Can Hemp-Derived CBD Help People Reduce High-THC Cannabis Use?
A clinical trial protocol published in PLoS ONE in 2024 outlines a test of hemp-derived cannabidiol (CBD) as a possible treatment tool for cannabis use disorder (CUD). The study, called LOTUS, is designed to determine whether CBD can help heavy users of cannabis concentrates reduce their consumption of tetrahydrocannabinol (THC) and manage withdrawal symptoms.
The researchers are not reporting treatment results. Instead, the paper describes how the randomized controlled trial will be conducted. The distinction is important: the study is intended to answer whether hemp-derived CBD works under controlled conditions, not to establish that CBD is already an effective treatment for CUD.
Testing CBD in people who use cannabis concentrates
The University of Colorado Boulder and University of Colorado Denver researchers plan to recruit adults who use cannabis concentrates heavily, meet criteria for at least moderate CUD, and want to reduce or stop using cannabis. Concentrates can deliver much higher levels of THC than traditional cannabis products, and high-potency use has been associated with more severe cannabis-related problems, including withdrawal and difficulty cutting back.
Participants will be randomly assigned to one of three groups:
- Broad-spectrum CBD: 400 milligrams of CBD per day with no THC
- Full-spectrum CBD: 400 milligrams of CBD per day with a small amount of THC, consistent with the study’s hemp-derived formulation
- Placebo: Softgels containing neither CBD nor THC
The study is double-blind, meaning that neither participants nor the staff conducting most assessments will know which treatment a participant is receiving. The daily dose consists of eight 50-milligram softgels, divided between morning and evening. Participants will also receive five sessions of standard psychotherapy intended to support cannabis reduction or cessation.
The medication period will last eight weeks, while the full study will extend over 16 weeks. Researchers will assess self-reported cannabis use, withdrawal symptoms, cannabis-related problems, mental health measures, medication adherence, and biological markers obtained from blood and urine samples.
Why compare full-spectrum and broad-spectrum CBD?
The trial’s three-arm design allows researchers to compare two hemp-derived CBD formulations with a placebo. Broad-spectrum CBD is intended to contain CBD without THC, while full-spectrum CBD contains CBD alongside trace amounts of THC. Comparing the two could help determine whether the small amount of THC in a full-spectrum product changes its effects on withdrawal or cannabis use.
Previous research has produced signals that relatively high doses of isolated or synthetic CBD may reduce cannabis use, craving, anxiety, or withdrawal-related symptoms. However, those findings do not necessarily predict how commercially available hemp-derived products will perform. The LOTUS study is intended to address that gap by testing plant-derived formulations with and without trace THC in people who regularly use high-potency concentrates.
The researchers will examine whether changes in withdrawal—such as irritability, anxiety, sleep disruption, or physical discomfort—help explain any reduction in THC use. They will also explore possible differences in cannabinoid metabolism and treatment response between sexes.
A treatment possibility, not an established therapy
CUD can involve unsuccessful attempts to stop, cravings, continued use despite personal or social problems, and withdrawal symptoms after reducing consumption. The Centers for Disease Control and Prevention describes CUD as a condition in which a person has difficulty controlling cannabis use despite harmful consequences.
There are currently no medications approved by the U.S. Food and Drug Administration specifically to treat CUD. Behavioral approaches, including cognitive behavioral therapy, motivational interventions, and contingency management, remain important treatment options. A positive result from LOTUS would not automatically make over-the-counter CBD products an approved treatment, but it could provide evidence for developing and testing cannabinoid-based therapies more rigorously.
Safety and product quality also require caution. The FDA warns that unapproved CBD products have not been evaluated for effectiveness, appropriate dosing, drug interactions, or manufacturing quality. CBD may affect the way other medicines work and has been associated with risks such as liver injury and drowsiness. The dose used in a supervised clinical trial should not be treated as a general recommendation for self-medication.
The LOTUS protocol is registered as ClinicalTrials.gov study NCT06107062. Its findings will be needed to determine whether hemp-derived CBD can meaningfully reduce THC use or withdrawal symptoms beyond the effects of psychotherapy and placebo. Until those results are available, CBD remains an experimental possibility rather than a proven treatment for cannabis use disorder.
