Given the mixed evidence for N-acetylcysteine in adolescent cannabis use disorder, how do you approach discussing this with families?

A thoughtful addition to the discussion on NAC in adolescents with cannabis use disorder is to emphasize how and when it is used. In many young patients, cannabis use is not simply recreational or oppositional, but a compulsive attempt to manage obsessional anxiety. When this pattern is recognized—placing the behavior on the OCD spectrum—the clinical frame shifts in a crucial way.

Motivating both the adolescent and family begins with helping them understand the compulsive cycle: intrusive anxiet...

The use of treatments with limited evidence and without FDA approval always raises challenges. NAC has shown mixed and often negative results in studies. Still, if families are interested in trying an alternative option, it’s important to share the evidence that does exist.

For adolescents seeking help to reduce cannabis use, therapy and a supportive home environment are essential. If the adolescent refuses therapy, NAC could be considered on its own, but the level of support will be limited. Me...

Is anyone considering or using natural (and wholly legal) hemp as a harm reduction measure for Cannabis Use Disorder (contains no more than 0.3% THC and primarily CBD), of course, assuming good quality-control measures to ensure it is what the company says it is? Theoretically, this takes out the psychoactive aspect of the addiction and may even lead to medicinal or psychiatric benefits when primarily CBD.