This item covers developments relevant to cannabis medicine and clinical practice. Clinicians monitoring evidence in this area should review the source material.

Our primary aim was to conduct a network meta-analysis (NMA) for the effectiveness, safety and acceptability of all psychosocial interventions and all pharmacotherapies for cannabis use disorder (CUD). We conducted a NMA of studies identified from two completed systematic reviews examining the effectiveness, safety and acceptability of pharmacotherapies and psychosocial interventions for CUD in people aged ≥16 years. Outcomes were level of cannabis use, abstinence, adverse events and treatment completion. Fifty-seven studies were eligible for NMA. Depending on outcome, NMAs of psychosocial interventions included 6-16 studies (445-2287 participants), and NMAs of pharmacotherapies included 5-36 studies (260-3106 participants). Results are described relative to minimum clinically meaningful difference [mean difference (MD) ± 0.05, odds ratio (OR) ≤ 0.8 or ≥1.25]. Evidence for pharmacological interventions reducing cannabis use was very uncertain. However, low-certainty evidence suggested

“This is a development worth tracking. The clinical implications will become clearer as more evidence accumulates.”

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