Semaglutide for the Treatment of Cannabis Use Disorder

Who can take part

• Adults aged 18-60 years, inclusive
• Use cannabis daily or near daily and have been using cannabis consistently for at least the past year, by self-report
• Diagnosed with moderate to severe DSM-5 cannabis use disorder
• Access to a mobile device to complete daily surveys
• Desire to quit or reduce cannabis consumption
• Be able to read, speak, and understand the English language. English can be a second language provided that the subject understands all the questions used in the assessment measures

Who cannot take part

• Use of any GLP-1 agonist medications in the prior 3 months
• Anticipating use of any other GLP-1 agonist medications during the trial
• Currently taking GLP-1 agonists or other weight loss drugs
• Anticipated to participate in a concurrent drug trial
• Active psychosis, active suicidality (current suicidal ideation with specific plan or intent) or homicidality, suicide attempt or psychiatric hospitalization in the past year, or any psychiatric condition that may impair ability to provide informed consent
• Any current or lifetime diagnosis of eating disorders including anorexia, bulimia, or binge eating
• Any current substance use disorder other than cannabis or mild alcohol use disorder
• MRI contraindications (including presence of metallic foreign bodies such as cardiac pacemakers, perfusion pumps, aneurysm clips, metallic tattoos anywhere on the body, tattoos near the eye)
• Current or lifetime diagnosis of Type 1 or Type 2 diabetes
• Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2
• Untreated cholelithiasis or gallbladder disease
• History of acute myocardial infarction, cerebrovascular accident (stroke), unstable angina, or congestive heart failure in the last year
• History of inflammatory bowel disease, bariatric surgery, pancreatitis, diabetic gastroparesis, or non-arteritic anterior ischemic optic neuropathy
• History of hypersensitivity or allergy to semaglutide
• Any other reason or clinical condition that the investigators judge may interfere with study participation and/or be unsafe for a participant
• Current hypoglycemia as indicated by a blood sugar level of <71 mg/dL measured at baseline visit
• Renal impairment as indicated by eGFR of <30
• BMI <21 kg/m2
• Systolic blood pressure persistently above 160mmHg or diastolic blood pressure persistently above 100mmHg during screening
• Liver function test greater than 3 times upper normal limit at baseline
• Pregnant or breastfeeding
• Anticipating to undergo elective surgeries or procedure requiring general anesthesia during duration of the study