Possible Treatment Option for Cannabis Use Disorder

Recent discoveries about fatty acid amide hydrolase may lead to treatments for cannabis use disorder, which currently does not have a treatment.

In chronic cannabis users, levels of fatty acid amide hydrolase (FAAH) are reduced. This enzyme breaks down endocannabinoids in the brain, and makes them inactive.

In recent years, cannabis has been used to treat patients with various conditions, including glaucoma, cancer, multiple sclerosis, and other chronic illnesses. Medical cannabis use has also been estimated to save millions of dollars per year on prescription drugs.

However, like all altering substances, there is a risk for substance abuse, and biological changes that accompany the use of the drug.

The study, published by Biological Psychiatry, included 10 active users of cannabis, and 22 control patients. The active cannabis users have all been using the drug for an average of 18 years, but were on withdrawal during the study period.

Investigators used a positron emission tomography radiotracer ([11C]CURB) to measure the levels of FAAH in each patients. Investigators also analyzed blood, urine, and hair for presence of cannabinoids.

They found that levels of FAAH in chronic cannabis users were reduced between 14% and 20% compared with those who did not use cannabis. Low levels of FAAH are linked to high levels of cannabinoids in the blood and urine, which suggests that FAAH levels correlate to chronic cannabis use, according to the study.

Effects from cannabis use are elicited from the stimulation of CB1 cannabinoid receptors, the endocannabinoid target. For chronic users, the increased stimulation of CB1 receptors, known to downregulate the receptors, could lead to reduced FAAH levels in order to restore normal CB1 stimulation from natural cannabinoids, according to the study.

These findings suggest that normalizing CB1 receptor activity could potentially treat chronic cannabis users, and could also assist with impulse control.

Frequent cannabis use downregulating FAAH levels after cessation of cannabis use may also explain why there are few withdrawal symptoms. This insight could be used to create strategies to keep the levels of FAAH low to reduce symptoms, the study concluded.