Medical-grade cannabidiol (CBD), an active cannabis ingredient, could treat opioid addiction, according to a study report published in The American Journal of Psychiatry. The study explores the potential of CBD to overcome symptoms of heroin addiction. Dr. Yasmin Hurd and her lab team seek to check whether the compound can reduce cue-induced craving and anxiety in drug-abstinent individuals or not.
Earlier preclinical trials demonstrated that CBD reduced the tendency of heroin addiction in animals. To determine the effects on humans, her team conducts this exploratory double-blind randomized placebo-controlled trial. The study was held at the Mount Sinai Beth Israel Hospital, New York. And, the institutional review board of the Icahn School of Medicine approved the report.
The wide availability and addiction of heroin and prescription opioid analgesics have led to the unprecedented epidemic. The crisis has led to millions of deaths globally. Despite the staggering death toll, limited opioid substitutions have been pursued. While pharmacotherapies, such as methadone and buprenorphine may help, these medications are addictive. Some nations even face tight governmental regulations for using them. That’s why millions of people diagnosed with opioid use disorder still do not get proper treatment. According to the National Institute on Drug Abuse, only one-third of US patients dependent on opioids receive these medications in private treatment centers. Eventually, there’s an urgent need to develop novel therapeutic strategies for the welfare of patients.
Dr. Yasmin Hurd’s Opinion
Dr. Yasmin Hurd, the leading researcher on the study says, “To address the critical need for new treatment options for the millions of people and families who are being devastated by this epidemic, we initiated a study to assess the potential of a non-intoxicating cannabinoid on craving and anxiety in heroin-addicted individuals.”
She further says that “The intense craving is what drives the drug use. If we can have the medication that can dampen that [craving], that can greatly reduce the chance of relapse and overdose risk.” According to Hurd and her team, craving and anxiety are two critical features of addiction that contribute to relapse and continued drug use. They began the study with 50 adults recruited through advertisements.
However, eight participants were soon excluded due to health issues unrelated to drug testing. The team reviewed CBD potential with the remaining 42 participants who had used heroin for about 13 years. Some even had a history of alcohol use disorder, cannabis use disorder, and tobacco smoking. But now the majority of participants had gone without utilizing heroin for less than a month.
How Was This Study Conducted?
For the study, all were randomly divided into three treatment groups. The medical history, drug addiction, and psychiatric status of the three groups were almost similar. They were given 400 or 800 mg of CBD, once daily for three consecutive days. One group received a non-active placebo oral solution dose. The CBD oral solution used for testing was Epidiolex (100 mg per 1ml serving). It is an FDA-approved medication derived from organically grown industrial hemp. Its formulation also contains ethanol, sucralose, refined sesame oil, and strawberry for flavor.
The matched placebo solution comes from GW Pharmaceuticals (a UK-based company). The appearance, taste, and composition of the placebo oral solution are almost the same. The only difference is that it does not have the active ingredient of pure CBD. Depending on individual weight and body chemistry, the participants received their oral dose. Research noticed that CBD appeared in their bloodstream soon and reached peak plasma concentration within 3–4 hours.
Enrolled participants completed four test sessions in two weeks. During the session course, participants were exposed to neutral and drug-related cues. Neutral cues included a three-minute video showing relaxing scenarios, like scenes of nature. However, drug-related cues comprised a three-minute video showing intravenous or intranasal drug use. It exposed the subjects to heroin-related paraphernalia like syringes, rubber ties, and powder packets resembling heroin. The strategy was to determine the opioid craving, anxiety, temperament, and responses. The researchers assessed the skin temperature, blood pressure, heart rate, respiratory rate, and oxygen saturation at different times.
Findings Of The Study
Researchers assessed participants’ behavior, including positive/negative attitude, cognition, and physiological status. They noticed that CBD could significantly reduce both craving and anxiety in contrast to placebo. The patients who took CBD observed their cravings drop two to three times more than the placebo group. They also reported reduced anxiety problems after being exposed to drug cues.
Both low-dose and high-dose CBD could lower anxiety. There were no significant differences in the emotional state of mind between the two CBD groups. The compound seemed to affect drug cue-induced physiological measures, including heart rate and stress hormones. While it reduced salivary cortisol levels, there were no considerable effects on cognition. Moreover, there were no serious adverse effects.
Yasmin Hurd concludes, “Our findings indicate that CBD holds significant promise for treating individuals with heroin use disorder,”
Another aspect of this study is that the overall effects lasted for seven days after the subjects administered their CBD dose.
Measures, like blood pressure, respiration rate, and oxygen saturation were normal in all sessions. The results provide a base for further investigation of phytocannabinoids as a treatment option for opioid use disorder. While CBD is a potential treatment for alleviating the symptoms of heroin addiction, more research is necessary.
Currently, the research team of Dr. Hurd is working on two crucial studies. One study aims to understand the CBD effects has on the brain. The other looks for the development of unique CBD medicinal formulations. The researchers believe that CBD can become a vital part of the medical arsenal that addresses the opioid epidemic.
According to the National Institute on Drug Abuse, more than 45,000 people died from an opioid-related drug overdose in 2017. It includes deaths due to prescription opioids, fentanyl, heroin, and methadone. Over the years, research revealed the benefits of medical cannabis for reducing opioid withdrawal symptoms. But the new study by Hurd and her research team is different. It highlights how CBD might help with opioid use disorder.
Dr. Chinazo Cunningham, a researcher who studies and treats drug addiction, finds the study acceptable and remarks that the CBD effects on opioid use deserve to be further studied. Another researcher, Cooper says, “This is definitely a step in the right direction, with respect to future studies addressing the potential utility of cannabidiol to help as an adjunct medication for opioid use disorder.”