Randomized controlled trial of zolpidem as a pharmacotherapy for cannabis use disorder

被引：1

作者：

Lee, Dustin C. ^{[1
,5
]}

Schlienz, Nicolas J. ^{[1
]}

Herrmann, Evan S. ^{[2
]}

Martin, Erin L. ^{[1
]}

Leoutsakos, Jeannie ^{[1
]}

Budney, Alan J. ^{[3
]}

Smith, Michael T. ^{[1
]}

Tompkins, Andrew ^{[4
]}

Hampson, Aidan J. ^{[2
]}

Vandrey, Ryan ^{[1
]}

机构：

[1] Johns Hopkins Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD USA

[2] Natl Inst Drug Abuse, Div Therapeut & Med Consequences, NIH, Bethesda, MD 20892 USA

[3] Geisel Sch Med Dartmouth, Ctr Technol & Behav Hlth, Lebanon, NH USA

[4] Univ Calif San Francisco, San Francisco Sch Med, Dept Psychiat & Behav Sci, San Francisco, CA USA

[5] Johns Hopkins Sch Med, Dept Psychiat & Behav Sci, Behav Pharmacol Res Unit, 5510 Nathan Shock Dr, Baltimore, MD 21224 USA

来源：

JOURNAL OF SUBSTANCE USE & ADDICTION TREATMENT | 2024年 / 156卷

关键词：

Cannabis use disorder; Cannabis withdrawal; Randomized controlled trial; Sleep; COGNITIVE-BEHAVIORAL THERAPY; DYSFUNCTIONAL BELIEFS; WITHDRAWAL SYMPTOMS; NIGHTLY ZOLPIDEM; ABSTINENCE; INSOMNIA; ATTITUDES; SEVERITY; EFFICACY; TOBACCO;

D O I：

10.1016/j.josat.2023.209180

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

Background: Sleep disturbance is commonly reported among individuals meeting criteria for cannabis use disorder (CUD), and people who use cannabis frequently report sleep disturbance as a contributor to failed quit attempts. The purpose of this study was to measure sleep in individuals enrolled in treatment for CUD, and to determine whether use of hypnotic medication during treatment increased abstinence rates. Method: The study enrolled 127 adults seeking treatment for CUD in a 12-week clinical trial and randomized to receive extended-release zolpidem (zolpidem-XR) or placebo. All participants received computerized behavioral therapy and abstinence-based contingency management. The study conducted in-home ambulatory polysomnography (PSG) assessments at baseline and during treatment to objectively measure sleep. Self-report measures of recent sleep, Insomnia Severity Index (ISI), and drug use (Timeline Follow-Back) were collected at each study visit, and the study confirmed self-reported abstinence via quantitative urine drug testing. Result: Participants randomized to placebo, but not zolpidem-XR exhibited significant sleep disturbance during week 1 of treatment. Sleep disturbance emerged in the zolpidem-XR group after study medication was stopped at the end of treatment. Though participants assigned to the zolpidem-XR condition had qualitatively greater rates of abstinence compared with placebo (27 % versus 15 % negative at end of treatment), the difference was not statistically significant. Treatment retention was poor (about 50 % drop out in both groups) and medication adherence was a challenge without the use of contingent incentives. Conclusion: Results from this randomized controlled trial suggest that zolpidem-XR can attenuate abstinenceinduced sleep disturbance early in treatment for CUD, but that sleep problems are likely to emerge after the medication is stopped. Further research should identify alternative pharmacotherapies and behavioral treatments for CUD and elucidate the role of sleep disturbance in the development and maintenance of CUD.

引用

页数：8