Excitatory rTMS to the Left Dorsolateral Pre-Frontal Cortex to Reduce Cannabis-Cue Induced Craving

Our primary aims are to determine the effect of a single session of 10 Hz L DLPFC rTMS on cannabis cue induced craving (Aim1), and behavioral tasks of impulsive decision making (Aim2), in non-treatment seeking individuals with Cannabis Use Disorder. The aims of the study will be accomplished by performing a double-blind, sham-controlled crossover trial. Non-Treatment seeking individuals with CUD will be recruited through media advertisements, as well as via a pre-established database of non-treatment seeking individuals who have participated in previous Cannabis trials and agreed to be re-contacted. Interested individuals will undergo a brief phone screen to determine if they meet general inclusion/exclusion criteria, and if so will be invited to meet with study personnel in order to sign informed consent, and undergo a screening visit. There will then be two experimental visits separated by at least one week. During each of these visits participants will undergo either a real, or sham rTMS treatment, as well as a cannabis cue Paradigm. Data on craving as well as on impulsive decision making will be collected before and after each treatment.

Inclusion criteria

• Participants must be able to provide informed consent and function at an intellectual level sufficient to allow accurate completion of all assessment instruments.
• Participants must be between the ages of 18 and 60.
• Participants must meet DSM-V criteria for Cannabis Use Disorder, with use of at least 20 days/month.
• Participants must agree to abstinence from Cannabis for at least 24 hours prior to each visit.
• Participants must have a Positive UDS for cannabis (confirming they are regular users), and a negative salivary cannabis test (Confirming no use within 10-14 hours)

Exclusion criteria

• Participants must not be pregnant and participate in the study.
• Participants must not test positive for any substance other than cannabis on UDS.
• Participants must not meet criteria for any other Substance Use Disorders with the exception of Nicotine Use Disorder.
• Participants must not be on any medications that have central nervous system effects.
• Participants Must not have a history of/or current Psychotic disorder.
• Participants must not have a history of Dementia or other cognitive impairment.
• Participants must not have active suicidal ideation, or suicide attempt within the past 90 days.
• Participants must not have any contraindications to receiving rTMS as assessed by the TMS safety sheet.
• Participants must not have any unstable general medical conditions.