How CBD is Helping to End the Opioid Crisis

By Danny Pollack

Over the past decade, opioid use disorder has infiltrated various segments of society, from college campuses to blue-collar and white-collar workplaces, professional sports leagues to Parent-Teacher-Associations, small towns to major metropolises. About two million people in the United States have opioid use disorder, and about one in three people know someone with the disease. According to the National Institute on Drug Abuse, in 2018, an average of 128 people died every day from opioid overdoses.

One of the most significant public health crises the nation has ever faced, medical and social welfare professionals have been working tirelessly to find a solution. Recently, research indicates there may be promise in CBD.

In an interview with Consumer Reports, Commissioner of New Jersey's Department of Health, Shereef Elnahal, M.D., said, "CBD has promising effects on pain, which could make it an effective substitute for opioids."

Shereef also referenced studies showing states that have legalized marijuana have also seen a dramatic decrease in filled opioid prescriptions and opioid overdoses and fatalities than states where cannabis is still illegal.

Many states have started allowing patients to substitute medical marijuana and/or CBD for opioid prescriptions. Some states also allow patients enrolled in certified opioid use disorder treatment to use marijuana and/or CBD as a part of their recovery plan.

New York State Health Commissioner Howard Zucker, M.D., said in a statement to Consumer Reports, "Adding opioid replacement as a qualifying condition for medical marijuana offers providers another treatment option, which is a critical step in combating the deadly opioid epidemic."

Here's more information on how CBD could be a powerful tool in fighting the crisis.

Most people who begin taking opioids do so to relieve pain. Rather than seeking out illicit drugs on the street, they are prescribed these drugs in a medical setting to treat severe or chronic pain.

According to the National Institute on Drug Abuse, in the 1990s, pharmaceutical companies assured the medical community patients would not become addicted to opioid pain relievers. However, we now know that is far from the truth. About 21 to 29% of people who receive opioids for chronic pain misuse them, and about 8 to 12% develop opioid use disorder. Approximately 4 to 6% of those who misuse prescription opioids eventually use heroin, often because it is easier to obtain, and about 80% of people who use heroin used prescription opioids first.

Because research shows that CBD can be an effective pain reliever and anti-inflammatory, it may offer a safe and non-addictive alternative solution for people looking to manage chronic pain and related conditions without potentially dangerous prescription opioids.

While doctors are not (yet) allowed to prescribe CBD in every state, the number of doctors and patients exploring CBD's benefits is rapidly increasing.

A study conducted at the Icahn School of Medicine at Mount Sinai, published in the American Journal of Psychiatry, found CBD can reduce cravings and anxiety in people with a history of opioid abuse. Researchers also found CBD can reduce physiological indicators of stress, such as an increased heart rate and cortisol levels, that occur with drug cues.

"The intense craving is what drives the drug use," said Yasmin Hurd, the lead researcher on the study and director of the Mount Sinai Addiction Institute, in a press release. "If we can have the medications that can dampen that [craving], that can greatly reduce the chance of relapse and overdose risk."

"The specific effects of CBD on cue-induced drug craving and anxiety are particularly important in the development of addiction therapeutics because environmental cues are one of the strongest triggers for relapse and continued drug use," Hurd continued.

In the study, Dr. Hurd and her team used a double-blind, randomized, placebo-controlled model to investigate acute, short-term, and protracted CBD effects on 42 drug-abstinent individuals with a history of opioid use disorder. The participants were either given a placebo or 400 mg or 800 mg of oral CBD solution. The researchers introduced volunteers to neutral and drug-related cues over three sessions, immediately after administration, 24 hours afterward, and seven days after taking a placebo or CBD for the third consecutive time. Researchers measured participants' opioid cravings, anxiety, positive and negative affect, and vital signs throughout the sessions.

Researchers concluded that compared to the placebo, participants who used CBD had significantly reduced anxiety and cravings when exposed to drug cues than neutral cues. They also found participants who had taken CBD had fewer physiological indicators of anxiety or stress. There were no significant cognitive effects or adverse side effects.

According to the Recovery Research Institute, the most widely-used medications used to treat opioid use disorder are prescription methadone and buprenorphine. The latter is often prescribed as Suboxone, a mixture of buprenorphine and naloxone.

According to Mount Sinai, these medications work on the same opioid receptors (mu receptors) as heroin and other opioid agonists.

But treatment barriers can make it difficult for those in need to access these medications. The Institute explains these medications are often underutilized in some areas, in part because of tight government regulation.

Furthermore, about 20 to 40% of patients with an opioid use disorder do not want to take agonist medications, the Institute reports. Researchers believe this may, in part, be because methadone and Suboxone can produce euphoria, which may lead to misuse or relapse.

CBD may provide a safe alternative. It does not interact with the mu receptors. And according to numerous experts and health authorities, including the World Health Organization, it does not pose a risk of dependency or addiction. CBD also has a very low risk of any adverse side effects in general.

In fighting a pervasive and widespread epidemic like the opioid crisis, those on the front lines must have multiple tools at their disposal. While more research is needed, the evidence thus far shows CBD may offer an effective alternative to prescription opioids and a useful treatment option for those battling addiction. If you or a loved one are struggling with opioid addiction, seek professional support. Addiction can feel all-consuming and insurmountable, but there is hope. Find stories of others who have defeated the disease here.