More than just a fad

If you keep up with health trends you’ve probably heard of CBD, or cannabidiol, an ingredient in marijuana known for its anti-inflammatory effects.  Unlike THC, CBD is not an intoxicant…and is therefore considered much safer for public consumption.  Scientists studying the compound believe it may help with everything from anxiety to chronic pain to cancer treatment.  Though these hypotheses is as yet unproven in human subjects, they’ve turned CBD into a wellness buzzword.  The compound has found its way into everyday products including face masks, bath bombs, and even coffee.

Will this mass adoption of CBD help Americans, or is it just another self-care trend?  Though consumer products such as the ones above aren’t tested for effectiveness, a recent study by the Addiction Institute at Mount Sinai found that CBD can help reduce cravings among participants who had regularly used heroin in the past and were not on any form of medication-assisted treatment (MAT).  The two-week study showed promising results, and researchers are already planning a longer-term follow up to dig deeper into their findings.

What is CBD?

The rise of CBD coincided with the expansion of marijuana legalization in the US.  Considered an active ingredient in marijuana, CBD has noticeable effects on the human body.  However, it does not have any mind-altering properties—the things that give users a “high”—and is not addictive.  Because it is derived from marijuana, CBD is classified as a Schedule I drug by the Federal Government.  This classification, which signals “no currently accepted medical use and a high potential for abuse,” requires researchers to conduct both clinical and nonclinical studies on the likelihood that users will develop related substance use disorders.

Currently, the FDA warns consumers that mass-market CBD products have not been tested and are not endorsed by the government.  Only one drug has been approved for marketing: Epidiolex, which helps treat epileptic seizures.  Though FDA officials recognize that CBD could have legitimate medical uses, they urge consumers to exercise caution when purchasing products containing CBD.  Scientific studies of each specific use case are the only way to know that a substance is both effective and safe to use medically.

CBD may reduce cravings and lower stress

Just this year, a team of researchers from Mount Sinai tested CBD in a clinical setting, among ex-heroin users.  The study built off the success of Epidiolex, using the drug as a CBD source for their two-week test.  They split 42 adults into three groups, who either received a high dose (800 mg), a low dose (400 mg) or a placebo each day for three days at the beginning of the study.  Then, they were exposed to images that included scenes of drug use, including powders that looked like heroin and syringes.  Such imagery is often responsible for producing cravings among users, even if they are living a sober lifestyle at the time.

For the participants who received either dosage of CBD, these images were much less likely to lead to strong cravings for heroin.  The control group reported cravings at a rate of around 2 times more than their CBD-dosed peers. 

Participants who received CBD were also less anxious during the test period, according to self-reporting from each group.  Medical tests confirmed that participants in the CBD groups had less cortisol in their saliva and lower average heart rates than those in the control group, substantiating their claims about their anxiety levels. 

CBD gets at the source of drug use

As the opioid epidemic rages on, scientists have concentrated their efforts on finding medications to help reverse an overdose and support a return to sobriety.  Opioids have a particularly difficult withdrawal period, so less-potent, non-intoxicating opioids such as Methadone, Suboxone, and Vivitrol are prescribed to help users wean themselves off of drugs.  Naloxone can when administered to a person who has overdosed, override the suppressant effects of opioids and prevent overdose death.  Such advances have moved MAT to the forefront of drug policy discussions and increased acceptance for recovery assisted by potentially addictive medications.

While these drugs used in MAT stop the body from achieving a high through heroin use while fighting withdrawal symptoms, CBD goes one step further to reduce cravings.  One of the biggest drawbacks of MAT has been its low rates of long-term success—as patients, still craving the high, find themselves drawn back to their cycle of opioid use.  The Mount Sinai researchers suggest that CBD may increase patient success rates by removing the need for the drug rather than simply nullifying its effect.  Further, the reduced levels of anxiety among the CBD groups may also prove a boon for drug users whose use is prompted by the need to tune out of highly stressful situations.

Much more to learn

CBD joins gene therapy as a subject that may provide the breakthrough in addiction science that we’re all hoping for, but one short study with a small subject pool is a starting point, not a definitive endorsement.  Though the scientists did not observe any serious side effects over the course of the study, other researchers have found that CBD may damage liver function much as alcohol does.  Longer-term studies are necessary to evaluate the risks of CBD use, not to mention its effects on other common medications.

Scientists in other realms are exploring the possible benefits of CBD, with ongoing studies examining its effectiveness as a treatment for PTSD, cancer, chronic pain, Tourette syndrome, and more.  Existing studies have given hope that CBD’s anti-inflammatory and anti-anxiety properties can be used as a treatment for health conditions across the spectrum.   

The Mount Sinai research team knows that they have only uncovered the tip of the iceberg, and that further studies will be needed not only to understand the nuances of CBD as a potential choice for MAT but also to learn why it works.  But, even in this early stage of their research, they are hopeful that CBD can become a part of the successful recovery process…and even save lives.