A randomized placebo-controlled trial of N-acetylcysteine for cannabis use disorder in adults
Gray KM
Published in Drug and Alcohol Dependence
Methodology
12-week double-blind randomised placebo-controlled trial across six National Drug Abuse Treatment Clinical Trials Network sites; 1:1 randomisation to N-acetylcysteine 1200 mg or placebo twice daily plus contingency management and medical management; primary efficacy measure the odds of negative urine cannabinoid tests during treatment.
Key Findings
302 treatment-seeking adults aged 18-50 with cannabis use disorder at six clinical trial network sites were randomised to N-acetylcysteine 1200 mg twice daily (n = 153) or placebo (n = 149) for 12 weeks, with everyone receiving contingency management and medical management. There was no evidence of a difference in abstinence: odds ratio 1.00 (95% CI 0.63 to 1.59, p = 0.984), with 22.3% of urine cannabinoid tests negative on N-acetylcysteine versus 22.4% on placebo. Many participants were not adherent to medication, and analyses restricted to adherent subgroups also showed no difference. This contradicts earlier positive findings in adolescents.
Conclusions
There is no evidence that NAC 1200mg twice daily plus CM is differentially efficacious for CUD in adults when compared to placebo plus CM.
Limitations
Medication non-adherence was common, which could dilute a true effect, and all participants received contingency management that may have masked any drug benefit; the trial cannot explain why the adolescent result did not replicate.
Supplements Studied
There is no evidence that NAC 1200mg twice daily plus CM is differentially efficacious for CUD in adults when compared to placebo plus CM.
Related Health Concerns
Study Details
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