The expanding legalization of cannabis across the United States is associated with increases in cannabis use, and accordingly, an increase in the number and severity of individuals with cannabis use disorder (CUD). The lack of FDA-approved pharmacotherapies and modest efficacy of psychotherapeutic interventions means that many of those who seek treatment for CUD relapse within the first few months. Consequently, there is a pressing need for innovative, evidence-based treatment development for CUD. Preliminary evidence suggests that repetitive transcranial magnetic stimulation (rTMS) may be a novel, non-invasive therapeutic neuromodulation tool for the treatment of a variety of substance use disorders (SUDs), including recently receiving FDA clearance (August 2020) for use as a smoking cessation aid in tobacco cigarette smokers. However, the potential of rTMS for CUD has not yet been reviewed. This paper provides a primer on therapeutic neuromodulation techniques for SUDs, with a particular focus on reviewing the current status of rTMS research in people who use cannabis. Lastly, future directions are proposed for rTMS treatment development in CUD, with suggestions for study design parameters and clinical endpoints based on current gold-standard practices for therapeutic neuromodulation research.

美国大麻合法化的扩大与大麻使用的增加有关，因此，大麻使用障碍（CUD）患者的数量和严重程度也有所增加。缺乏 FDA 批准的药物疗法和心理治疗干预的适度疗效意味着许多寻求 CUD 治疗的人在最初几个月内复发。因此，迫切需要针对 CUD 进行创新的、基于证据的治疗开发。初步证据表明，重复经颅磁刺激 (rTMS) 可能是一种新型的非侵入性治疗性神经调节工具，用于治疗各种物质使用障碍 (SUD)，包括最近获得 FDA 批准（2020 年 8 月）用作吸烟吸烟者的戒烟援助。然而，rTMS 用于 CUD 的潜力尚未得到审查。本文提供了有关 SUD 治疗性神经调节技术的入门知识，特别侧重于回顾 rTMS 研究在使用大麻的人群中的现状。最后，提出了 CUD 中 rTMS 治疗发展的未来方向，并根据当前治疗性神经调节研究的金标准实践对研究设计参数和临床终点提出建议。