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Research Report: Cannabidiol (CBD) for Opioid Use Disorder

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

As the nation wrestles with the opioid epidemic, health scientists work to find new, evidence-based methods to help people struggling with opioid addiction. Research shows that a combination of Medication-Assisted Treatment (MAT), therapy, and social support is the most effective way to treat opioid addiction.

The benefits of MAT are significant. Over 40 years of research shows that MAT decreases:

In addition, MAT increases:

  • Social functioning
  • Time in treatment

To this point, most MAT research has been performed on adult populations. Researchers know little about the effectiveness of MAT for adolescents. In 2016, the American Academy of Pediatrics (AAP) recommended “increasing access to MAT of opioid addicted adolescents and young adults” and further advised that “pediatricians consider offering MAT to their adolescent patients with severe opioid use disorder.” A study published in 2018 on high-risk adolescents in Ohio – one of the states most severely impacted by the opioid crisis – strongly recommends MAT for adolescents, also.

However, this article is not about traditional MAT. It’s about a new medication that’s clinicians think may soon be approved as an effective treatment for people with OUD.

Despite the demonstrable success of MAT in treating opioid use disorder (OUD), only about a third of individuals with OUD receive MAT. Also – despite the success of MAT – very little research has been performed to develop new medications to treat addiction. Methadone, Buprenorphine, and Naltrexone are used in clinical setting every day – and earlier this year, a study published in The Journal of American Psychiatry offered promising evidence for a new medication to add to the list of effective Medications for Opioid Use Disorder (MOUDs): Cannabidiol, a.k.a. CDB.

How MAT Works

The short version: MAT reduces the extremely uncomfortable withdrawal symptoms and intense drug cravings that occur when an individual with OUD stops taking opioids. In the absence of withdrawal symptoms, they no longer seek the drug to relieve symptoms such as nausea, vomiting, diarrhea, and anxiety. In the absence of cue-related drug cravings – meaning cravings that occur when an individual with OUD experiences external stimuli that remind them of opioids – drug seeking decreases.

The absence of withdrawal symptoms and cravings is significant. It allows individuals to receive treatment, participate in recovery activities, return to work, and fulfill a majority of their family and social commitments and responsibilities.

The current, opioid-based medications work because they target and occupy opioid receptors in the human brain. In addition to mitigating withdrawal symptoms, the action of these medications significantly reduces the euphoric effects of opioids. This one-two punch is why MAT if effective. It breaks patients out of the cycle of addiction and allows them to begin building a life without opioids.

Enter Cannabidiol (CBD)

CBD is a non-intoxicating, non-addictive, non-psychoactive chemical found in hemp and marijuana. It’s important to understand the beginning of that sentence. CBD does not get you high, is not addictive, and does not alter your perception of reality.

The recent trend in legalizing both medical and recreational marijuana has led to a deluge of press reports and claims – some substantiated and some completely speculative – that promote CBD or hemp/marijuana-derived medications as wonder drugs that can cure a host of physical and psychological problems.

We’re not on that bandwagon: we’re all about the evidence. And the evidence from this recent study offers promising results. Researchers found that in comparison to placebo, administration of CBD in individuals with opioid use disorder:

  • Reduced drug cravings
  • Reduced anxiety
  • Decreased salivary cortisol levels (cortisol, a.k.a. the stress hormone)

Combined with previous research that offers preliminary evidence that CBD can also mitigate the physical symptoms of withdrawal, this recent study is good news in the evolving field of MAT, and suggests promising directions for future research into non-opioid medications for the treatment of opioid use disorder.

Treating Opioid Addiction

Evidence shows that the most effective treatment for OUD is a combination of MAT, therapy, and social support. However, powerful stigma against the use of opioid-derived medications to treat opioid use disorder still exists. We’re making progress in eliminating this stigma, but we may never eliminate it completely. Opinions against MAT are firmly entrenched and can be found in OUD patients, treatment providers, and public policy makers.

CBD may thread the needle for some of these skeptics.

While derived from a recreational drug, CBD is not used recreationally because it has no euphoric or psychoactive properties. CBD may not change everyone’s mind about MAT, but it may help to open the door to MAT for some. Which means it has the potential to free a new population of patients from the cycles of addiction. At very least, the evidence in this new study indicates that in the near future, we may have a new, FDA-approved medication to help battle the ongoing opioid crisis.

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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