Gender differences among treatment-seeking adults with cannabis use disorder: Clinical profiles of women and men enrolled in the achieving cannabis cessation-evaluating N-acetylcysteine treatment (ACCENT) study

Am J Addict. 2017 Mar;26(2):136-144. doi: 10.1111/ajad.12503. Epub 2017 Feb 2.

Abstract

Background and objectives: Recent evidence suggests that women may fare worse than men in cannabis trials with pharmacologic interventions. Identifying baseline clinical profiles of treatment-seeking cannabis-dependent adults could inform gender-specific treatment planning and development.

Methods: The current study compared baseline demographic, cannabis use, and psychiatric factors between women (n = 86) and men (n = 216) entering the Achieving Cannabis Cessation-Evaluating N-acetylcysteine Treatment (ACCENT) study, a multi-site, randomized controlled trial conducted within the National Drug Abuse Treatment Clinical Trials Network.

Results: Women reported greater withdrawal intensity (p = .001) and negative impact of withdrawal (p = .001), predominantly due to physiological and mood symptoms. Women were more likely to have lifetime panic disorder (p = .038) and current agoraphobia (p = .022), and reported more days of poor physical health (p = .006) and cannabis-related medical problems (p = .023). Women reporting chronic pain had greater mean pain scores than men with chronic pain (p = .006). Men and women did not differ on any measures of baseline cannabis use.

Discussion and conclusions: Cannabis-dependent women may present for treatment with more severe and impairing withdrawal symptoms and psychiatric conditions compared to cannabis-dependent men. This might help explain recent evidence suggesting that women fare worse than men in cannabis treatment trials of pharmacologic interventions. Baseline clinical profiles of treatment-seeking adults can inform gender-specific treatment planning and development.

Scientific significance: Cannabis-dependent women may benefit from integrated treatment focusing on co-occurring psychiatric disorders and targeted treatment of cannabis withdrawal syndrome.(Am J Addict 2017;26:136-144).

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine* / administration & dosage
  • Acetylcysteine* / adverse effects
  • Adult
  • Cannabinoids / pharmacology*
  • Comorbidity
  • Female
  • Free Radical Scavengers / administration & dosage
  • Free Radical Scavengers / adverse effects
  • Help-Seeking Behavior
  • Humans
  • Male
  • Marijuana Abuse* / drug therapy
  • Marijuana Abuse* / epidemiology
  • Marijuana Abuse* / psychology
  • Mental Disorders / epidemiology
  • Middle Aged
  • Patient Acceptance of Health Care / psychology*
  • Patient Care Management / methods
  • Sex Factors
  • Substance Withdrawal Syndrome / diagnosis
  • Substance Withdrawal Syndrome / prevention & control

Substances

  • Cannabinoids
  • Free Radical Scavengers
  • Acetylcysteine