The opioid epidemic has swept across the United States with more than 400,000 Americans who have died due to opioid-related reason since 2000. There has emerged a serious need for developing medications to cope with this crisis. Cannabidiol(CBD), a non-intoxicating plant-derived compound, is being looked into for reducing cue-induced craving and anxiety, two crucial factors of addiction that often lead to relapse and continued drug use, in drug-abstinent individuals with a history of heroin use. However, a current study has indicated that CBD can curb cravings in individuals having opioid dependence. This is one among the first double-blind controlled trials, the gold standard for a drug study, to exhibit the benefits of CBD beyond epilepsy therapy.

This particular study is an experimental double-blind randomized placebo-controlled trial which evaluated the acute, short-term and prolonged (seven days following the last of three consecutive daily doses ) effects of administering CBD (400 or 800 mg) everyday for three consecutive days on drug cue-induced craving and anxiety in drug-abstinent persons with a history of heroin use disorder. Secondary measures evaluated the positive and negative effects, cognition and physiological condition of the participants.

The outcome revealed that acute administration of CBD, compared to placebo, considerably lowered both craving and anxiety caused by the presence of prominent drug cues as against neutral cues. CBD also displayed important prolonged effects on such measures seven days following the final short-duration (3 days) exposure. Further, CBD decreased the drug cue-induced physiological measures of heart rate and salivary cortisol levels which is a biological indicator of stress reaction. There were no serious adverse reactions and neither any marked effects on cognition.

The findings point towards the potential of CBD to lower cue-induced craving and anxiety has opened up future research on this phytocannabinoid as a therapy for opioid use disorder.

Addiction Is A Brain Disease

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Addiction can change normal behavior and has been categorized as a disease since addiction drives and modifies the manner in which the brain deals and processes information. Addiction has been extensively defined by the American Psychiatric Association as a “complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence.”
More so, the regions of the brain crucial in regulating the perception of daily and satisfying activities are more prone to the impact of addictive drugs. As the brain gets rewired under addiction, a person often observes the world relative to their selected drug. The brain forms connections between the drug and related paraphernalia and locations to increase cravings, often causing a relapse. Such events often take place with the recognized drugs of abuse like alcohol, cocaine, heroin, nicotine, methamphetamines, and opioids. In fact, individuals with opioid addiction can get triggered by watching drug paraphernalia.

Based on the drug, the signs of drug withdrawal can differ and be moderate or severe intensity.
The symptoms of opioid withdrawal can involve anxiety, vomiting, diarrhea, nausea, increased heart rate, and abdominal cramps. Most likely, an individual experiencing opioid withdrawal will revert back to opioids to calm that anxiety. Such behavior can become recurrent causing what is known as a feed-forward loop of reliance on an abused drug.

Another report of 2015 of a small double-blind study performed in individuals who were opioid-dependent revealed that a single administration of CBD, compared to a placebo, reduced the cue-induced craving of opioids and anxiety. Double-Blind, placebo-controlled research indicates that doctors and patients in the study are not aware as to who is receiving a real drug or getting a placebo. That is to protect against what is called the placebo effect.

These findings are further supplemented by a double-blind placebo-controlled study published in the American Journal of Psychiatry on May 21, 2019, which proved that the FDA approved Epidiolex which is highly purified plant-based cannabidiol or CBD, can lower cue-induced cravings in individuals with an earlier history of heroin use. In addition, in these individuals, Epidiolex regulated reports of anxiety, and cortisol blood levels, the stress hormone.

Nevertheless, further studies are required, but the present volume of studies strongly indicate that CBD can show great promise in combating the opioid epidemic. More research is still forthcoming to study CBD as an adjunct treatment to present medications like methadone or buprenorphine.



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