Cannabidiol, also known as CBD, is everywhere and continues to grow in popularity. CBD is a phytocannabinoid and is one of many identified cannabinoids in cannabis plants. Recent research shows that CBD might be beneficial for some health conditions. Some of these health conditions include pain, inflammation, arthritis, and anxiety. Until recently, there has been a lack of studies regarding CBD because it’s still federally illegal.
Until now, the only condition that CBD treated in humans is seizures with pediatric epilepsy. However, a new study suggested that CBD curbed cravings in people with opioid dependence. This study is one of the first double-blind trials to show the benefits of using CBD outside epilepsy treatment. Researchers can now say with great confidence that CBD may help fight the war against opioid addiction.
This study used specific and limited amounts of CBD. The results do not suggest that buying over-the-counter CBD will help with opioid cravings or other medical conditions.
Addiction: A Disease of the Brain
To better understand how CBD might help treat opioid addiction, it is helpful to know how addiction alters behavior. The American Psychiatric Association did its best to define addiction. Addiction is a complex condition. A brain disease that manifests compulsive substance use despite harmful consequences. It is classified as a disease because addiction hijacks and changes the way the brain works.
Regions of the brain critical in controlling the perception of pleasurable activities are susceptible to addictive drugs. Due to addiction’s rewiring of the brain, the individual often views the world in relation to their drug of choice. The brain learns to associate drug paraphernalia or the location of drug partaking in the context of receiving a drug. These cues become triggers and reinforcers of drug use. These triggers happen with most known drugs such as cocaine, alcohol, nicotine, methamphetamines, and opioids.
People often think of addiction as chasing the “high” associated with the use of a drug. However, most users continue to abuse or relapse when trying to quit their respective addictive drugs. Despite the desire and pressure by friends, family, and co-workers to stop, drug withdrawal’s adverse effects make quitting difficult.
Withdrawals and Dependency
Depending on the drug, drug withdrawal symptoms can vary and range from low to high intensity. In the case of opioid withdrawal, symptoms include vomiting, anxiety, nausea, diarrhea, abdominal cramps, and fast heartbeat. A user going through opioid withdrawal experiencing extreme stress is likely to take opioids to alleviate that same stress. This sort of behavior repeats itself, leading to a feed-forward loop of dependence on a drug.
Doctors refer to users as “dependent” on a drug when the drug must be present for the individual to function normally. Notably, anxiety and depression correlate with opioid dependence.
For dependent individuals, ongoing drug use is not a conscious choice but rather a complete necessity. Medication-assisted treatment with pills like methadone or buprenorphine allows an individual to recover from an opioid use disorder. Medication-assisted therapy significantly decreases the likelihood of an individual relapse and deadly overdose due to dependence symptoms or withdrawal.
CBD and Epidiolex
Scientists tested CBD in several clinical trials and it appeared safe in treating a rare form of epilepsy. A pharmaceutical-grade CBD, Epidiolex, received FDA approval in June 2018 for this unique usage.
Doctors only prescribe CBD as the drug Epidiolex. Until now, CBD has only been safe and effective in treating intractable pediatric epilepsy.
Notably, CBD binds to different receptors than those that lead to opioid addiction.
CBD and Opioid Addiction
In experiments reported in 2009, rats pressed a lever to take heroin. CBD did not lower the amount of heroin that the rats self-administered or the rat’s drug-seeking behavior while taking heroin. However, when doctors took the rats off heroin and given CBD, there was a lowering in drug-seeking behavior when the animals saw a heroin-associated cue.
The first studies of CBD in humans verified that CBD, when co-administered with fentanyl, is safe and well-tolerated in healthy, non-opioid-dependent individuals. A small 2015 double-blind study conducted in opioid-dependent individuals found that a single administration of CBD, compared to a placebo, decreased cue-induced craving for opioids and feelings of anxiety. A double-blind, placebo-controlled study means doctors and patients do not know who is getting an actual drug and getting a placebo. That is to protect against what is known as the placebo effect.
A double-blind placebo-controlled report published in 2019, adds to these findings. It demonstrates that the Food and Drug Administration-approved Epidiolex can reduce cue-induced craving in individuals who had been former heroin users. Furthermore, in these individuals, Epidiolex reduced reports of anxiety and blood levels of cortisol, a hormone known to increase under conditions of stress and anxiety.
Although further research is needed, these studies strongly suggest that Epidiolex or CBD may hold promise as a critical weapon in fighting the opioid epidemic.
In other words, this could be a really big deal.
Before rushing out to purchase over-the-counter CBD to treat any medical condition, you should consider several practical considerations.
Only Epidiolex is FDA-approved for one medical condition – pediatric seizures. All other forms of CBD aren’t regulated. Numerous consumer reports show that the actual amount of CBD in over-the-counter products is significantly less than what the label says. Also, some of these over-the-counter products contain enough THC to show up on drug tests.
Although Epidiolex was safe in clinical trials, it can interact with other drugs prescribed for migraines and bipolar disorder. This could mean that taking CBD with certain drugs could diminish or enhance the effects of prescriptions, leading to problems controlling particular medical conditions that were once well-managed or increasing the other medications’ side effects. For this reason, it is imperative to talk to your doctor or pharmacist about potential drug interactions before using CBD products.