Can CBD Treat Opioid Addiction?

By Nicco Reggente, PhD

Cannabidiol (CBD), the therapeutically powerful and non-psychoactive component in marijuana, may help people quit heroin, Oxycontin, fentanyl and other opioid drugs that are ravaging the U.S. So...can CBD treat opioid addiction?

Dosing heroin addicts with CBD during the course of their withdrawal makes them significantly less likely to crave the needle, even when they see videos of people shooting up, or needles and white powder piled in front of them, according to a 2019 study published in the American Journal of Psychiatry

For years, study author Yasmin Hurd, a big-wig neuroscientist and addiction researcher at Mount Sinai, has been trying to figure out just how effective CBD can be to help people quit opioids. She started with experiments on lab animals who had “a history of heroin self-administration.” She showed in animal research that the junkie rats dosed with CBD and denied heroin “demonstrated that CBD reduced the animals’ tendency to use heroin in response to a drug-associated cue.” 

But the biggest news is that the results of the animal study seem to translate to human addicts.

“The specific effects of CBD on cue-induced drug craving and anxiety are particularly important in the development of addiction therapeutics because environmental cues are one of the strongest triggers for relapse and continued drug use,” Hurd said in a press release.

Can CBD treat opioid addiction? The cycle of addiction. Image courtesy of the journal Neurotherapeutics. The cycle of addiction. Image courtesy of the journal Neurotherapeutics.[/caption]

The study of 42 male and female volunteers measured not only the addicts’ subjective responses about how they felt, but also measured stress hormone levels, heart rate and other objective physiological responses during the people’s exposure to drug stimuli.

Not only did the CBD work, it kept working a week after the subjects quit taking it.

“Measures of opioid craving, anxiety, positive and negative affect, and vital signs (skin temperature, blood pressure, heart rate, respiratory rate, and oxygen saturation) were obtained at different times during the sessions,” according to the study.  “CBD, in contrast to placebo, significantly reduced both the craving and anxiety... CBD also showed significant protracted effects on these measures seven days after the final short-term exposure.”

What is the current treatment for opioid addiction?

Life isn’t great for an opioid addict, even if you have the money, family resources and desire to get clean. 

You can try to quit cold turkey and experience the anxiety, pain, insomnia, vomiting and diarrhea that come with withdrawal. Toughing it out may sound attractive in a “hero’s journey” kind of way, but statistics aren’t on your side if you choose that route.

“The chronic nature of the disease means that relapsing to drug abuse is not only possible but also likely, with symptom recurrence rates similar to those for other well-characterized chronic medical illnesses—such as diabetes, hypertension, and asthma that also have both physiological and behavioral components,” according to the National Institute on Drug Abuse.

Can CBD treat opioid addiction? This chart shows how treatment is different for hypertension vs. addiction Though opioid addiction has a similar relapse profile to medical conditions like high blood pressure, it's not treated the same. Image courtesy of[/caption]

You could try methadone and other maintenance drugs that are essentially just weaker opioids. These significantly reduce relapse rates and make it more likely you’ll stick with therapy and stay off the harder stuff. The trouble is, methadone and its cousin buprenorphine are as tightly controlled as the more potent opioids, and it’s tough to get enrolled in a program. 

Furthermore, though the opioid effect is weak, methadone has its own addiction problems.

Can CBD treat opioid addiction? How does CBD work to curb opioid cravings?

As many ex-smokers know, quitting cigarettes using nicotine gum still leaves you craving a smoke if you’re out of gum. Your nicotine craving isn’t gone, you’re just fulfilling it with a less-dangerous product. Similarly, if you’re a heroin addict and your methadone treatment stops, you’ll go into withdrawal.

That’s what makes CBD so attractive; it targets a whole different brain system than the opioid receptor signaling system. This means it reduces cravings without activating your opioid receptors, giving your body a chance to acclimate to abstinence in a way methadone never could.

This is why Hurd and her team are aiming to address the “urgent need to develop novel therapeutic strategies that do not target the... opioid receptor(s).”

But why would CBD reduce the physical craving for heroin? No one has really hashed out the mechanism for how CBD could help you kick the monkey off your back, but the mechanism probably depends on the endocannabinoid system’s regulatory role in your neural functioning.

The endocannabinoid system is a series of neurotransmitter molecules and their molecular docking stations, the CB1 and CB2 receptors that sit on the outer membranes of neurons. CBD and other cannabinoids in marijuana, notably the high-producing Delta-9 tetrahydrocannabinol (THC), hijack these receptors to produce the psychotropic and therapeutic effects.

Read our full medical article on the endocannabinoid system.

Unrelated research has shown that the endocannabinoid system interacts with stress centers in the brain to regulate the flow of adrenaline, lower heart rate, regulate breathing and temper other physiological stress signals. This keeps your body from tearing itself apart under prolonged stress. In other words, your endocannabinoid system is a big reason you can be calm and cool during a public presentation at work, for example, even though you’re still nervous.

Read our article on the endocannabinoid system’s role in stress response.

Trying not to use heroin is probably the most stressful thing that can happen to a heroin addict. Perhaps CBD activating the endocannabinoid system reduces cravings by tempering that stress response, thus enabling you to exercise greater executive function (the research community’s fancy term that encompasses “willpower” in its definition) in response to your physical withdrawal symptoms. 

But that’s only an educated guess until further research is available. The question "can CBD treat opioid addiction?" remains unanswered, but there is certainly evidence on the horizon.

According to Hurd, it will be soon. The next steps in her research will be developing different dosages and formulations for CBD-based addiction treatment, and then move into clinical trials for new pharmaceutical products developed from cannabis.

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