Juan Esteban Perez, MD 

 

The problem: In the past 10 years, opioid use has led to more than 300,000 deaths in the US alone. Heroin is a principal player in the opioid crisis, which creates new urgency for managing this form of drug addiction. 

 

Why do this study? Despite efforts to control opioid use in the United States, opioid addiction has continued to increase and is turning into a global issue. There are only a few available treatment options, and their use can be limited by bias and regulatory issues. There’s an urgent need for new strategies to control and treat opioid addiction. 

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The study:  This was a double-blind placebo-controlled randomized clinical trial whose objective was to determine the effectiveness of Cannabidiol (CBD) in reducing cue-induced craving and anxiety in patients undergoing opioid addiction recovery.  Participants who fulfilled criteria (DSM-IV) for a diagnosis of opioid dependence were enrolled and randomized to receive 400 mg CBD, 800 mg CBD or placebo. The study assessed the severity of craving and anxiety before and after exposure to video clips showing intravenous and intranasal drug use. (This is a common technique used to study people’s responses to situations that can trigger drug use and relapse).  The study found that CBD administration significantly reduced both craving and anxiety in the acute phase (1 hour following administration) in both treatment groups (400 mg, 800 mg) compared to placebo. No significant difference was observed between treatment groups. These effects were also seen in the short term (3 days) and protracted (7 days) periods after the last CBD dosage. There were no adverse effects. 

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Conclusions:  CBD appears to reduce the effect of visual triggers on people with opioid dependence.  It may play a role in the future treatment of opioid abuse and maintenance during recovery.   

 

What does this study add?  This study is new.  There haven’t been well-designed studies of CBD in opioid addiction, and the findings the researchers report here are promising. 

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Funder: The study was funded by the Icahn School of Medicine at Mount Sinai and supported in part by GW Pharmaceuticals (involved in the production of CBD and other cannabinoid derivatives). 

 

Author Conflicts: None 

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Commentary:  This is one of those rare studies that is novel, well-designed, and offers enormous potential.  It’s too soon to recommend CBD as part of routine treatment of opioid use disorder—we need clinical trials in real-world settings first.  However, this study offers a great deal of promise, particularly since CBD itself isn’t habit-forming.  It’s possible that, with additional evidence, CBD prove to have an important role in the treatment of opioid use disorders.