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Since 2018, there’s been a whirlwind of publicity about CBD. Cannabidiol (CBD) is a non-psychoactive compound in cannabis that’s being used for pain relief, treatment of anxiety and other health issues.
Is there a place for CBD in the addiction treatment space? Many people shy away from talking about cannabis in the same breath as recovery, so it’s understandable why CBD may not be a big part of the discourse, but should it be?
We discuss the research associated with CBD for withdrawal and recovery as well as the implications for treatment at FHE Health and other, similar inpatient treatment facilities.
Claims About CBD
CBD, in its many forms, is relatively unstudied. The first FDA-approved medication didn’t hit markets until the second half of 2018, and the drug (Epidiolex) was only approved to prevent seizures and other symptoms experienced by people with epilepsy.
What’s contributing to the excitement about CBD are the small studies that suggest CBD could be used to treat a jaw-dropping number of health conditions from stress to cancer, although federal regulators haven’t addressed the veracity of these claims.
A few of these claims are particularly relevant when it comes to withdrawal and the many unpleasant and uncomfortable symptoms that accompany it.
CBD for Withdrawal
Withdrawal is marked by physical symptoms — headaches, nausea, vomiting, fever — and mental/emotional symptoms — depression, anxiety, intense cravings and stress.
Viewing CBD’s practicality through the lens of these symptoms, there’s some obvious potential. Studies suggest that CBD can lessen pain as well as treat stress and anxiety.
One study provides more hope for CBD’s integration into addiction treatment and recovery than most: A randomized trial published in The American Journal of Psychiatry found that CBD could reduce the stress and cravings associated with withdrawal from opiates.
CBD Oil for Addiction: How Does It Work?
Let’s take a multidimensional view of CBD’s potential use in treating addiction. We know that it has potential — a double-blind study clearly showed that people who used CBD during detox had fewer cravings for opiates/opioids than those who didn’t.
But this research doesn’t tell us how this potential comes to be, beyond speculation. The investigating scientists can make a reasonable assumption, based on physiology and knowledge of the science behind CBD.
The thought is that cravings are caused by stress and anxiety, prompted by the brain in the face of a stimulus. CBD has been shown in other studies to reduce that negative feedback, thus reducing an addict’s urge to use their opiate of choice.
What About CBD for Withdrawal From Other Substances?
We know that the chemical components of CBD don’t bond to opiate receptors, so the effect of cannabidiol in assisting recovery doesn’t operate like other drugs used in medication-assisted treatment (MAT) for opiate use disorders.
For example, Suboxone® and other products containing buprenorphine compete for space in the brain, which is why they’re effective in reducing cravings for drugs. Buprenorphine is a partial opioid agonist; the molecules bind to opiate receptors, satiating the brain and promoting a controlled release of dopamine.
Because CBD doesn’t work the same way, it’s reasonable to consider that it might be useful in reducing cravings for other drugs (and addictive behaviors) as well. If cravings for, say, benzos or cocaine are fueled by stress and anxiety, there’s more than a little reason to believe that CBD oil (and other forms of the compound) can be helpful in recovery from a variety of substances.
Other Positive Uses for CBD
There’s reason to believe that CBD can be used in conjunction with MAT as well. Since the compound doesn’t compete with opioids, it seems that it can safely be used with a drug like Suboxone® or Vivitrol to accompany the modern standard of evidence-based treatment during detox.
Additionally, if CBD is effective in pain management, and FDA-approved medications become available for this purpose, it has the potential to be an alternative to opioid pain relievers, preventing some cases of opiate addiction before it starts.
Potential Risks of CBD
As with any chemical that hasn’t been studied thoroughly, there are reasons to be skeptical. There’s minimal research for many of the purported benefits of CBD products, and the FDA is actively warning against companies marketing products containing CBD for insufficiently founded reasons.
There are also other risks of CBD, many of which exist for any drug but should be considered:
Side Effects
Like many drugs, taking CBD in too high a dose can lead to nausea, vomiting, headache and a host of other side effects, although there are no known instances of deaths from an overdose of a CBD product.
One issue that has been pointed out (see our breakdown of CBD to learn more) is that CBD deactivates an enzyme in the liver that supports human metabolism, meaning that CBD could potentially change the way the body metabolizes other drugs and substances.
Possible Addiction
CBD is non-psychoactive, meaning it doesn’t produce a high and, thus, doesn’t have much potential as a standard abused subtance. This does not, however, mean the compound is risk free. If CBD is consumed in the form of medical marijuana, which also contains THC, the psychoactive component of cannabis, there is a higher risk. While cannabis itself doesn’t have a high potential for chemical addiction, the act of getting high can spark a behavioral addiction, a category that definitely includes marijuana consumption as well as the recognized ‘marijuana use disorder’.
The salve can also become part of a process addiction, similar to how NSAIDs can be abused. While ibuprofen does not contain any recognized habit forming chemicals, it can be used incorrectly and create a behavioral dependency.
CBD Can Be a Tool for Recovery
Here’s our view on using CBD for withdrawal and to support addiction treatment: Regardless of the specific neurological pathways a treatment takes to provide positive outcomes in treatment, there are cases in which CBD has helped addicts recover. If a given treatment can be administered safely AND has the potential to help a patient reach a sustainable recovery, there’s value in further study, clinical trials and potential use as a holistic treatment in a facility like ours.
To learn more about potential integrative treatments for addiction and mental health, contact FHE Health. We’re constantly researching emerging treatments in order to provide the best possible care for you or your loved ones.
