Culture Current Affairs

Cannabis Meets the Twilight Zone: Nicotine for Cannabis Withdrawal Symptoms

The National Institute of Drug Abuse (NIDA) collaborated on a clinical trial in 2015 that investigated whether a nicotine patch could help those dependent on cannabis kick their “withdrawal symptoms.” [1]

You are not dreaming. This is reality and it often gets weird.

The clinical trial used a 7 mg nicotine patch. The average cigarette has 10 to 12 mg of nicotine. Like a joint, however, a burning cigarette has lots of sidestream smoke, so it’s thought that you might actually inhale approximately 10-20% of the contents. Ultimately, the researchers hypothesized that a larger dose may be warranted across the 15-day study. They also reasoned that a longer study, perhaps up to 90 days, “might provide a more convincing demonstration of the potential efficacy of [the nicotine patch].”

The study concluded that “[t]he findings provide the first evidence that [a nicotine patch] may be able to attenuate [negative effect]-related withdrawal symptoms in individuals with cannabis use disorder who are not heavy users of tobacco or nicotine.”

Interestingly, the clinical trial authors state that “[t]he study was not designed with the expectation that the methods we used would be used in normal clinical practice. Instead, it was designed to understand and provide a rigorous assessment of [cannabis] withdrawal symptoms that may drive some individuals in real-world situations to relapse to chronic [cannabis] use.”

Nicotine to quench cannabis withdrawal symptoms so there’s no relapse? The DSM-5 lists cannabis withdrawal symptoms as: irritability-anger-aggression, nervousness-anxiety, depressed mood, restlessness, sleep difficulty, decreased appetite or weight loss, and one or more physical symptoms like abdominal pain, tremors, sweating, fever, chills, or headache. [1]

Interestingly, WebMD lists the potential side effects of nicotine patches as dizziness, headache, nausea, racing heartbeat, muscle pain/stiffness, or sleep difficulty. The overlap is apparent.

That’s not to insinuate that the alkaloid nicotine cannot provide medical benefits. An article in Scientific American opined that nicotine, once “freed of it’s noxious host, tobacco, and delivered instead by chewing gum or transdermal patch—may prove to be a weirdly, improbably effective cognitive enhancer and treatment for relieving or preventing a variety of neurological disorders, including Parkinson’s, mild cognitive impairment, ADHD [attention deficit/hyperactivity disorder], Tourette’s, and schizophrenia.”

But another study reported that tobacco companies “implemented strategies to promote benefits of nicotine to scientific and general audiences while minimizing its health risks. These strategies reappeared at the time novel tobacco products like electronic cigarettes were introduced.” [2]

So, following a scientific study back to its funding sources is likely an informative exercise. As an example, consider a paper regarding the effects of transdermal nicotine on non-smokers with schizophrenia. [3] The authors concluded that “a single dose of nicotine improves attention and suggests that nicotine may specifically improve response inhibition in nonsmokers with schizophrenia.” And under the section entitled Additional Information, you can find that several of the authors were affiliated with drug companies, including manufacturers of nicotine patches.

Such is also the case for the study about the patch alleviating cannabis withdrawal systems revealing author ties to Big Pharma and Big Tobacco. [1]

So, maybe with diminished sales [4], it’s the old adage of ‘if you can’t beat ‘em, join ‘em’ (more on this soon). Or find new applications for your product to shine.

However you look at it, using nicotine to supplant cannabis withdrawal symptoms seems like something Rod Serling would have said, puffing on his square, out in the Twilight Zone.

References

  1. Gilbert D, et al. Nicotine patch for cannabis withdrawal symptom relief: A randomized controlled trial. Psychopharmacology. 2020;237(5):1507-1519. [journal impact factor = 3.179; times cited = N/A (Semantic Scholar)]
  2. Ling P, Glantz S. Tobacco company strategies to identify and promote the benefits of nicotine. Tob Control. 2019;28(3):289–296. [journal impact factor =6.726; times cited = 2 (Semantic Scholar)]
  3. Barr R, et al. The effects of transdermal nicotine on cognition in nonsmokers with schizophrenia and nonpsychiatric controls. Neuropsychopharmacology. 2008;33(3):480-490. [journal impact factor = 7.16; times cited = 197 (Semantic Scholar)]
  4. Creamer M, et al. Tobacco product use and cessation indicators among adults — United States, 2018. Morbidity and Mortality Weekly Report. 2019;68(45):1013-1019. [journal impact factor = 14.874; times cited = 45 (cdc.gov)]

Image Credits: Wikimedia Commons and “Nicotine Tabs: cigarette tin” by lydia_shiningbrightly, CC BY 2.0

About the author

Jason S. Lupoi, Ph.D.

Jason S. Lupoi, Ph.D.

Leave a Comment