According to a latest study, cannabidiol reduces stress hormone levels and reduces the urge to use opioids.
This is not new, previous studies show that cannabinoids reduce cravings of heroin addicts as well as their level of anxiety. Yasmin Hurd, senior research fellow and director of the Mount Sinai University Institute of Addiction, said "It's the state of intense need that drives drug use, if we can have drugs that can alleviate that need, it can significantly reduce the risk of relapse and overdose."
As anyone with addictions can tell you, breaking the physical intimacy with drugs is not always the most difficult part of treatment. People who try to avoid resuscitating their addiction must also tackle reminders: the images, sounds, and people that were part of their addictive behaviors. These clues can trigger a desire to consume the drug, which creates anxiety that puts them directly into dependence to relieve their dependence.
Medications available for opioid dependence, such as buprenorphine, tramadol and methadone, work the same way, reducing cravings. Except that, more than 2,5 million Americans suffer from opioid-related disorders, resulting in more 28000 overdose deaths in 2014. In FranceThe National Agency for the Safety of Medicines (ANSM) provides an update on opioid pain medicines and also notes an increasing number of poisoning and deaths.
The use of opioids, including heroin and prescription pain medications, can lead to neonatal abstinence syndrome and the spread of infectious diseases such as HIV and hepatitis.
Public health experts say there are barriers to obtaining these drugs, widely distributed. In addition, treatment with these drugs may require frequent visits to the practitioner. "It's really a burden for doctors," says neuroscientist Yasmin Hurd.
In his study, published Tuesday in the American Journal of Psychiatry, Hurd and colleagues examined 42 adults who had a recent history of heroin use and who did not take methadone or buprenorphine. Recruited into social service groups, halfway houses, and treatment centers, participants used heroin for an average of 13 years, and most of them had spent less than a month without consuming. They had to abstain from heroin throughout the trial period.
The participants were divided into three groups: one group received 800 milligrams of CBD, another 400 milligrams of CBD and another a placebo. All participants received one dose per day for three consecutive days and were followed for the next two weeks.
During these two weeks, during several sessions, participants were able to see images or videos of nature scenes as well as images of drug use and heroin-related objects, such as syringes and powder that look like heroin. They were then asked to rate their need for heroin and their level of anxiety.
One week after the last CBD administration, those who received CBD had two to three times less cravings than the placebo group. The research team also measured heart rate and cortisol, the "stress hormone," and found that rates in people using CBD were significantly lower than those who had not received the drug.
These results are similar to those of a pilot study conducted by Hurd, but she says the next step is to do a longer-term study, following the topics for up to six months.
"Not only does the CBD manage anxiety and the cycle of anxiety, but it also decreases the initial pain and inflammation that leads to the use of opiates. There are still many questions to science in the next study:
- What is the better dosage of CBD
- Know how many times it should be administered
- Determine the best route, oral or by inhalation
- Knowing the mechanism in the brain that works to decrease cravings
Acute administration of CBD, in contrast to placebo, significantly reduced both the urge and anxiety induced by the presentation of salient drug indices compared to neutral indicators. CBD also showed significant prolonged effects on these 7 measurements days after the last exposure (3 days). In addition, CBD has reduced physiological measures of heart rate and salivary cortisol levels induced by drug signals. There were no significant effects on cognition or serious side effects.
The effects of anxiety seem promising, but we do not know whether they will generalize or not, says Chandni Hindocha, a researcher in the Division of Psychiatry at University College London. Referring to a other study showing that a dose of 400 mg CBD reduced public speaking anxiety, she says that in both cases, something triggers anxiety, rather than its chronic, generalized nature. "The system on which CBD acts to bring the body back to a state of equilibrium in times of acute anxiety," says Hindocha, so that the CBD can have its effects by speeding up this process.
The CBD's potential for reducing craving and anxiety provides a solid foundation for further research on this phytocannabinoid as a treatment option for opioid disorder.