The opioid crisis has ravaged many communities across the country, and researchers are trying to find new ways to treat it. Some experts are looking at cannabis as a potential alternative to pharmaceutical opioids.
While research on this subject is ongoing, some evidence suggests that it may help reduce opioid withdrawal symptoms and improve treatment outcomes. Studies also show that cannabis can be used to increase the effects of methadone, a common treatment for opioid addiction.
Addiction
An addiction to opioids is a serious problem that affects millions of people across the country. Addiction is a chronic and relapsing condition that can be treated successfully with the help of medications, behavioral therapies, and support from family, friends, and other people in recovery.
The cause of an addiction to opioids is not fully understood, but it may involve how the brain and body respond to the drug, as well as genetic factors. Symptoms include craving and intense withdrawal symptoms when the drug is no longer in use.
There is a growing body of research suggesting that cannabinoids (compounds found in cannabis) may be helpful in treating opioid addiction and other pain conditions. One of the most promising compounds in marijuana is cannabidiol, or CBD.
A new study suggests that CBD may help to curb craving in patients with opioid addiction. It also reduces the amount of pain and inflammation that leads to opiate use in the first place.
While these results are promising, they also suggest that there is a need to conduct clinical trials and monitor patient outcomes with CBD before it becomes a routine part of treatment for OUD. This is because unsubstantiated claims by the cannabis industry have the potential to mislead patients who might forgo evidence-based OUD treatments like methadone or buprenorphine, which are proven to help prevent opioid overdose and associated deaths.
As state laws relax and allow for medical use of cannabis, there has been a significant rise in research on the potential benefits of cannabis to treat opioid addiction. In fact, studies have shown that in states with legal cannabis, prescriptions for opioids were reduced and there was a lower rate of opioid overdose and death.
In addition, many of the same studies show that cannabis can be used as a medication-assisted treatment (MAT) for OUD. Adding cannabis to methadone can increase the efficacy of this treatment and lower the dose needed.
But it is important to understand that the role of cannabis in treating OUD is still unclear. Although some studies show that it can decrease craving for opioids and reduce the number of times a person uses them, the study did not show any effect on the duration or frequency of withdrawal or the likelihood of relapse. Moreover, the use of cannabis has not been approved as a treatment for OUD by the FDA or the DEA.
Withdrawal
There’s growing interest in using cannabis as a treatment for opioid addiction. It may work for people with different kinds of opioids, and it’s an effective alternative to medications that can cause side effects or put people at risk for overdose.
The plant marijuana (cannabis) contains chemicals called tetrahydrocannabinol and cannabidiol, which are thought to help ease pain and reduce reliance on opioids. They also have the potential to reduce withdrawal symptoms and help people stay abstinent.
Despite the growing research and interest in cannabis as a treatment for opioid addiction, many questions remain. The most important is how to use it safely and effectively to treat patients.
Withdrawal from opioids is a painful and often life-threatening condition. It’s caused by the body’s reaction to stopping opioid use and can cause a lot of unpleasant symptoms, such as nausea, vomiting, diarrhea, and sweating. The most common treatments for withdrawal are methadone and buprenorphine.
These medications are approved by the FDA for treating addiction, but they can be difficult to get and don’t always work. Studies show that individuals with opioid use disorder who forgo these medications have a higher risk of death.
To combat this, researchers are studying the ability of cannabis to alleviate the symptoms of withdrawal and prevent relapse. One study, for example, looks at how CBD, a compound in the marijuana plant that doesn’t make people high, could prevent addiction and relapse by curbing cravings.
But before it can be used to treat patients, clinical trials are needed to show how it works in people. And the drug’s status as a Schedule I substance, which makes it illegal to sell and grow in most states, limits research.
For example, researchers at Mount Sinai in New York City are launching a trial to see if CBD can prevent heroin craving in people with opioid use disorder. It’s based on early research by neurobiologist Yasmin Hurd, Ph.D.
Similarly, cannabis can increase the effects of methadone, which is a medication that helps people with opioid use disorder stop taking opiates. It can also decrease the amount of methadone that people need to take, which may help them stay abstinent or avoid experiencing severe side effects.
Prevention
There is a growing interest in the use of cannabis as a treatment for opioid addiction, but there are significant knowledge gaps. As with other treatment options, randomized controlled clinical trials are needed to confirm preliminary findings and understand the risk of cannabis as a potential OUD medication.
Research has shown that cannabis reduces withdrawal symptoms in patients who are dependent on opioids and improves outcomes in individuals seeking recovery from OUD. However, the research is incomplete and outcomes to date are mixed. Moreover, the lack of rigorous scientific evidence regarding the efficacy of cannabis as a treatment for OUD suggests that unconfirmed claims made by dispensaries could mislead patients to seek cannabis as a treatment and/or to forgo FDA-approved medications (i.e., buprenorphine and methadone).
This is because medications like buprenorphine and methadone are proven to help prevent opioid-related overdose and individuals who forgo these medications have significantly increased risk of mortality. Therefore, encouraging patients to seek cannabis as an alternative to these medications could hinder efforts to increase access to evidence-based OUD treatments and overdose prevention.
Another promising therapeutic strategy for OUD is the use of cannabidiol, or CBD, an active ingredient in cannabis. Research shows that CBD can reduce cue-induced craving and anxiety, two common withdrawal symptoms, among abstinent heroin-dependent individuals who are currently receiving pharmacotherapy.
While CBD is well-tolerated and has a low rate of toxicity, there are significant limitations to its use as an OUD treatment. There are important safety issues related to a person’s mental health, and it is not yet FDA-approved for use in patients with OUD.
In addition, there is a growing body of research on how cannabis industry marketing influences patient behavior and substance misuse. Studies have found that marijuana-focused advertisements are associated with higher rates of cannabis use and OUD diagnoses in children. This suggests that dispensaries may be more likely to target their marketing efforts at youth.
Although there are several effective prevention strategies, many barriers exist to implementing, scaling up, and sustaining these interventions. As a result, reducing opioid misuse is challenging.
Treatment
As the opioid epidemic continues to plague the United States, there is growing interest in the role of cannabis in treating pain and opiate addiction. This is largely due to anecdotal reports and research studies that support the use of cannabidiol (CBD) as a potential medication-assisted treatment for opioid withdrawal.
Some studies have shown that CBD may help treat withdrawal symptoms by decreasing cue-induced craving and anxiety in abstinent heroin-dependent individuals. This research is encouraging, but more research needs to be done on the effectiveness of CBD in treating opioid dependence.
Moreover, some states are allowing patients with opioid use disorder to substitute medical marijuana (cannabis with high concentrations of THC and low levels of CBD) for their prescription opioids. This is a promising step in the battle against the opioid crisis, according to New York State Health Commissioner Howard Zucker.
In addition to CBD, other pharmacotherapy approaches for the treatment of opioid addiction include opiate-agonist treatments (e.g., methadone and buprenorphine) and opioid antagonists (e.g., naltrexone). These medications have been proven to reduce withdrawal symptoms and prevent relapse, but they do not cure OUD and are not available for all patients. In light of this, there is a strong need for additional drug-assisted treatment options to treat OUD and prevent opioid misuse and overdose.
For example, a study at the University of Colorado in Aurora is currently recruiting patients with back and neck pain who will receive either vaporized cannabis, the opioid drug oxycodone or a placebo. The results of the study will be used to see whether cannabis is more effective than opioids in treating chronic back and neck pain.
However, there is still a lot of research that needs to be done on using cannabis with methadone as a medication-assisted therapy for opiate addiction. One survey found that people who used cannabis with methadone misused fewer opioids than those who did not. Another study found that people who used cannabis with methadone were less likely to overdose.
The role of cannabis in treating OUD is a highly controversial issue among addiction medicine professionals, as it has not been proven to be a safe and effective treatment. In addition, unsubstantiated claims by the cannabis industry that cannabis can treat OUD and replace evidence-based opiate agonist treatments like methadone and buprenorphine can mislead individuals with OUD into seeking this alternative medication or forgoing these medications. For these reasons, we call for more rigorous scientific investigation of the benefits and harms of cannabis use in this setting.
