Addiction

Addiction

With cannabis, there is a risk of abuse and addiction. However, ironically, a few cannabinoids such as CBD can in fact, help with addiction. 

Alcoholism

Interestingly, the feeling of cravings for alcohol can have “outside the nervous system” causes. More specifically, in the digestive system. A 2019 study published in the journal Cell Metabolism found that the activation of the CB1 receptor with the release of ghrelin in the gut can stimulate alcohol cravings. When inhibiting CB1, this craving will be significantly reduced. The use of THC-containing cannabis activates CB1, and it is hypothesized that this will lead to more alcohol consumption.[1] However, in reality, there is no evidence that people who use marijuana will drink more alcohol. In contrast, CBD works by somewhat inhibiting CB1, so it may play a role in helping to reduce alcohol consumption.

A team of Canadian scientists came together to review scientific studies on CBD and alcoholism. In their report published in the scientific journal Alcoholism: Clinical and Experimental Research in 2019, they concluded that CBD is not harmful to humans and does not interact adversely with alcohol. In contrast, animal studies suggest that CBD may help protect against many alcohol-related problems, including wet brain syndrome[2], neurodegeneration, inflammation, hepatotoxicity and fatty liver. CBD even helps reduce cravings for alcohol.[3] However, scientists still think that more research is needed to confirm this with more certainty.

Not only cannabinoids, a terpene in the cannabis plant called beta-caryophyllene may also play a role in the treatment of alcoholism and in reducing the harmful effects of alcohol.[4] Beta-caryophyllene is also abundant in some other plants such as cloves, rosemary and hops.

Opioid addiction

Opioid addiction and overdose is an epidemic in North America. On average, more than 40,000 people die from opioids in the United States each year. These include both use of opioid pain relievers (such as morphine) and the use of illegal opioid drugs (such as heroin).

Fortunately, cannabis could be the answer to this problem. Yes, even recreational cannabis. According to the latest statistics, in the states that have legalized medical cannabis in the US, the number of deaths from overdoses of prescription opioids has dropped sharply. The Journal of the American Medical Association (AMA) reported that these states have 24.8% fewer opioid overdose deaths than elsewhere.[5] This may be attributed to the fact that many patients can now use cannabis, which is a much safer drug, to manage their symptoms instead of relying solely on dangerous opioids. 

Cannabinoid therapy works with the opioid problem by helping to reduce opioid cravings while also making opioid use safer. A 2013 animal study using morphine found that CBD interferes with the brain's reward mechanism, which plays a role in the development of opioid addiction.[6]

Cannabinoids such as THC can amplify the effects of opioids, making it more effective with smaller doses. This greatly reduces the risk of opioid overdose. A 2019 study published in the journal Neuropharmacology showed that after using THC, rats not only no longer wanted to take more oxycodone, but THC also increased the painkilling effect of oxycodone.[7] Indeed, many people have, in fact, been able to replace or reduce their use of opioid pain relievers by using medical cannabis.

A tightly controlled clinical study (randomized, placebo-controlled, and double-blind) published in May 2019 in The American Journal of Psychiatry showed that using a single high dose of CBD (400 - 800mg) drastically reduces people’s cravings in the presence of heroin, while alleviating their stress. Furthermore, after following the protocol for 3 consecutive days, the participants were able to maintain this effect of CBD for up to 7 days afterwards.[8] 

Tobacco addiction

CBD can be used to help you quit smoking. A small trial of 24 people in 2014 found that smokers reduced their weekly tobacco use by 40% when using CBD compared with a placebo group.[9]

And as we may already know, tobacco use can increase the risk of many different medical conditions including cancer, cardiovascular disease, stroke, respiratory disease, etc. Medical cannabis may not only help with tobacco addiction, but help in combating such complications as well. 

However, be aware that sometimes, the act of inhaling a smoke by itself can be addictive. So, you may want to avoid using cannabis in any kind of smoking form, such as via joint or pipe, or even vaporizers.

Cocaine, Methamphetamine and other hard drugs addiction

Currently, research into the use of cannabinoids to help hard drug addiction such as cocaine or methamphetamine (meth) is very limited. But still, a 2019 article found that CBD has the potential to help reduce craving, reduce the toxicity and seizures caused by cocaine, behavioural sensitization induced by amphetamines, and even reduce the motivation to self-administer cocaine and METH. The mechanism of action may be through blocking the formation of brain connections to such drugs, or helping people forget painful memories, or alleviating mental disorders comorbid with drug abuse.[10]

A 2016 study found that CBD can be beneficial in reducing meth-induced psychosis. In addition, a recent Australian study successfully demonstrated the ability of CBD to reduce meth cravings in lab rats for the first time.[11]

However, more research is needed to confirm such benefits of CBD and help us come up with a standardized protocol that can be widely and effectively used for drug addictions

How to use CBD for addiction

In the beginning, dosage is usually aimed at medium or high dose, in the range of 10-1000mg of total CBD per day. This dose can be broken down to smaller doses, administered 2 or 3 times a day. Always start from the smallest dose of about 5mg CBD on the first day, then gradually increase the dose every two days by 5-10mg until you find the right dose that gives the desired effect.

Fighting addiction can be a drawn out battle, so please be patient. Seek help if needed, especially when there are psychological problems related to addiction, such as stress, anxiety or depression. Cannabis may also interact with other drugs, so it’s a good idea to let your doctor know before using any form of cannabis.

Later on, if succeeded, you can reduce the CBD dose to a maintenance dose of 1-20 mg CBD everyday.  

When using cannabis together with opioids, please be aware that cannabinoids and opioids can act synergistically, causing the user to require less opioids to be effective. You may not need as much opioid as you did before. Therefore, gradually increasing the CBD dose and gradually reducing the opioid dose may be a good strategy.

If you also suffer from anxiety, insomnia, headaches or loss of appetite, then cannabis can also help. 

References

[1] Godlewski et al., “Targeting Peripheral CB1 Receptors Reduces Ethanol Intake via a Gut-Brain Axis.”

[2] Wernicke-Korsakoff syndrome, also known as "wet brain syndrome," consists of a sudden decrease in mental ability, confusion, tremors, and memory loss.

[3] Turna et al., “Cannabidiol as a Novel Candidate Alcohol Use Disorder Pharmacotherapy: A Systematic Review.”

[4] Oppong-Damoah et al., “The Sesquiterpene Beta-Caryophyllene Oxide Attenuates Ethanol Drinking and Place Conditioning in Mice.”

[5] Bachhuber et al., “Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010.”

[6] Katsidoni, Anagnostou, and Panagis, “Cannabidiol Inhibits the Reward-Facilitating Effect of Morphine: Involvement of 5-HT1A Receptors in the Dorsal Raphe Nucleus.”

[7] Nguyen et al., “Δ 9 -Tetrahydrocannabinol Attenuates Oxycodone Self-Administration under Extended Access Conditions.”

[8] Hurd et al., “Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals with Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial.”

[9] Morgan et al., “Cannabidiol Reduces Cigarette Consumption in Tobacco Smokers: Preliminary Findings.”

[10] Calpe-López, Pilar García-Pardo, and Aguilar, “Cannabidiol Treatment Might Promote Resilience to Cocaine and Methamphetamine Use Disorders: A Review of Possible Mechanisms.”

[11] Hay et al., “Cannabidiol Treatment Reduces the Motivation to Self-Administer Methamphetamine and Methamphetamine-Primed Relapse in Rats.”

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