To hear its proponents tell it, cannabidiol, the non-psychoactive extract from cannabis commonly known as CBD, is a one-stop cure-all for nearly every medical disorder that plagues humanity.
CBD has been touted as an effective treatment for everything from joint pain to tinnitus to depression to cancer. Over the past few years it has exploded onto the market in pills, tinctures, ointments, food additives and more. In 2018, more than $1 billion in CBD products were sold nationwide, with some forecasters claiming it could be $15 billion to $20 billion market by 2025.
But the reality, so far at least, is that little scientific evidence supports the anecdotal claims offered by consumers of the product. Until recently, the only study that had found a confirmed medical benefit from the extract was a 2017 paper published in the Journal of Epilepsy Research that found CBD effective in reducing seizures brought on by both Dravet and Lennox-Gastaut syndromes. This in itself was huge news since those two forms of epilepsy don’t respond to other anti-seizure medications, and it led to FDA approval of the first ever cannabis-derived pharmaceutical product, Epidolex.
This spring, however, brought reports of a different finding regarding CBD’s potential, one that could have a profound impact on one of the nation’s most vexing problems. Researchers reported in the American Journal of Psychiatry that in a controlled double-blind study of recovering opioid addicts treated with a prescription level dosage, those given CBD demonstrated reduced cravings for the drugs compared with others administered a placebo in the same experiment.
The primary author of the study is Yasmin Hurd, director of the Addiction Institute at the Icahn School of Medicine at Mount Sinai. Between 2016 and 2018, she and her assistants studied 42 heroin addicts who had been on the drug for an average of 13 years and who were only a month or so into their efforts at quitting. Divided into three groups, each was provided with either a 400 mg solution, 800 mg, or a placebo for three consecutive days.
Three times – immediately after receiving the initial dose, 24 hours later, and then a week after the final dose – participants were presented with neutral visual cues, such as nature scenes, as well as a three-minute video showing heroin paraphernalia and packets of powder. To prevent biasing the results, neither the participants nor the researchers knew who had been given which of the three solutions. But the results, when unveiled, were significant.
Recovering addicts given the placebo experienced heightened heart rates, increases in the stress hormone cortisol, and reported strong cravings for drugs. Meanwhile, “Those who received the CBD,” Hurd told National Public Radio’s Allison Aubrey, “showed a reduction of their craving and they also showed a reduction of their anxiety.” Among those given CBD, these responses were at their lowest one to two hours after it was administered, but the effect was still notable even a week after the final dose.
Environmental cues such as witnessing drug use, even on television or in a movie, can have strong impacts on those withdrawing from opioids and heroin and are a leading cause of relapse. It is for this reason, Hurd told the website MedPage Today, “this research is extremely promising. If we can find the medication that targets that kind of system, that would be amazing.”
How long CBD can reduce desire for opioids and heroin is a question yet to be answered, but the initial results are extremely promising, especially since CBD lacks psychoactive properties and isn’t addictive. This is in contrast to methadone, the most well-known treatment for heroin addiction, which is an opioid itself that carries its own potentially serious complications.
Opioid abuse in America began surging in the 1990s, when pharmaceutical companies started flooding the market with a new generation of opium-based painkillers. Despite claims by manufacturers that the drugs were neither addictive nor harmful, many patients were soon hooked, and overdose statistics started climbing steadily.
Between 1999 and 2010, prescriptions quadrupled, and by 2017, overdose deaths were six times as high as when the drugs first came into widespread use. According to the Centers for Disease Control, more than 47,000 Americans died from opioid-related or heroin overdoses that year. This factors out to nearly 130 deaths per day, and the problem is worsening. The National Institutes of Health estimates that 2 million people in America misuse prescription pain killers, and fifteen million worldwide.
As opioid users shift from doctor’s prescriptions, which are becoming harder to get, to the black market, heroin and synthetics have inundated the nation, showing up even in small rural communities where they were once impossible to obtain. Getting people off of the drug is a top medical priority, and the promise CBD shows in doing this safely and effectively is potentially ground shifting.
Some warnings do need to be presented before individuals look to self-treat their drug cravings with CBD. In the study, patients were given a clinically measured dose, and purity was controlled for. Unfortunately, like most over-the-counter supplements found on the market, CBD purchased in shops is unregulated, and a 2017 NIH study found that with some commercially available products, the actual quantity of CBD differs from what is claimed on the label. Buyer beware. Also, if you have to take a drug test for work, know beforehand that a few of those supplements contain trace amounts of THC.
Further research is needed, but the results of this study confirm what cannabis legalization advocates have always maintained. The anecdotal evidence for the plant’s medicinal and therapeutic properties has long been noticed by consumers. So it’s high time for scientists to examine these claims. If CBD, which is safe, can combat addiction to prescription opioids, which aren’t, this is one more argument to continue expanding the legalization process and learn what else it can do.
David James is a freelance writer in Fairbanks. Comments about this story? Email editor@AlaskaCannabist.com.