A preliminary study from researchers at the Icahn School of Medicine at Mount Sinai suggests cannabidiol, or CBD, can reduce cravings and anxiety in subjects with a history of heroin use. The study doesn't imply CBD alone can help break an opioid addiction but instead points to the marijuana ingredient acting as a tool to help reduce cravings in those struggling with heroin addiction.
The small, but rigorous, trial recruited 42 former heroin users, all currently reporting as drug-free. The trial explored whether doses of CBD altered users' psychological and physiological responses when confronted with drug-related cues such as a video showing heroin-related paraphernalia.
Subjects were administered one of two different strengths of CBD solution, or a placebo. They were then shown two short videos, one consisting of neutral scenes of nature, and the other filled with cues designed to trigger heroin cravings. A number of different measures were used to record the subjects' responses to the video cues, from self-reported senses of anxiety and drug cravings, to physiological signs such as skin temperature, blood pressure, heart rate, and cortisol levels in saliva.
The tests were repeated daily for three days, with the subjects' responses to the cues tracked across the test days and then again a week after the final CBD treatment. The results were compelling, with the CBD groups showing significant reductions across all measured responses compared to the placebo group. The CBD particularly reduced salivary cortisol levels and heart rate responses to the drug-associated video cues. Even more importantly, the effects seemed to hold for at least the seven days following the final CBD dose.
Needless to say, there are significant limitations in how we can interpret these results. The study focused on subjects with well-managed addictions so it is unclear how useful CBD would be for a person acutely suffering from a relapse. The trial was also conducted over a very short time frame with no indication as to if CBD has any tangible effect on whether a person would relapse over time in real-world conditions.
However, these limitations do not detract from the value of the research. There is a significant volume of observational study showing a correlation between cannabis legalization and reduced opioid consumption. This new randomized control trial does offer a clue to help explain those epidemiological studies. If CBD does indeed effectively help reduce opioid cravings and anxiety then it certainly would explain the observation that when US states legalize marijuana, either medicinal or recreational, a drop in opioid prescriptions can be subsequently seen.
Yasmin Hurd, first author on the new research and director of the Addiction Institute at Mount Sinai, suggests this study paves the way for exciting new pathways into better understanding what brain mechanisms contribute to addiction relapses, and one of the team's follow-up studies is homing in on the brain mechanisms that CBD influences. Hurd also notes that if the results from this study can be further verified in wider trials, CBD could become a useful tool to help doctors better treat those subjects trying to move past opioid addiction.
"Our findings indicate that CBD holds significant promise for treating individuals with heroin use disorder," says Hurd. "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."
The new study was published in The American Journal of Psychiatry.
Source: Mount Sinai
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