In the U.S., 128 people die everyday due to illicit or prescription opioid use, including oxycodone, heroin and fentanyl, reports the Center for Disease Control and Prevention (CDC). Such opioids are responsible for “46,802 overdose deaths in 2018” alone, or over 69% of “all drug overdose deaths” in America.
Despite the public health crisis, there’s a lack of research on non-toxic alternatives.
At the same time, more Americans are turning to cannabis for pain management.
Those factors motivated a group of scientists to investigate CBD’s effect on opioid use. They were particularly keen to determine whether or not patients could use CBD to safely treat heroin use disorder. The disorder is defined by the American Psychiatric Association as, “a problematic pattern of opioid use leading to clinically significant impairment or stress.”
More specifically, the study set out to investigate CBD’s potential, “to reduce cue-induced craving and anxiety, two critical features of addiction that often contribute to relapse and continued drug use, in drug-abstinent individuals with [the disorder],” the authors wrote.
Results, published in the American Journal of Psychiatry in May 2019, proved promising.
Trial and Triggers
The trail involved 42 “drug-abstinent” participants. On average, they used heroin for 10 years. The majority didn’t use drugs for just under month prior to the study. Researchers randomly gave each former user a 400mg or 800mg dosage of CBD, or a placebo. They took it once per day for three days.
While the study did not specify what type of CBD was used, the Research Recovery Institute (RRI), a nonprofit located at the Harvard-affiliated Massachusetts General Hospital, reports that the prescription drug, Epidiolex, was used in the trial. The FDA approved the CBD-only medication in 2018 to treat seizures.
After administration of the CBD/placebo, researchers exposed participants to neutral cues, and drug-use triggers at several different points: one hour, three hours, 24 hours, three days, and again after seven days. Neutral cues included three minute videos of nature, while triggers included videos of people using drugs.
Researchers also tested participants’ heart rates, brain function, and cortisol levels.
"A Strong Basis for Further Investigation"
Those who took CBD experienced a significant reduction in cravings and anxiety brought on by negative triggers, found researchers. The effects lasted for an impressive seven days after their final dosages. Notably, there were no major differences between lower and higher doses of CBD.
The study also found, “CBD reduced the drug cue–induced [...] heart rate and salivary cortisol levels. There were no significant effects on cognition, and there were no serious adverse effects.” Therefore, the cannabinoid "provides a strong basis for further investigation," authors wrote.
While promising, the researchers hesitated to promote “medical marijuana,” according to the RRI. The authors also noted that the trial only examined the effects of Epidiolex for one week. Therefore, more research, particularly on long-term effects, are needed before the U.S. enters yet another wave in the opioid epidemic.