Substance Use Treatment Providers’ Perceptions of Research Fund Allocations Toward Development of Medications for Cannabis Use Disorder

Background and Purpose: As recreational cannabis legalization (RCL) spreads across the United States, there has been evidence of an increase in cannabis use disorder (CUD). While there have been some promising clinical trials on medications to treat CUD, no medication has emerged as clearly effective, and, to date, there are no medications that are FDA-approved to treat CUD. In this study, we examined substance use disorder (SUD) treatment providers’ perspectives on the priority of allocating federal research funds towards the development of new medications for CUD treatment.

Methods: Data were collected using in-depth phone interviews from 406 clinical directors of SUD treatment centers throughout the United States as part of a larger study examining treatment delivery of cannabis-using clients. Using a scale of 1 to 5, with 1 representing “a very low priority” and 5 representing “a very high priority,” respondents were asked what priority should be placed on allocating federal research funds for the development of new medications to treat CUD. Open-ended perceptions on this topic were coded by three independent coders and thematically analyzed through iterative rounds of coding that identified themes.

Results: The sample of treatment center clinical directors was predominantly female (63%)and White (78.1% White; 13.3% Black/African American; 2.2% Asian; ; 1% Native American/Alaska Native; 1.2% Native Hawaiian/Pacific Islander; 2.9% identified as multiracial, and 6.4% as Hispanic/LatinX; 1.3% as other). The mean response on whether priority should be placed on developing new medications for CUD was 3.15 (sd=1.37) Five main themes emerged from the open-ended responses: 1) perception that the development of a CUD medication is unnecessary because most patients do not view their cannabis use as problematic; 2) priority on developing medications to treat substances considered to be more dangerous than cannabis, such as opioids/fentanyl or methamphetamine; or on 3) developing medications to treat the more serious negative side effects of cannabis use, such as cannabis-induced psychosis; 4) developing new evidence-based behavioral treatment for CUD rather than medications; and that; 5) legalization should first occur at the federal level before allocating research funds to developing CUD medications.

Conclusions and Implications: Cannabis is the most common substance reported by adolescents presenting for SUD treatment. With more states enacting RCLs, federal research funds are being allocated toward clinical trials on potential medications for treating intoxication and withdrawal symptoms of CUD. With an increased prevalence of CUD, the development of safe and effective CUD medications is an urgent public health priority. However, treatment providers placed only a moderate priority on the development of new medications and preferred to have funding allocated toward CUD-specific behavioral treatment and medications for more serious symptoms, such as cannabis-induced psychosis, or have funding distributed to other SUD populations. The variety in themes highlights the many implications of treating CUD beyond medication such as legalization and treatment motivation. It is important to consider SUD treatment programs’ perspectives and CUD patients’ needs as well as the likelihood that treatment programs would utilize innovative behavioral and pharmacological treatments being developed for CUD.