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Commentary |

Cannabinoid Antagonists:  A Treatment in Search of an Illness

Deepak C. D'Souza, MD; Thomas R. Kosten, MD
Arch Gen Psychiatry. 2001;58(4):330-331. doi:10.1001/archpsyc.58.4.330.
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THE TREATMENT of substance abuse has a history of developing "ideal" treatments that few patients are willing to take, such as disulfiram for alcoholism and naltrexone for opioid dependence. Despite its safety, few adverse effects, and infrequent dosing advantages, most heroin addicts shun naltrexone and prefer methadone maintenance.13 Similarly, alcoholics shun disulfiram. Thus, we are cautiously optimistic about the therapeutic promise of this first report demonstrating cannabinoid receptor antagonism by Huestis et al.4 However, treatments developed for one disorder often end up showing greater use for another. Thus, naltrexone has shown greater utility for alcoholism than opioid dependence, and disulfiram may have greater utility for cocaine dependence than alcoholism.25 The study by Huestis et al4 builds on a burgeoning preclinical knowledge about cannabinoid pharmacology and has promising implications for neuropsychiatric disorders involving cannabinoid receptor dysfunction.

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