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    Gabapentin Helps Marijuana Addicts Kick The Habit
    By News Staff | April 29th 2012 12:30 AM | 27 comments | Print | E-mail | Track Comments
    Researchers have presented clinical evidence that the drug gabapentin, currently on the market to treat neuropathic pain and epilepsy, also helps people to quit smoking marijuana (cannabis). Unlike traditional addiction treatments, gabapentin targets stress systems in the brain that are activated by drug withdrawal.

    In a 12-week trial of 50 treatment-seeking cannabis users, those who took gabapentin used less cannabis, experienced fewer withdrawal symptoms, like sleeplessness, and scored higher on tests of attention, impulse-control, and other cognitive skills, compared to patients who received a placebo. If these results are confirmed by ongoing larger trials, gabapentin could become the first FDA-approved pharmaceutical treatment for cannabis dependence.

    “A lot of other drugs have been tested for their ability to decrease cannabis use and withdrawal, but this is the first to show these key effects in a controlled treatment study,” said Barbara J. Mason, the Pearson Family Chair and Co-Director of the Pearson Center for Alcoholism and Addiction Research at Scripps Research, who led the new gabapentin study. “The other nice thing about gabapentin is that it is already widely prescribed, so its safety is less likely to be an issue.”

    Addiction researchers have long known that recreational drugs hook users by disrupting the normal tuning of their brains’ reward and motivation circuitry. But as scientists at Scripps Research and other institutions have shown in animal studies, cannabis withdrawal after prolonged heavy use also leads to the long-term activation of basic stress circuits. “In human cannabis users who try to quit, this stress response is reflected in reports of drug craving, sleep disturbances, anxiety, irritability, and dysphoria, any one of which can motivate a person to return to using, because cannabis will quiet these symptoms,” said Mason.

    A 2008 study by Pearson Center Co-Director George Koob and his colleagues found that gabapentin, an FDA-approved anticonvulsant drug that resembles the neurotransmitter GABA, can quiet this withdrawal-related activation in stress circuitry in alcohol-dependent rats. That finding motivated Mason to set up a pilot trial of gabapentin in cannabis-dependent individuals, whose withdrawal syndrome features a similar over-activation of stress circuits.

    She and her colleagues recruited cannabis users with local newspaper and web ads headlined: “Smoking too much pot? We want to help you stop.” “We needed only 50 subjects, but we quickly got more than 700 queries from cannabis users who were eager to quit,” Mason said. “Some people deny that cannabis can be addictive, but surveys show that between 16 and 25 percent of substance use treatment admissions around the world every year involve people with primary cannabis dependence.”

    The trial was based at Mason’s laboratory at The Scripps Research Institute. Half of the 50 recruits were randomly assigned to take 1,200 mg/day of gabapentin; the rest were given identical-looking placebo capsules. Over 12 weeks, Mason and her colleagues, including a medical team from the nearby Scripps Clinic, monitored the subjects with tests. Using standard behavioral therapy techniques, they also counseled the patients to stay off cannabis.

    The subjects’ self-reports and more objective urine tests revealed that gabapentin, compared to placebo, significantly reduced their continuing cannabis use. “Urine metabolite readings indicate about twice as many of the gabapentin subjects had no new cannabis use during the entire study, and, in the last four weeks of the study, all of the gabapentin subjects who completed the study stayed abstinent,” Mason said.

    Gabapentin also clearly reduced the reported symptoms of withdrawal such as sleep disturbances, drug cravings, and dysphoria. And even though gabapentin normally is thought of as a brain-quieting drug that can cause sleepiness as a side effect, there was some evidence that it sharpened cognition among the cannabis users. Seven gabapentin and ten placebo patients sat for tests of attention, impulse-control, and other executive functions just before the start of the trial and at week four. While the placebo patients tended to score lower after four weeks of attempted abstinence, the gabapentin patients generally scored higher.

    Help Resisting Cravings

    Addiction researchers now recognize that one of the effects of repeated drug use is the weakening of executive functions—which can happen through the over-activation of reward circuitry as well as by withdrawal-related stress. “That weakening of self-control-related circuits makes it even harder for people to resist drug cravings when they’re trying to quit, but gabapentin may help restore those circuits, by reducing stress and enabling patients to sleep better, so that they function better while awake,” Mason said.

    She is now conducting a larger, confirmatory study of gabapentin in cannabis users, as well as a new study of a novel drug that targets the same stress circuitry.

    “People in the treatment community have told me that they’re eager for these trial results to come out, because until now nothing has been shown to work against both relapse and withdrawal symptoms,” Mason said.


    Citation: Barbara J Mason, Rebecca Crean, Vivian Goodell, John M Light, Susan Quello, Farhad Shadan, Kimberly Buffkins, Mark Kyle, Murali Adusumalli, Adnan Begovic and Santosh Rao,'Concept Randomized Controlled Study of Gabapentin: Effects on Cannabis Use, Withdrawal and Executive Function Deficits in Cannabis-Dependent Adults', europsychopharmacology advance online publication 29 February 2012; doi: 10.1038/npp.2012.14

    Comments

    Is this some kind of weird and dangerous joke?

    Here are the most COMMON side effects when using Gabapentin:

    Diarrhea; dizziness; drowsiness; dry mouth; tiredness.

    Seek medical attention right away if any of these SEVERE side effects occur when using Gabapentin:
    Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); behavior changes; confusion; difficult or painful urination; fever; memory problems; new or worsening mental or mood changes (eg, depression, agitation, anxiety, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, inability to sit still); new or worsening trouble sleeping; red, swollen, blistered, or peeling skin; severe headache or dizziness; suicidal thoughts or actions; swelling of the hands, legs, or feet.

    Well Malcolm, when deciding on whether to use a specific drug to treat a specific condition (like for instance cannabis addiction) a clinician must weigh the risks and the benefits of a given medication against the costs of leaving an illness untreated. So, objectively, costs to the health of an individual from receiving the treatment need to be lower than the costs of leaving the illness untreated. In the example at hand, one would consider the risks of Gabapentin on the one hand, against the risks of continued cannabis use on the other. As anyone can see, the risks to the individual from Gabapentin are clearly less significant than occasional excessive Oreo consumption, frisbee playing and a lifetime of listening to Grateful Dead albums. (snark)
    What is really at stake here is a huge and growing number of people entering treatment as a result of court referrals, and the HUGE amount of money any drug approved for cannabis addiction stands to make. I'm a Psychologist, and I'd like to venture a guess that the success of Neurontin in the treatment of the side effects of marijuana with drawl is probably due to the fact that IT GETS YOU HIGH. It is replacement therapy, pure and simple.
    After you've completed your court ordered treatment, with the help of Neurontin, then we get to talk about what may happen to you when you try to with draw the Gabapentin...
    You may be right in your initial assessment: it does sound like some weird and dangerous joke. Really, having worked extensively with this medication, ...it is chilling.

    I am also a licensed psychologist and I am in total agreement with Dr. Chanen. I would like for him to get in contact with me at DrJosephVidmar@gmail.com

    In a 12-week trial of 50 treatment-seeking cannabis users, those who took gabapentin used less cannabis, experienced fewer withdrawal symptoms, LIKE sleeplessness,..... wtf is that.... that was the worst side affect they had for pot.... wow... I am a regular smoker 2 or 3 times a day i still have a real full time non min wage job and marjiuana just make the stress of the day go away and alows me to actully eat a real meal and get a good night sleep. pills are ALWAYS a no no the drug companys are money hunger corporations why would u purchase there product over the one that grows in the ground.... u cant no OD or become dependant on marjiuana like u can ciggertts wich are discusting and habit forming. the governmet wants you to eat there magic pills thus they call marjiuana a
    'drug'. and legalize hemp already you cant no get 'high' from it and it will save the entire economy! the government is selfish we are not a reblic or a democracy we are a corperation.....

    Was the study sponsored by the corrupt DEA? Let's end this senseless prohibition.

    WTF is this? Seems some Big Pharma company is looking to peddle their designer drug, which is far more dangerous than cannabis, and this website took the bait. Irresponsible science journalism here people don't believe the propaganda.

    http://en.m.wikipedia.org/wiki/Gabapentin

    Read the side-effects and dependency on this awful synthetic drug. If you honestly think this is better than smoking MJ then I'll sell you some beautiful oceanfront property in Kansas.

    I have epilepsy and have been put on 3 different prescriptions so far. None of them work very well and all have absolutely horrible side effects. I would rather have seizures than suffer the side effects. Marijuana works better and without the side effects so it isn't a hard choice. It is sick that a pharmaceutical company would even come up with this. Phuck pharmaceutical poisons.

    Believe it or not there are a lot of people who have had their marijuana habit seriously interfere with their ability to live a happy productive life. There may be side effects, but why deny a drug to others just because YOU don't want to use it. Sounds a little HYPOCRITICAL given the context, don't you think? It looks like Gabapentin could be used as a short term aid in quitting, not a permanent medication.

    The reason to deny this drug to others is beacause it is much more dangerous than the habit against which it should help you. This is no short term aid in quitting as it takes weeks or months with gradual reduction of Gabapentin to reduce its severe withdrawal syndromes. But i'm sure there's a pharmaceutical corporation that will soon produce some drugs to help people quit Gabapentin...

    Common side effects of marijuana withdrawal: sleeplessness, mild agitation. Potential side effects of Gabapentin withdrawal: nausea, vomiting, fevers, chills, delirium, difficulty breathing, tremor, hallucinations, seizures, death.
    Still think it's worth it just to MASK the symptoms of marijuana withdrawal?

    "Gabapentin could become the first FDA-approved pharmaceutical treatment for cannabis dependence."

    Oh the hypocrisy! My sister was prescribed Nupentin for her epilepsy and after a while she found the side-effects like depression and swelling were not worth the benefits. Her withdrawal time were some of the worst days of her life. Now the FDA is considering this for "cannabis dependence"? Get real. This synthetic drug is far more addictive hence dangerous than the natural compounds of cannabis.

    It's really a shame how the American government aka FDA is making its citizens addicted to prescription drugs.

    Did those running the study mention to their guinea pigs how many people have suffered death as a side effect from this drug? I guess the fact that those deaths were FDA approved make it OK.

    Just Google +neurontin +death to see just how misplaced the priorities of those prosecuting the war on (some) drugs are. These people aren't noble benefactors. They are dastardly villains perpetrating crimes against humanity.

    The pharmaceutical companies will go to any length to get our money and to demonize the effects of that evil drug marijuana that has never killed by overdose in over 5,000 years of use by humans. It makes real sense to use something toxic to cure something that is not.

    Another big pharma joke with the side effects being worse than the disease. Oh btw marijuana is not addictive.

    Hank
    “Some people deny that cannabis can be addictive, but surveys show that between 16 and 25 percent of substance use treatment admissions around the world every year involve people with primary cannabis dependence.”
    So why would 700 people respond to an ad asking for 50 people who want to quit but cannot?
    “Some people deny that cannabis can be addictive, but surveys show that between 16 and 25 percent of substance use treatment admissions around the world every year involve people with primary cannabis dependence.”

    People are given the option of go to jail or take cannabis rehab. So many take rehab. Been smoking cannabis for 40 years and had to stop and there is no side effects of quitting. Now you want to consider a dependence as an addiction but people are no more dependent on cannabis than they are coffee. So 16 AND 25% of the treatments are for the most widely used illicit drug? Why do you suppose the percentage is so low?

    Gerhard Adam
    Quite frankly, most of this sounds like bullshit.  Even this information from the NIH, suggests that this report and study leave a lot to be desired.

    Long-term marijuana abusers trying to quit report withdrawal symptoms including: irritability, sleeplessness, decreased appetite, anxiety, and drug craving, all of which can make it difficult to remain abstinent. These symptoms begin within about 1 day following abstinence, peak at 2-3 days, and subside within 1 or 2 weeks following drug cessation.3
    http://www.drugabuse.gov/publications/infofacts/marijuana
    So why would you go into 12 weeks of treatment for something that only takes 1 to 2 weeks to overcome the symptoms?
    Mundus vult decipi
    My wife takes Gabapentin for Fibromyalgia and I don't know what is worse, the cure or the disease.

    MikeCrow
    I find other than a day or two to get out of the habit of smoking, no effects other than after 1 to 2 weeks I start(to remember) dreaming again.
    Easiest way to get out of the habit, is to not buy more.
    Never is a long time.
    Coffee is more addictive than Cannabis. [Henningfield, Benowitz] You got something for the Starbucks crowd?

    Damned charlatans.

    Hank
    I don't know if they have a coffee division in the Scripps alcoholism and addiction center but you can always ask them.  I have never heard of anyone losing their job because they couldn't leave the house due to too much coffee.
    John Hasenkam
    So why would you go into 12 weeks of treatment for something that only takes 1 to 2 weeks to overcome the symptoms? 

    Exactly. What the hell is wrong with people? Of course it is going to hurt if you change a big habit of any kind. Stop crying and deal with it. Gabapentin is a GABA agonist, THC is a retrograde inhibitory neurotransmitter, both can tone down neural activity but I wouldn't surprised if Gabapentin induces greater cognitive deficits than marijuana. Doctors gone crazy, perhaps they are the ones who need some psychoactive drugs. 
    Marijuana withdrawal for me is nothing short of hell and the only way to do it `naturally' is to kick my best mate out on the street and leave him homeless as my autism spectrum disorder becomes more profound when I do withdraw from THC, making me fight with him. We live next to a very busy intersection and I am a recluse from my disability so that contributes to my withdrawal symptoms.
    To say that this is all in my head and I need to pop a placebo is like denying a cancer patient to be denied conventional medical treatment because `it supports those evvvviiiilll drug companies and its for her `own' good''

    Folks, we need to consider a fair balance if we want to uphold our image as an advanced society that looks after 100% of its citizens. Obviously the authorities are not budging on their attitudes towards cannabis and the last thing we need is more deaths of the most vunerable because the people in society fail to even think that we are out there when they complain about who is killing whom out of corporate greed.

    Gabapentin is used as a recreational euphoria-inducing drug, and often abused because it is considered "non-addictive." That may explain why so many people are clamouring to join the study. ;) This isn't new information -- people have been abusing Gaba for years.

    In truth Gaba has some very serious and dangerous addictive properties. I've read reports about people who chose to buy more Gaba over paying rent or buying food. Without it, they feel 'urges' for more. Gaba can be chemically addictive. (Source: http://www.erowid.org/pharms/gabapentin/)

    I beleive Big Pharma has seen an opportunity for quick cash. The statistics on "marijuana addiction" mostly come from criminal cases in which the offender was given a choice between rehab and no criminal record, or jail time. These rehab centers rake in millions from it. It is a business and saying this will "treat marijuana addiction" is a billion dollar lie for the first Pharma Co. who can sell it.

    Do you really beleive that a chemically addictive side-effect riddled drug like Gaba is preferable -- and will even "treat" -- marijuana use?

    That's like trying to cure a caffeine addict by switching them to crack.

    Ladies and Gentlemen, this is a fraud. There is now and never has been any benefit to Gabapentin due to overwhelming negative side effects. The only reason I'd prescribe it is if all else fails for neuropathy, since medical marijuana is not legal in our state yet. We the people and professionals (who aren't so damn chicken) need to get the word out about the benefits of a purity controlled, quality tested, marijuana standard for all who chose to grow it. Once we get to that point, people will be able to buy those varieties with confidence that the oil produced will be of the utmost quality and purity. Guidelines for oil as well.
    End of story. Unfortunately with the Rombama/Obamney choices out there, this will not happen until we get a true Constitutional President.

    I was so excited that I might have found a cool new science blog until I read this. What a crock! As a 40 year marijuana smoker and research scientist, I think it is absolutely ridiculous to suggest that people need Gabapentin to quit smoking marijuana. There is very little if any physical dependence with cannabis, and it is much less toxic than Gabapentin. I've decided not to add this site to my list after reading this ridiculous article.

    I wonder if Gabapentin would help me with my processed sugar addiction?

    http://www.cbsnews.com/8301-18560_162-57407294/is-sugar-toxic/

    .