Emerging Evidence for Cannabis' Role in Opioid Use Disorder

Abstract

Introduction: The opioid epidemic has become an immense problem in North America, and despite decades of research on the most effective means to treat opioid use disorder (OUD), overdose deaths are at an all-time high, and relapse remains pervasive.Discussion: Although there are a number of FDA-approved opioid replacement therapies and maintenance medications to help ease the severity of opioid withdrawal symptoms and aid in relapse prevention, these medications are not risk free nor are they successful for all patients. Furthermore, there are legal and logistical bottlenecks to obtaining traditional opioid replacement therapies such as methadone or buprenorphine, and the demand for these services far outweighs the supply and access. To fill the gap between efficacious OUD treatments and the widespread prevalence of misuse, relapse, and overdose, the development of novel, alternative, or adjunct OUD treatment therapies is highly warranted. In this article, we review emerging evidence that suggests that cannabis may play a role in ameliorating the impact of OUD. Herein, we highlight knowledge gaps and discuss cannabis' potential to prevent opioid misuse (as an analgesic alternative), alleviate opioid withdrawal symptoms, and decrease the likelihood of relapse.Conclusion: The compelling nature of these data and the relative safety profile of cannabis warrant further exploration of cannabis as an adjunct or alternative treatment for OUD.

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

“…A recent report has highlighted the lower mortality from opioids' overdose in states with medical cannabis legalization. Similarly, Medicare prescriptions' reports revealed reduced opioids' use and their consequent adverse events in the United States (U.S.) with legalized cannabis access [13]. In addition, cannabinoids use may mitigate the escalation of opioid doses in patients with chronic pain with a substantial reduction in opioid intake [14].…”

Does Cannabis Dependence Add on to the Neurocognitive Impairment Among Patients With Opioid Dependence? A Cross‐Sectional Comparative Study

“…These results suggest the potential mechanism of cognitive impairment. Additional dysfunctions in the executive domain seen in patients with a dual dependence of cannabis and opioids pose a threat to the current proposition of using cannabis for the treatment of patients with opioid dependence . Cognitive impairments early in the course of abstinence could potentially mediate the treatment, modality, and outcome .…”

“…Additional dysfunctions in the executive domain seen in patients with a dual dependence of cannabis and opioids pose a threat to the current proposition of using cannabis for the treatment of patients with opioid dependence. 11 Cognitive impairments early in the course of abstinence could potentially mediate the treatment, modality, and outcome. 15 Although we failed to observe any difference in the cognitive functions in patients with opioid dependence and with dual dependence, future studies should attempt to answer this question more definitively with a larger sample and longitudinal design.…”

“…A more permissive attitude might set in motion a greater likelihood of use and problematic use of cannabis or use disorders . Moreover, the proposed medicinal use of cannabis for the treatment of opioid addiction and chronic pain might also lead to a greater association between these two drugs . Delta 9‐tetrahydrocannabinol (THC) is the major active constituent of cannabis.…”

“…9,10 Moreover, the proposed medicinal use of cannabis for the treatment of opioid addiction and chronic pain might also lead to a greater association between these two drugs. 11,12 Delta 9-tetrahydrocannabinol (THC) is the major active constituent of cannabis. It has been implicated both in the cognitive side effects and the addictive properties of cannabis.…”