COVID-19 and Cannabidiol (CBD)

Abstract

COVID-19 pandemic has resulted in devastating mortality and morbidity consisting of socioeconomic and health effects that have included respiratory/pulmonary, cardiovascular, mental health and neurological consequences such as anxiety, depression, and substance use. Extensive efforts are underway to develop preventive vaccines and therapeutics such as remdesivir, dexamethasone, convalescent plasma, and others to treat COVID-19 but many report residual mental health problems after recovery. Cannabis products such as cannabidiol (CBD) are being advertised for the treatment of COVID-19 associated mental health problems and substance use disorders. This commentary will briefly clear the myth that CBD can ameliorate a wide range of COVID-19 associated health effects including anxiety, depression, or any substance use disorder, and show that there is a clear lack of sufficient unbiased clinical evidence from well-designed double-blind, placebo-controlled clinical trials to prove the antianxiety or antidepression therapeutic properties of CBD and support its wide use as medicine to treat COVID-19- associated mental health conditions or substance use disorders. Finally, we suggest that addiction physicians must play an important role in dealing with their patients requesting CBD prescription for treating any of these conditions.

Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic

“…This reinforces our findings that CBD may have a differential effect depending on anxiety severity. Regarding the effects of CBD on depression symptoms, further research is required to draw conclusions (Khalsa et al 2020;Schier et al 2014;Turna et al 2017).…”

“…CBD is widely touted as a panacea for a wide range of health problems and has been marketed as a dietary and "wellness" product (Russo 2017;Khalsa et al 2020;Eisenstein 2019). CBD's potential effects as an add-on therapy have been studied for social anxiety disorders, schizophrenia, non-motor symptoms in Parkinson's disease, and substance use disorders (Bergamaschi et al 2011;Crippa et al 2019;McGuire et al 2018;Millar et al 2019;Prud'homme et al 2015;Thiele et al 2019;Leehey et al 2020).…”

The Link between Cannabis Use, Immune System, and Viral Infections

“…Finally, cannabis smoking or vaping may exacerbate cerebrovascular and neurological dysfunction in patients with COVID-19 [65]. Whether cannabis or CBD can be used to treat any of the COVID-related health effects remains unclear at this time [73].…”

Opportunities, Challenges and Pitfalls of Using Cannabidiol as an Adjuvant Drug in COVID-19

“…Within the group of papers dealing with the literature, seven publications consider the potential use of CBD for the treatment of COVID-19 mainly due to its potent antiinflammatory activity [14,15,[56][57][58][59][60]. However, as suggested by another three authors, there is a lack of high-quality studies dedicated to the anti-inflammatory effects of CBD [61,62] or to its effects on the central nervous system (e.g., anxiety or neurological complications) [63]. Two authors warn that the anti-inflammatory action of CBD might exert a potential detrimental effect on the immune system even leading to enhancement of viral infections [64,65].…”

“…b. Anxiolytic and antinociceptive properties of CBD, given alone or together with THC, which have been identified in clinical studies ( Table 2), suggest that it may be used as an adjuvant treatment to improve the quality of life of patients with COVID-19 and, even after recovery, may limit post-traumatic stress symptoms. However, welldesigned double-blind, placebo-controlled clinical trials regarding the efficacy of CBD against COVID-19-associated panic, anxiety, depression and neurological complications are so far missing [63]. c. The decreases in ACE2 and TMPRSS2 protein expression in a human tissue model are extremely interesting but so far this effect has only been shown in an in vitro study by Wang et al [67].…”