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By Shamard Charles, M.D. and Ali Galante
Add the possibility of reducing cravings and anxiety in heroin addicts to the growing list of potential CBD uses.
Researchers at Mount Sinai Hospital in New York announced Tuesday that results of a small study found a promising, and unexpected, new use of CBD: a reduction of cue-induced cravings and anxiety in individuals with a history of heroin abuse, suggesting a potential role for it in helping to break heroin drug addiction.
The results of the study are published in the American Journal of Psychiatry.
“To address the critical need for new treatment options for the millions of people and families who are being devastated by this epidemic, we initiated a study to assess the potential of a nonintoxicating cannabinoid on craving and anxiety in heroin-addicted individuals,” said lead study author Yasmin Hurd, director of the Addiction Institute at Mount Sinai in a statement.
“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 and her team at Mount Sinai previously studied the effects of CBD in animals on heroin. They found that CBD reduced the animals’ tendency to use heroin in response to a drug-associated cue, so they decided to study the drug’s effects on humans.
The researchers looked at 42 drug-abstinent men and women — ages 21 to 65 — with heroin use disorder. Half of the group, who had recently stopped using heroin, received CBD — 400 mg or 800 mg once daily — and the other half received a placebo. Participants were then exposed to neutral and drug-related cues during the course of three sessions: immediately following administration, 24 hours after CBD or placebo administration, and seven days after the third and final daily CBD or placebo administration.
They found that those who received CBD had significantly reduced drug cravings. They also found that the participants reported less anxiety when looking at pictures of people using drugs. Moreover, CBD seemed to have a lasting effect — the drug continued to reduce cravings and anxiety for seven days, well beyond the time the drug is expected to be present in the body.
Vital signs including skin temperature, blood pressure, heart rate, respiratory rate and oxygen saturation were obtained at different times during the sessions. To the researchers’ surprise they found that CBD reduced heart rate and salivary cortisol levels, which typically increase when anxiety provoking images are shown to addicts. This objective finding further supported Hurd’s idea that CBD may be a promising tool in helping to curb opioid addiction.
“Cravings and anxiety are very subjective effects. One of the things people can do is trick themselves. That’s why we measured their physiological responses. These drug cues increase heroin users’ heart rates and the levels of cortisol so we know it’s not subjective because with the CBD their heart rates and levels of cortisol decreased — that’s really important,” Hurd told NBC News.
Still, without more research it is impossible to prove if the findings were due to the use of CBD alone, a combination of multiple factors, or by other factors entirely.
Drug overdose deaths rose above 70,000 in 2017, a record high and an increase of almost 10 percent from the previous year, according to the Centers for Disease Control and Prevention. Young adults and teens have been hit hardest by the opioid epidemic. In fact, death rates among younger adults have risen so much that they have reduced the overall life expectancy for the U.S. population as a whole.
We’re too slow to address addiction in our society. When the flu comes up and the measles comes up, we have so many people trying to help. But we don’t have the same kind of urgency with addiction.
Many experts believe that with limited non-opioid medication options, the need for new alternatives is more important than ever.
“We’re in the middle of a huge movement in CBD research, but the Mount Sinai study is not the first,” said Dr. Danesh Alam, medical director of behavioral health at Northwestern Medicine Central DuPage Hospital, who was not involved in the study. “We’ve seen results like this from studies done in the heroin population in 2015-16. There are many chemicals found in marijuana including CBD that need to be studied further, but the restrictions on marijuana research have set us back.”
Alam notes that conducting research in the field of addiction increases the challenge of finding pharmacological solutions to addiction.
“Heroin addiction is challenging to study because we can’t bring in 100 recovering patients to our clinics, so we often have to look at the disease’s symptoms which occur in three phases: the intoxication phase, the dependence phase, and the relapse phase,” Alam said. “CBD may have a role in helping in all three, but we don’t know for sure. We have so much to learn about its role in anxiety and addiction in general.”
CBD, the component of marijuana that does not get people high, has an inhibitory effect and therefore an anti-anxiety effect, Alam added.
As the popularity of CBD grows and more research is done, its role in helping to curb addiction may become a more realistic alternative.
“We’re too slow to address addiction in our society. When the flu comes up and the measles comes up, we have so many people trying to help. But we don’t have the same kind of urgency with addiction,” Hurd told NBC News.
“A successful nonopioid medication would add significantly to the existing addiction medication toolbox to help reduce the growing death toll and enormous health care costs.”
Previous studies in animals suggest that it might help with anxiety, pain and inflammation. Even further, recent studies published in the Journal of the American Medical Association showed that in states where people could legally use marijuana, the number of filled opioid prescriptions dropped significantly, and there were lower rates of opioid overdose and death, compared with states without legal cannabis.
This growing body of research adds to be an increasingly popular belief in the scientific community that CBD may have broad medicinal value in the fields of pain management, addiction medicine, and neurology.
“In addition to epilepsy one thing that’s been replicated over and over is anxiety,” Hurd said. “I don’t think this is just drug-induced anxiety; I think it’s anxiety in general.”
Hurd’s team plans to conduct longer, larger trials as well as human imaging studies to see if CBD use can decrease the rate of relapse long-term.
Dr. Shamard Charles is a physician-journalist for NBC News and Today, reporting on health policy, public health initiatives, diversity in medicine, and new developments in health care research and medical treatments.