Condition
CBD for Addiction
What is Addiction
Alcohol and/or drug addiction is a complex brain disease that involves compulsive substance use despite harmful physiological, psychological and social consequences. Individuals suffering from a severe substance use disorder have an intense focus on using certain substance(s) to the point that it consumes their life.
People begin using alcohol and drugs for a variety of reasons, including feelings of pleasure, relieving stress, improve performance and/or curiosity and peer pressure. People with addiction disorders might or might not be aware of their problem but, if they are, they are unable to stop it even if they want to.
The reason for this is that the body coordinates all physiological processes and actions by sending neurological signals via various neurotransmitters. These “bump” into the membranes of cells from where they bind to a corresponding receptor, triggering events within it, including playing an important role in controlling things like mood, sleep, appetite, and stimulus-reward signaling.
The reason for addictive drugs being so addictive is because of their interaction with the reward centers of the brain. When someone uses a drug such as an opioid, amphetamine or cocaine, vast amounts of neurotransmitters (e.g., endorphins, dopamine, and serotonin) that regulate systems such as pain, mood and behavior are released.
This release typically induces feelings of euphoria, emotional numbness, and intoxication that are so pleasant and comforting, the brain’s reward centers kick into overdrive, constantly seeking these feelings. When this cycle is repeated often enough, it eventually leads to both psychological dependency and physical addiction.
Symptoms of Addiction
Many people experience both mental illness and addiction. The mental illness may be present before the addiction, or the addiction may trigger or exasperate a pre-existing mental disorder. Symptoms of addiction and substance abuse usually revolve around six primary behavioral and/or psychological themes. Some or these may be present and include:
- Impaired control: A craving or strong urge to use the substance with a desire or failed attempts to cut down or control substance use.
- Continued use despite health problems: Continued regular use of the substance(s) despite having developed a related illness and being aware of the health impact of the substance or behavior.
- Social problems: Substance use causes a failure to complete major tasks at work, school or home with social, work or leisure activities being given up or cut back because of substance use
- Dealing with problems: Feeling the need to take the drug or carry out the behavior to deal with problems, often accompanied by avoidance behaviors.
- Taking risks: The substance(s) is used in risky settings with continued use despite knowing this, disregarding danger, taking risks to obtain the substance, engaging in risky and/or illegal behaviors to obtain and/or use it. While under the influence risky activities, such as fast and dangerous driving or violence, is sometimes engaged in.
- Obsession: Becoming obsessed with the substance, and spending increasing amounts of time and energy finding ways of getting it, and in some cases how they can use it.
- Drug effects: Includes developing tolerance (need for larger amounts to get the same effect), withdrawal symptoms (different for each substance) and/or taking an initial large dose/consuming large quantities in order to feel the effects and feel good.
Addiction Medications & Treatments
Addiction is a chronic disease in which people cannot simply stop using the drugs for a few days and be cured. Most patients require long-term and repeated care to achieve full recovery. The main aims of addiction treatment are to stop drug use, remain drug free, and become productive in their families, work and society.
Pharmaceutical Interventions
Medications are used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions. Common medications include:
- Opioids: Methadone, buprenorphine and naltrexone are used to treat opioid addiction and act on the same targets in the brain and blocks the effects of opioids at their receptor sites
- Alcohol: Naltrexone (blocks opioid receptors that are involved in reward centers), acamprosate (reduce symptoms of long-lasting withdrawal), disulfiram (interferes with the breakdown of alcohol that leads to unpleasant reactions) and topiramate (alters GABA, decreasing the release of dopamine involved in the pleasure caused by alcohol consumption).
- Other medications: Several medications are used to treat withdrawal symptoms and/or mental health conditions that may be contributing to the person’s addiction.
Non-Pharmaceutical Interventions
Patients can receive treatment in a variety of settings, either as part of inpatient or outpatient treatment program. The most common therapies include:
- Cognitive-behavioral therapy: Helps recognize, avoid, and cope with the situations in which they are most likely to use drugs
- Multidimensional family therapy: Addresses a range of influences on drug abuse patterns and is designed to improve overall family functioning
- Motivational interviewing: Makes the most of a readiness to change behavior and enter treatment
- Motivational incentives: Uses positive reinforcement to encourage abstinence from drugs
CBD and Addiction
Research & Scientific Evidence
A limited number of preclinical human studies suggest that CBD may have therapeutic properties on opioid, cocaine, and psychostimulant addiction.
Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence
In a 2015 article published in Substance Abuse: Research and Treatment, researchers reviewed the data from these studies to ascertain its effectiveness for treating addiction disorders.
They found that, because CBD exercises its effects via several neural mechanisms relevant to addictive disorders including interacting with, and binding to the same neuroreceptors as addiction causing drugs, it can have positive effects on the last phases of addiction.
They also concluded that CBD shows benefits for the withdrawal phase, reducing symptoms, as well as reducing the chance of relapse during the last phase of addiction by decreasing cue-induced, drug-seeking behaviours.
Further investigating the viability of CBD for treating drug addiction, in particular the “anti-relapse” potential of a transdermal CBD preparation in animal models, researchers published the results of their 2018 study in Neuropsychopharmacology.
Rats with alcohol or cocaine self-administration histories received transdermal CBD at 24 h intervals for 7 days and were tested for context- and stress-induced reinstatement, as well as experimental anxiety on the elevated plus maze. Effects on impulsive behavior were established using a delay-discounting task following recovery from a 7-day dependence-inducing alcohol intoxication regimen.
The researchers found that CBD attenuated context-induced and stress-induced drug seeking, reduced anxiety as well as prevented the development of high impulsivity in rats with a dependence history, without tolerance, sedative effects, or interference with normal motivated behavior. Reinstatement remained attenuated up to 5 months, providing evidence supporting the potential of CBD in relapse prevention along two dimensions: beneficial actions across several vulnerability states; and long-lasting effects with only brief treatment.
Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial
Along similar lines, in a 2019 study published in the American Journal of Psychiatry, researchers investigated the potential of CBD to reduce cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder, two critical features of addiction that often contribute to relapse and continued drug use.
In their exploratory double-blind randomized placebo-controlled trial, they assessed the acute (1 hour, 2 hours, and 24 hours), short-term (3 consecutive days), and long-term (7 days after the last of three consecutive daily administrations) effects of the administration of 400 or 800 mg of CBD in drug-abstinent individuals with heroin use disorder. Primary measures assessed drug cue–induced craving and anxiety, with secondary measures assessing participants’ positive and negative affect, cognition, and physiological status.
The results showed that acute CBD administration significantly reduced both craving and anxiety induced by the presentation of salient drug cues compared with neutral cues. CBD also showed significant long-term effects on these measures 7 days after the final short-term (3-day) CBD exposure. In addition, they found that CBD reduced the drug cue–induced physiological measures of heart rate and salivary cortisol levels without any significant effects on cognition or serious adverse effects providing a strong basis for it potential as a treatment option for opioid use disorder.
Cannabidiol for the treatment of cannabis use disorder: a phase 2a, double-blind, placebo-controlled, randomized, adaptive Bayesian trial
The THC in cannabis is a basic cannabinoid that produces intoxicating effects. Daily use of THC-rich products is associated with the severity of various disorders, and may even cause psychosis. As there is currently no pharmacological form of treatment for side effects of THC use, it was decided to conduct a study (2020) to determine which dose of CBD would be most effective in limiting the use of cannabis containing significant amounts of THC.
After the screening, participants attempted to quit smoking cannabis to determine eligibility and were scheduled to start at baseline. At the end of this stage, patients were randomly assigned to 3 groups. Subjects received 400/800 mg of CBD and placebo. Compared to placebo, 400 mg CBD reduced THC-COOH:creatinine by -94.21 ng/ml and increased cannabis abstinence by 0.48 days per week. Compared to placebo, CBD 800 mg reduced THC-COOH:creatinine by -72.02 ng/ml and increased cannabis abstinence by 0.27 days per week. The study was conducted in accordance with the principles of Good Clinical Practice (GCP).
CBD in the treatment of cannabis smoking disorders has been shown to be well tolerated, as evidenced by the absence of serious adverse events. Cannabidiol was safe and more effective than placebo in reducing the use of THC-rich cannabis. The results of the study indicate the need to test also lower doses of CBD, due to the better results achieved by the group taking 400 mg of CBD compared to the group taking 800 mg of CBD.
CBD as a Complementary Treatment
Cannabidiol (CBD) is well known for its analgesic, anxiolytic, antiemetic and anti-depressant
properties that can be invaluable as a complimentary therapy in helping addicts deal with symptoms of addiction, withdrawal and relapse.
Many addiction recovery patients have co-existing conditions, and CBD can help alleviate many of these. This includes including withdrawal symptoms such as diarrhea and nausea by helping relieve gastrointestinal issues. Likewise, CBD can reduce symptoms associated with depression and anxiety while its calming properties can help mediate insomnia and other types of sleep difficulties and promote REM sleepduring withdrawal and recovery phases.
Bottom Line
Addiction is a problematic disease in which, for many addicts, long-term recovery remains an uphill battle. However, scientific evidence is showing that CBD may be effective in treating substance abuse related issues, and might just be the solution to this widespread problem. CBD is shown to help with symptoms of addiction and withdrawal, in addition to helping with the recovery process itself by preventing addiction relapse. In addition, because CBD is non-intoxicating, and non-addictive, it may also serve as a better alternative for maintenance therapies like methadone and for reducing cravings, depression and anxiety addicts experience during recovery. Similarly, CBD can also act as a powerful ally when used as a complementary therapy. However, speak to your treating physician before using CBD as it is contraindicated with use with certain medications. They can also monitor dosage, symptom severity and other clinical parameters, helping ensure that your CBD treatment is both safe and effective.
Further investigating the viability of CBD for treating drug addiction, in particular the “anti-relapse” potential of a transdermal CBD preparation in animal models, researchers published the results of their 2018 study in Neuropsychopharmacology.
Rats with alcohol or cocaine self-administration histories received transdermal CBD at 24 h intervals for 7 days and were tested for context- and stress-induced reinstatement, as well as experimental anxiety on the elevated plus maze. Effects on impulsive behavior were established using a delay-discounting task following recovery from a 7-day dependence-inducing alcohol intoxication regimen.
The researchers found that CBD attenuated context-induced and stress-induced drug seeking, reduced anxiety as well as prevented the development of high impulsivity in rats with a dependence history, without tolerance, sedative effects, or interference with normal motivated behavior. Reinstatement remained attenuated up to 5 months, providing evidence supporting the potential of CBD in relapse prevention along two dimensions: beneficial actions across several vulnerability states; and long-lasting effects with only brief treatment.
Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial
Along similar lines, in a 2019 study published in the American Journal of Psychiatry, researchers investigated the potential of CBD to reduce cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder, two critical features of addiction that often contribute to relapse and continued drug use.
In their exploratory double-blind randomized placebo-controlled trial, they assessed the acute (1 hour, 2 hours, and 24 hours), short-term (3 consecutive days), and long-term (7 days after the last of three consecutive daily administrations) effects of the administration of 400 or 800 mg of CBD in drug-abstinent individuals with heroin use disorder. Primary measures assessed drug cue–induced craving and anxiety, with secondary measures assessing participants’ positive and negative affect, cognition, and physiological status.
The results showed that acute CBD administration significantly reduced both craving and anxiety induced by the presentation of salient drug cues compared with neutral cues. CBD also showed significant long-term effects on these measures 7 days after the final short-term (3-day) CBD exposure. In addition, they found that CBD reduced the drug cue–induced physiological measures of heart rate and salivary cortisol levels without any significant effects on cognition or serious adverse effects providing a strong basis for it potential as a treatment option for opioid use disorder.
Cannabidiol for the treatment of cannabis use disorder: a phase 2a, double-blind, placebo-controlled, randomized, adaptive Bayesian trial
The THC in cannabis is a basic cannabinoid that produces intoxicating effects. Daily use of THC-rich products is associated with the severity of various disorders, and may even cause psychosis. As there is currently no pharmacological form of treatment for side effects of THC use, it was decided to conduct a study (2020) to determine which dose of CBD would be most effective in limiting the use of cannabis containing significant amounts of THC.
After the screening, participants attempted to quit smoking cannabis to determine eligibility and were scheduled to start at baseline. At the end of this stage, patients were randomly assigned to 3 groups. Subjects received 400/800 mg of CBD and placebo. Compared to placebo, 400 mg CBD reduced THC-COOH:creatinine by -94.21 ng/ml and increased cannabis abstinence by 0.48 days per week. Compared to placebo, CBD 800 mg reduced THC-COOH:creatinine by -72.02 ng/ml and increased cannabis abstinence by 0.27 days per week. The study was conducted in accordance with the principles of Good Clinical Practice (GCP).
CBD in the treatment of cannabis smoking disorders has been shown to be well tolerated, as evidenced by the absence of serious adverse events. Cannabidiol was safe and more effective than placebo in reducing the use of THC-rich cannabis. The results of the study indicate the need to test also lower doses of CBD, due to the better results achieved by the group taking 400 mg of CBD compared to the group taking 800 mg of CBD.
CBD as a Complementary Treatment
Cannabidiol (CBD) is well known for its analgesic, anxiolytic, antiemetic and anti-depressant properties that can be invaluable as a complimentary therapy in helping addicts deal with symptoms of addiction, withdrawal and relapse.
Many addiction recovery patients have co-existing conditions, and CBD can help alleviate many of these. This includes including withdrawal symptoms such as diarrhea and nausea by helping relieve gastrointestinal issues. Likewise, CBD can reduce symptoms associated with depression and anxiety while its calming properties can help mediate insomnia and other types of sleep difficulties and promote REM sleepduring withdrawal and recovery phases.
Bottom Line
Addiction is a problematic disease in which, for many addicts, long-term recovery remains an uphill battle. However, scientific evidence is showing that CBD may be effective in treating substance abuse related issues, and might just be the solution to this widespread problem. CBD is shown to help with symptoms of addiction and withdrawal, in addition to helping with the recovery process itself by preventing addiction relapse. In addition, because CBD is non-intoxicating, and non-addictive, it may also serve as a better alternative for maintenance therapies like methadone and for reducing cravings, depression and anxiety addicts experience during recovery. Similarly, CBD can also act as a powerful ally when used as a complementary therapy. However, speak to your treating physician before using CBD as it is contraindicated with use with certain medications. They can also monitor dosage, symptom severity and other clinical parameters, helping ensure that your CBD treatment is both safe and effective.