{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:44:18Z","timestamp":1775123058268,"version":"3.50.1"},"reference-count":94,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Our primary aim was to conduct a network meta\u2010analysis (NMA) for the effectiveness, safety and acceptability of all psychosocial interventions and all pharmacotherapies for cannabis use disorder (CUD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 \u226516\u2009years. Outcomes were level of cannabis use, abstinence, adverse events and treatment completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty\u2010seven studies were eligible for NMA. Depending on outcome, NMAs of psychosocial interventions included 6\u201316 studies (445\u20132287 participants), and NMAs of pharmacotherapies included 5\u201336 studies (260\u20133106 participants). Results are described relative to minimum clinically meaningful difference [mean difference (MD)\u2009\u00b1\u00a00.05, odds ratio (OR)\u2009\u2264\u00a00.8 or \u22651.25].<\/jats:p>\n                    <jats:p>Evidence for pharmacological interventions reducing cannabis use was very uncertain. However, low\u2010certainty evidence suggested that dialectical behavioural\/acceptance and commitment therapies [DBT\/ACT; MD \u20100.18, 95% credible interval (\u22120.26 to \u22120.09)] and cognitive\u2010behavioural therapy with motivation enhancement (MET\u2010CBT) with contingency management [CM; MD \u20100.15 (\u22120.23 to \u22120.07)] reduced use frequency relative to a nonspecific comparator. Interventions including CM also supported abstinence (very low certainty). Limited, low\u2010certainty evidence indicated that cannabidiol [OR 2.91 (0.45 to 27.98)], N\u2010acetylcysteine [OR 1.30 (0.55 to 3.74)] and varenicline [OR 4.85 (0.65 to 48.26)] promoted abstinence compared with placebo, although cannabidiol was associated with adverse events [OR 1.58 (0.26 to 8.98)]. Very low\u2010certainty evidence suggested mixed\u2010action antidepressants, benzodiazepines, bupropion and buspirone also had more adverse events than placebo, without any indication of effectiveness. Very low\u2010certainty evidence indicated that DBT\/ACT and CM improved treatment completion. In contrast, MET\u2010CBT, with\/without affect management, reduced completion, relative to a nonspecific comparator. Low\u2010certainty evidence suggested N\u2010acetylcysteine [OR 1.29 (0.76 to 2.19)] and delta\u20109\u2010tetrahydrocannabinol preparations [OR 1.32 (0.89 to 1.97)] increased treatment completion, while fatty acid amide hydrolase inhibitor [OR 0.80 (0.40 to 1.58)] and selective serotonin reuptake inhibitors [OR 0.56 (0.29\u20131.04)] reduced it, relative to placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is some evidence that dialectical behavioural\/acceptance and commitment therapies, contingency management alone or with cognitive\u2010behavioural therapy with motivation enhancement, N\u2010acetylcysteine, cannabidiol or varenicline may facilitate abstinence, reduce use and\/or support treatment completion for cannabis use disorder. Some interventions may have unfavourable effects on those outcomes, relative to placebo or nonspecific comparators. While safety data for psychosocial interventions is lacking, several pharmacotherapies may be associated with adverse events. These findings should be interpreted with caution as all evidence is low\u2010 to very\u2010low\u2010certainty due to imprecise or heterogeneous treatment effects and high risk of bias in some study results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70399","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T08:44:59Z","timestamp":1775119499000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative effectiveness, safety and acceptability of pharmacological and psychosocial interventions for the treatment of cannabis use disorder: A network meta\u2010analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6283-9352","authenticated-orcid":false,"given":"Monika","family":"Halicka","sequence":"first","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"National Institute for Health and Care Research (NIHR) Bristol Evidence Synthesis Group University of Bristol  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6904-2247","authenticated-orcid":false,"given":"Francesca","family":"Spiga","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"National Institute for Health and Care Research (NIHR) Bristol Evidence Synthesis Group University of Bristol  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5667-507X","authenticated-orcid":false,"given":"Tom P.","family":"Freeman","sequence":"additional","affiliation":[{"name":"Addiction and Mental Health Group, Department of Psychology University of Bath  Bath UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-1055","authenticated-orcid":false,"given":"Suzanne","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University  Frankston Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2861-0578","authenticated-orcid":false,"given":"Jelena","family":"Savovi\u0107","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"},{"name":"NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8323-2514","authenticated-orcid":false,"given":"Julian P. 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