Addiction
July 21, 2020
If you keep up with health trendsyou’ve probably heard of CBD, or cannabidiol, an ingredient in marijuana knownfor its anti-inflammatory effects. Unlike THC, CBD is not an intoxicant…and is therefore considered muchsafer for public consumption. Scientistsstudying the compound believe it may help with everything from anxiety tochronic pain to cancer treatment. Thoughthese hypotheses is as yet unproven inhuman subjects, they’ve turned CBD into a wellness buzzword. The compound has found its way into everydayproducts including face masks, bath bombs, and even coffee.
Will this mass adoption of CBDhelp Americans, or is it just another self-care trend? Though consumer products such as the onesabove aren’t tested for effectiveness, a recent study by the Addiction Institute atMount Sinai found that CBD can help reduce cravings among participants who hadregularly used heroin in the past and were not on any form ofmedication-assisted treatment (MAT). Thetwo-week study showed promising results, and researchers are already planning alonger-term follow up to dig deeper into their findings.
The rise of CBD coincided withthe 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 thatgive users a “high”—and is not addictive. Because it is derived from marijuana, CBD is classified as a Schedule I drug by the FederalGovernment. This classification, whichsignals “no currently accepted medical use and a high potential for abuse,”requires researchers to conduct both clinical and nonclinical studies on the likelihoodthat users will develop related substance use disorders.
Currently, the FDA warnsconsumers that mass-market CBD products have not been tested and are notendorsed by the government. Only onedrug has been approved for marketing: Epidiolex, which helps treat epilepticseizures. Though FDA officials recognizethat CBD could have legitimate medical uses, they urge consumers to exercisecaution when purchasing products containing CBD. Scientific studies of each specific use caseare the only way to know that a substance is both effective and safe to usemedically.
Just this year, a team ofresearchers from Mount Sinai tested CBD in a clinical setting, among ex-heroinusers. The study built off the successof Epidiolex, using the drug as a CBD source for their two-week test. They split 42 adults into three groups, whoeither received a high dose (800 mg), a low dose (400 mg) or a placebo each dayfor 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 forproducing cravings among users, even if they are living a sober lifestyle atthe time.
For the participants who receivedeither dosage of CBD, these images were much less likely to lead to strongcravings for heroin. The control groupreported cravings at a rate of around 2 times more than their CBD-dosedpeers.
Participants who received CBDwere also less anxious during the test period, according to self-reporting fromeach group. Medical tests confirmed thatparticipants in the CBD groups had less cortisol in their saliva and loweraverage heart rates than those in the control group, substantiating theirclaims about their anxiety levels.
As the opioid epidemic rages on, scientists haveconcentrated their efforts on finding medications to help reverse an overdoseand support a return to sobriety. Opioids have a particularly difficult withdrawal period, so less-potent,non-intoxicating opioids such as Methadone, Suboxone, and Vivitrol areprescribed to help users wean themselves off of drugs. Naloxone can when administered to a personwho has overdosed, override the suppressant effects of opioids and preventoverdose death. Such advances have movedMAT to the forefront of drug policy discussions and increased acceptance forrecovery assisted by potentially addictive medications.
While these drugs used in MATstop the body from achieving a high through heroin use while fightingwithdrawal symptoms, CBD goes one step further to reduce cravings. One of the biggest drawbacks of MAT has beenits low rates of long-term success—as patients, still craving the high, findthemselves drawn back to their cycle of opioid use. The Mount Sinai researchers suggest that CBDmay increase patient success rates by removing the need for the drug ratherthan simply nullifying its effect. Further, the reduced levels of anxiety among the CBD groups may alsoprove a boon for drug users whose use is prompted by the need to tune out ofhighly stressful situations.
CBD joins gene therapy as a subject that may providethe breakthrough in addiction science that we’re all hoping for, but one shortstudy with a small subject pool is a starting point, not a definitiveendorsement. Though the scientists didnot observe any serious side effects over the course of the study, otherresearchers have found that CBD may damage liver function much as alcohol does. Longer-term studies are necessary to evaluatethe risks of CBD use, not to mention its effects on other common medications.
Scientists in other realms areexploring the possible benefits of CBD, with ongoing studies examining itseffectiveness as a treatment for PTSD, cancer, chronic pain, Tourette syndrome,and more. Existing studies have givenhope that CBD’s anti-inflammatory and anti-anxiety properties can be used as atreatment for health conditions across the spectrum.
The Mount Sinai research teamknows that they have only uncovered the tip of the iceberg, and that furtherstudies will be needed not only to understand the nuances of CBD as a potentialchoice for MAT but also to learn why it works. But, even in this early stage of their research, they are hopeful thatCBD can become a part of the successful recovery process…and even save lives.