Can CBD solve America’s crippling opioid crisis?

With CBD showing up just about everywhere nowadays, it can appear that if you’re not having a CBD coffee in the morning, you’re not living right.

It can be easy to have your viewpoint clouded by all of the hype and to forget that CBD can be attributed to having some remarkable aspects.

Previously, most medicinal claims attributed to CBD were based on animal studies. Recently, however, science-based studies have been conducted on humans for a variety of illnesses.

A study by The American Journal of Psychiatry has found that CBD may aid in reducing cravings in people who are suffering from opioid addiction, specifically reducing the cravings and anxiety often seen as the contributing factors to relapse.

It may appear contradictory, as some view CBD to be included under the umbrella of substances due to its close relation with cannabis. However, as CBD contains no psychoactive ingredients - namely THC - the effects of the compound react differently to the body’s natural endocannabinoid system to provide medicinal benefits without the ‘high’.

Relapse reduction

Currently, 40 million Americans - one in seven people - abuse or are addicted to nicotine, alcohol or other drugs. This statistic distinctly surpasses the amount of people suffering from heart conditions, diabetes and cancer across the country.

Opioids in America alone claimed 400,000 lives from 1999 to 2017, and despite the huge epidemic the country faces, the current methods for treatments offered are mainly opioid based, which could prompt users to trade one addiction for another.

Addiction is defined as “a complex disease, often chronic in nature, which affects the functioning of the brain and body”. Addiction is considered a disease as it rewires the user’s brain and effects how it processes information as a consequence of repetitive drug taking. Addiction is also characterised by a long-lasting risk of relapse.

Many addicts continue to use or relapse when trying to quit their addictive drug of choice, mostly due to the negative effects of withdrawal. Someone experiencing opioid withdrawal will likely experience anxiety, nausea, abdominal cramping and rapid heartbeat, with it being common for addicts to take more opioids to alleviate these symptoms.

With the most common treatments for opioid addiction being methadone and buprenorphine, both opioid based, the addition of CBD for harm reduction and prevention could signal a major breakthrough in the field.

CBD and addiction

Currently, the only prescribed version of CBD is the pharmaceutical grade version - Epidiolex - which gained FDA approval in 2018 for the specific use in treating a form of epilepsy.

A placebo-controlled trial conducted at the Icahn School of Medicine at Mount Sinai, publicised in May 2019, aimed to determine how effective CBD administration was on cue-induced craving and anxiety with individuals currently sober but having past heroin addiction problems. The study treated 42 individuals classed as recovering opioid addicts by administering 400 or 800 mg of CBD, once daily for three consecutive days, or a placebo.

The subjects were examined on the acute (one-hour, two-hour, and 24 hours), short-term (three days) and protracted (seven days after the last three consecutive days) effects of the CBD administered.

The participants were exposed to neutral and drug-related cues during the sessions with neutral cues showing videos of relaxing scenarios of nature while the drug-related cues included videos of intravenous and intranasal drug use, images of drugs and heroin-related paraphernalia such as syringes and rubber bands.

After recording vital signs such as participant temperature, blood pressure and heart rate alongside opioid cravings and anxiety levels at different points within the sessions, the study concluded that those who received CBD had significantly reduced cravings and anxiety after viewing the drug cues compared to the neutral cues.

Dr Hurd, the director of the study stated: “Our findings indicate that CBD holds significant promise for treating individuals with heroin use disorder, a successful non-opioid medication would add significantly to the existing addiction medication toolbox to help reduce the growing death toll, enormous health care costs, and treatment limitations imposed by stringent government regulations amid this persistent opioid epidemic.”

Though the evidence garnered from studies so far on CBD and addiction prove positive, studies still need to be undertaken in a setting other than a laboratory and under watchful eyes of scientists. It should also be considered that many forms of CBD aren’t regulated with a few CBD products shown to contain THC, with some containing enough to show up on drug tests.

Veterans for CBD

Armed Forces veterans not only have to face numerous enemies whilst in employment but also the real possibility of developing post-traumatic stress disorder (PTSD) as a result. Consequently, many find themselves trapped within the opioid crisis after suffering the effects of over-the-counter medicines to treat PTSD or through a debilitating drug addiction to deal with the horror of war. 

The White House’s official website states that veterans are twice as likely as others to die from opioids.

In 2013, US Marine Corps Sergeant Brett D’Alessandro returned from a deployment to Afghanistan and realised he felt “something was wrong”. After his behaviour grew erratic, he found himself in hospital after an acute mental-health episode, and six years later, after being prescribed 15 different medications, found his prescription opioid dependency led him to heroin.

D’Alessandro had tried and failed taking the often-deadly route of going cold turkey to rid him of his opioid addiction when, luckily, in 2017 the State of New Jersey added PTSD to one of the diagnoses that qualified for a medical marijuana program.

After originally feeling sceptical about whether he would be exchanging one addiction for another and breaking his recovery, he decided to enrol onto the program. After a few months D’Alessandro felt he did not feel the same intense reaction when quitting his prescription cannabis as he experienced when coming off his previous prescription medication.

“I wasn’t fiending for it, I could go days without it,” he commented.

After experiencing success using cannabis in place of opiates, D’Alessandro now feels that opening a veteran-owned medical dispensary would enable homeless veterans to have access to much needed medical cannabis with hopes that many will avoid succumbing to the deadly opioid epidemic.