintaining cessation. Thus, the use of medication during the cessation period may significantly improve quit rates and maintenance of abstinence. 

In summary, research on the use of antidepressants to treat cannabis dependence, particularly among individuals with comorbid major depressive disorder, although limited, offers a promising avenue for the development of pharmacological aids to assist in the treatment of cannabis withdrawal. There are clear parallels between this literature and the existing research on the use of antidepressants in the treatment of alcohol dependence comorbid with major depressive disorder (see Chapter 1, Medications to Treat Co-occurring Psychiatric Symptoms or Disorders in Alcoholic Patients). 

Lynskey MT, Heath AC, Nelson EC, et al Genetic and environmental contributions to cannabis dependence in a national young adult twin sample. Psychol Med 32 195-207, 2002... 

Miller NS and Gold MS (1989). The diagnosis of marijuana (cannabis) dependence. Journal of Substance Abuse and Treatment, 6, 183-192. 

Alcohol Abuse, Alcohol Dependence Amphetamine Abuse, Amphetamine Dependence Cannabis Abuse, Cannabis Dependence Cocaine Abuse, Cocaine Dependence Hallucinogen Abuse, Hallucinogen Dependence Inhalant Abuse, Inhalant Dependence Nicotine Dependence Opiate Abuse, Opiate Dependence Phencyclidine Abuse, Phencyclidine Dependence... 

Psychosocial morbidity association. Cannabis dependence is a prevalent comorbid substance use disorder among patients early in the course of a schizophrenia-spectrum disorder. Among 29 eligible patients, 18 participated in the study. First-episode patients with comorbid cannabis dependence (n = 8) reported significantly greater childhood physical and sexual abuse compared with those without comorbid cannabis dependence (n = 10). The result indicated the preliminary evidence of an association between childhood maltreatment and cannabis dependence among this especially vulnerable population. Child-... 

Kaslow. Preliminary evidence of an association between childhood abuse CS258 and cannabis dependence among Afri-can American first-episode schizophre-nia-spectrum disorder patients. Drug Alcohol Depend 2004 76(3) 311-316. 

Lynskey, M. T., A. L. Glowinski, A. A. Todorov, et al. Major depressive disorder, suicidal ideation, and suicide attempt in twins discordant for cannabis dependence and early-onset cannabis use. Arch Gen Psychiatry 2004 61(10) 1026-1032. 

Babor TF (2006). The diagnosis of cannabis dependence. In Roffman RA Stephens RS (eds.) Cannabis Dependence Its nature, consequences and treatment. London Cambridge University Press, pp. 21-36... 

---