Varenicline for Comorbid Tobacco and Cannnabis Use in Veterans

NIH Pandemic-Era Grants

Pandemic Era Grants

2024

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Principal Investigator: AIMEE L MCRAE-CLARK
Organization: RALPH H JOHNSON VA MEDICAL CENTER
Fiscal Year: 2024
Funding agency: Veterans Affairs

Tobacco and cannabis are commonly used together in the Veteran population and result in significant morbidity;
to date, however, advancements in medication development for this comorbidity have been limited. Varenicline,
a selective nicotinic nACH receptor partial agonist of the α4β2 subtype and a full agonist of the α7 subtype, is
arguably the most effective pharmacotherapy for promoting tobacco abstinence and has also shown promise for
the treatment of alcohol use disorder. Varenicline may improve cannabis use outcomes through multiple
mechanisms, including interaction with the mesolimbic dopamine system, enhancement of cognitive functioning,
and restoration of inhibitory control. Our pilot data also suggests that varenicline may be effective in improving
use outcomes in individuals who use both cannabis and tobacco. Given the prevalence of cannabis and tobacco
use disorder in Veterans, we propose to conduct a 12-week, placebo-controlled trial in 138 individuals to evaluate
the potential efficacy of varenicline in individuals with this comorbidity. Primary outcomes will be reduction in
cannabis and tobacco use, and exploratory analyses will examine retention in treatment.

Terms: <Agonist><Cannabis><Data><Development><Drug Therapy><Drugs><Individual><Mediating><Medication><Morbidity><Morbidity - disease rate><Outcome><Pharmaceutical Preparations><Pharmacotherapy><Placebo Control><Placebos><Prevalence><Randomized><Receptor Protein><Research><Sham Treatment><THC co-use><THC use><Tetrahydrocannabinol co-use><Tetrahydrocannabinol use><Tobacco><Tobacco Consumption><Tobacco Use Disorder><Tobacco use><Veterans><alcohol abuse therapy><alcohol abuse treatment><alcohol treatment><alcohol use disorder><cannabis use><cannabis use disorder><clinical effect><co-morbid><co-morbidity><cognitive enhancement><cognitive function><comorbidity><determine efficacy><developmental><drug treatment><drug/agent><efficacy analysis><efficacy assessment><efficacy determination><efficacy evaluation><efficacy examination><ethanol use disorder><evaluate efficacy><examine efficacy><improved><marijuana use><marijuana use and disorder><marijuana use disorder><mesolimbic dopamine system><mesolimbic system><military veteran><placebo control trial><placebo controlled><placebo controlled trial><primary outcome><psychosocial><randomisation><randomization><randomly assigned><receptor><reduce tobacco use><reduction in tobacco use><restoration><sham therapy><tobacco abstinence><tobacco disorder><tobacco product use><tobacco use reduction><varenicline><veteran population>