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

Hurd, Yasmin L.; Spriggs, Sharron; Alishayev, Julia; Winkel, Gary; Gurgov, Kristina; Kudrich, Chris; Oprescu, Anna; Salsitz, Edwin A.

doi:10.1176/appi.ajp.2019.18101191

Cited by 247 publications

(198 citation statements)

References 37 publications

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“…The results of this study suggest that using CBD-rich hemp extract oil may help reduce opioid use and improve quality of life, specifically in regards to pain and sleep, among chronic pain patients. This is consistent with emerging literature on the topic, which has concluded that CBD is an effective analgesic, and one that helps reduce barriers to opioid reduction, such as physiological withdrawal symptoms [22][23][24][25][26][27][28][29][30][31]. Recently, Wiese et al summarized the evidence for different used of the cannabinoids with opioids [13].…”

Section: Discussionsupporting

confidence: 78%

“…A recent survey study concluded that 44% of hemp CBD users reported it helped reduce the use of their opioid pain medication [25]. CBD was found to reduce the craving, anxiety and psychological manifestations significantly in drug-abstinent individuals with previous opioid dependency [26,27]. Emerging literature supports evidence for CBD in pain relief and opioid reduction, but no studies to date have evaluated the effects of readily available hemp CBD in chronic pain and opioid use in a single cohort.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study

Capano¹,

Weaver

Burkman

2019

Postgraduate Medicine

113

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Context: Chronic pain is highly prevalent in most of the industrialized nations around the world. Despite the documented adverse effects, opioids are widely used for pain management. Cannabinoids, and specifically Cannabidiol, is proposed as an opioid alternative, having comparable efficacy with better safety profile. Objectives: We aim to investigate the impact of full hemp extract cannabidiol (CBD) on opioid use and quality of life indicators among chronic pain patients. Methods: An initial sample of 131 patients was recruited from a private pain management center's investigative population. Ninety-seven patients completed the 8-week study. The primary inclusion criteria included patients between 30 and 65 years old with chronic pain who have been on opioids for at least 1 year. Data were collected at three different time points: baseline, 4, and 8 weeks. Opioid and other medication use were evaluated via the medication and psychiatric treatment receipt. Improvement was evaluated using four indices: Pain Disability Index (PDI-4); Pittsburgh Sleep Quality Index (PSQI), Pain Intensity and Interference (PEG); and Patient Health Questionnaire (PHQ-4). Results: Over half of chronic pain patients (53%) reduced or eliminated their opioids within 8 weeks after adding CBD-rich hemp extract to their regimens. Almost all CBD users (94%) reported quality of life improvements. The results indicated a significant relationship between CBD and PSQI (p = 0.003), and PEG (p = 0.006). There was a trend toward improvement but no significant relationship between CBD use and PHQ and PDI. Conclusion: CBD could significantly reduce opioid use and improve chronic pain and sleep quality among patients who are currently using opioids for pain management. Key Message: This is a prospective, single-arm cohort study for the potential role of cannabinoids as an alternative for opioids. The results indicate that using the CBD-rich extract enabled our patients to reduce or eliminate opioids with significant improvement in their quality of life indices. ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study

Capano¹,

Weaver

Burkman

2019

Postgraduate Medicine

113

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“…9,10 Recent experimental trials in humans have shown that lower doses of opioids co-administered with cannabinoids achieved analgesia equivalent to higher doses of opioids, 11 and administration of cannabidiol reduced cue-induced opioid craving among people with opioid use disorder. 12 In our 3 prospective cohorts of people at high risk of opioid overdose in Vancouver, we have found a number of beneficial long itudinal associations with consistent cannabis use, such as superior engagement in opioid agonist therapies for opioid use disorder, 13 reduced frequency of illicit opioid use in the context of chronic pain 14 and lower rates of exposure to fentanyl. 15 We strongly agree with the authors' views that governments, regulators and other stakeholders must support highquality independent research into cannabis in order to mitigate its harms and maximize its potential benefits.…”

Section: Evidence Shows That Cannabis Has Fewer Relative Harms Than Omentioning

confidence: 96%

Evidence shows that cannabis has fewer relative harms than opioids

Lake

Socías

Milloy

2020

CMAJ

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“…Cannabidiol (CBD), the most abundant non-psychotropic constituent of the Cannabis sativa plant, has drawn the attention of scientific community due to its putative desirable effects for the treatment of various psychiatric diseases (Devinsky et al, 2014), including drug addiction (Zlebnik and Cheer, 2016). CBD has been shown able to reduce the behavioural and molecular manifestations of maladaptive neuroplasticity underlying drug addiction (Hurd et al, 2019). However, available evidence supporting a 5 protective role of CBD in pre-clinical models of volitional drug seeking, and its mode of action, is still scarce.…”

Section: Introductionmentioning

confidence: 99%

The effects of cannabidiol on cue- and stress-induced reinstatement of cocaine seeking behavior in mice are reverted by the CB1 receptor antagonist AM4113

Luján

Alegre-Zurano

Martín‐Sánchez

et al. 2020

Preprint

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Cocaine addiction is a brain disorder characterized by the consumption of the drug despite harmful consequences, the loss of control over drug intake and increased risk of relapse. Albeit prolonged research efforts, there is no available medication approved for the treatment of cocaine addiction. In the last decade, cannabinoid-based compounds have drawn increased interest for its potential therapeutic applications in various psychiatric conditions. Cannabidiol, a non-psychotomimetic constituent of the C. sativa plant, shows promising results in rodent models of anxiety, schizophrenia, depression and drug addiction. However, the specific effects and mechanisms of action of cannabidiol in a rodent model of extinction-based abstinence and drug seeking relapse remain unclear. Here, we administered cannabidiol (20 mg/kg) to male CD-1 mice trained to self-administer cocaine (0.75 mg/kg/inf) during extinction training (8-12 days). Then, we evaluated the reinstatement of cocaine seeking induced by cues, stress and drug priming. To ascertain the participation of CB1 receptors in these behavioral responses, we systemically administered the neutral cannabinoid antagonist AM4113 (5 mg/kg) before each reinstatement session. The results document that cannabidiol (20 mg/kg) does not modulate extinction training but attenuates 'extinction burst' responding after one cannabidiol injection. Furthermore, cannabidiol specifically blocked the reinstatement of cocaine seeking triggered by a cue presentation, an effect prevented by AM4113 (5 mg/kg). Unexpectedly, cannabidiol facilitated stress-induced reinstatement of cocaine seeking behavior, also by a CB1-dependent mechanism.Finally, cannabidiol did not affect cocaine-primed (10 mg/kg) precipitation of cocaine seeking. Our results reveal a series of complex changes induced by cannabidiol treatment with opposite implications for the reinstatement of cocaine seeking behavior that may limit therapeutic opportunities. The activity of CB1 receptors seems to play a 3 crucial role in the expression of cannabidiol-induced neuroplasticity underlying both the desirable and undesirable reinstatement effects here detailed.

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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

Cited by 247 publications

References 37 publications

Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study

Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study

Evidence shows that cannabis has fewer relative harms than opioids

The effects of cannabidiol on cue- and stress-induced reinstatement of cocaine seeking behavior in mice are reverted by the CB1 receptor antagonist AM4113

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