Opioid Addiction Being Treated With Medical Marijuana

Posted by edocmmj on May 14, 2021May 14, 2021

The overwhelming and increasing severity of the opioid addiction epidemic provides more justification than ever to pursue the largely overlooked potential of cannabis in the treatment of addiction, and the spread of medical marijuana laws around the country may help give those efforts a needed boost, experts say.

In a review article published in Trends in Neurosciences notes that although evidence involving humans is sorely lacking due to the continuing status of marijuana as a Schedule I drug, studies in preclinical animal models, particularly involving the Phyto cannabinoid cannabidiol, show promising improvements in opioid withdrawal symptoms and heroin-seeking behavior that need to be pursued in larger studies. Research includes a study published in Addiction Biology in 2013 showing that cannabidiol inhibited the reward-facilitating effect of morphine, but not cocaine, in rats.

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Our research suggests that cannabidiol interferes with brain reward mechanisms responsible for the expression of the acute reinforcing properties of opioids thus indicating that cannabidiol may be clinically useful in combatting the effects of opioids.

Another study, published in the Journal of Neuroscience and conducted, showed an important effect of cannabidiol in normalizing heroin-induced impairment in the endocannabinoid system and glutamate receptors in the striatum, suggesting a possible effect of normalizing synaptic plasticity in the region. Among the scant research in humans is a pilot study, showing similar results in reducing heroin-related cue-induced craving in heroin abusers.

The strongest effects in that study were seen in reducing anxiety related to heroin cues. Similar to effects seen in animals, the reduction in general craving lasted for up to 1 week after the last administration of cannabidiol. Most evidence suggests that the mechanisms behind cannabidiol’s effects relate to its modulation of the 5-HT1A (5-hydroxytryptamine 1A subtype) receptor, consistent with many antianxiety drugs, which have partial agonist properties at the 5HT1A receptors.

For the study involving humans, the researchers used a cannabidiol solution and an oral formulation of cannabidiol (Epidiolex, GW Pharmaceuticals, Plc), which has been shown to have a strong safety profile and is used in the treatment of children with epilepsy. The formulation allows for cannabinoid treatment without the inclusion of tetrahydrocannabinol (THC), the psychoactive ingredient responsible for the “high” that results from cannabis use and is linked to an increased risk for opioid use. You can also consider cannabidiol has a low risk for diversion to the black market and retains a safe profile when combined with a strong opioid against.

One report suggests there is a trend toward reductions in prescriptions for opioid painkillers, as well as a reduction in opioid overdoses and lower opioid-positive screens associated with car fatalities, in states where medical marijuana laws have been passed. Although emphasizing that any benefits would apply solely to people who are already addicted to opioids, cannabis could feasibly represent a safer feeling of relief.

As more epidemiologic research becomes available on trends in states where marijuana laws have been passed, a clearer picture of those effects should emerge. But the stronger evidence that can come from more rigorous studies and clinical trials regarding cannabis or individual Phyto cannabinoids remains elusive as long as federal restrictions are in place, and, paradoxically, only strong evidence can change those policies.

We are in a ridiculous situation right now, there has to be some way that research can be done that fits within a federal guideline to allow us to see which components of the marijuana plant could be beneficial and which ones aren’t. Without that, we will still have these circular debates when we should be having evidence-based decisions and medicine. We could actually move very quickly if there was a federal mandate to put together a consortium that can quickly investigate this for opioid use disorder. We could really answer all the questions that are there. It doesn’t have to be 10 or 20 years from now.

Researchers are currently evaluating the use of cannabidiol in the treatment of addiction in a clinical trial involving adult and minor patients with cocaine addiction. The primary outcome of the study is drug-induced craving and number of days to relapse. Secondary outcomes are stress-induced craving and assessment of cocaine use during the post detoxification phase.