Posted on May 28, 2019, 8 p.m.
Cannabis compounds may help some people wean off of addictive pain medications, and even help some to fight the cause of the addiction: pain and inflammation.
Cannabidiol, CBD, is extracted from the cannabis plant, growing research suggests that it can help to ease pain, seizures, inflammation, anxiety, eating disorders, and now addiction to opioids. Unlike tetrahydrocannabinol, THC, CBD does not get people high, however THC concentration can be grown to have low values as in some medical marijuana. Some studies are showing that THC and CBD can work together to be even more beneficial for some people.
Breaking the stigma physicians and patients are increasingly using CBDs to not just ease pain but to reduce their reliance on opioids, and it is being studied to investigate whether CBDs alone or in combinations with THC will be a tool in the fight against the ongoing and increasing opioid crisis.
Shereef Elnahal, M.D., the commissioner of New Jersey’s Department of Health and a strong supporter of medical marijuana says “CBD has promising effects on pain, which could make it an effective substitute for opioids.”
In states where people can legally use marijuana the number of prescriptions for opioids being filled has significantly decreased, and they have lower rates of opioid overdose and mortality, according to a study published in the Journal of the American Medical Association.
Anecdotal reports and emerging studies have prompted several states to allow some patients to substitute cbds and/or medical marijuana for opioids, such as in New York patients enrolled in a certified treatment program for opioid addictions can now try medical marijuana as as alternative.
“Adding opioid replacement as a qualifying condition for medical marijuana offers providers another treatment option, which is a critical step in combating the deadly opioid epidemic,” says Howard Zucker, M.D., New York State Health Commissioner.
“Early research suggests that some cannabinoids or combinations of cannabinoids may have the potential to help people wean off opioids, but more rigorous studies are needed,” says Jeffrey Selzer, M.D., of the American Society of Addiction Medicine.
A considerable amount of evidence shows that when taken together CBD and THC can help to treat pain, but there is not as much for CBDs alone and most comes from animal studies and anecdotal reports. Even still CBDs are well known to fight inflammation which may help to relieve pain. Cannabinoids have been shown to interact with receptors in the endocannabinoid system which may explain how the compounds affect pain, moods, and appetite among others.
Research on CBDs potential to treat opioid addiction is preliminary but growing and showing positive results. For example Yasmin Hurd, Ph.D, director of the Addiction Institute at Mount Sinai has shown that CBD can reduce cravings for heroin in rats and humans.
Philip Blair M.D., says that he has helped dozens of patients taper off opioids by substituting with CBDs, and encouraging them to go at their own pace to stretch out time between opioids replaced with CBDs. “If they know they have something to rely on, to count on, to get back to normal and get them through this time period, they can do it.”
Julia Arnsten, M.D., of the Montefiore Medical Center says she has also weaned patients off of opioids by using both THC and CBDs, but says that it is a slow process and that we will most likely need to see thousands of patients before we can say it is really successful.
CBDs may help to treat opioid addiction by affecting how brain cells that have damaged by opioids to communicate with each other, this would also decrease cravings, anxiety, and other symptoms of opioid withdrawal. “Being able to decrease their stress and anxiety response will go very far in decreasing their drug use, so even if we don’t know exactly why CBD is working, if it works on craving and anxiety, that actually is very positive,” says Yasmin Hurd, Ph.D.
Scientists are studying the potential of CBDs to treat pain and/or addiction and caution people considering trying CBDs to be careful about what they purchase, especially online, and make sure that it is from a reputable source with a Certificate of Analysis as some places may have questionable quality, as well as to talk with their doctors to see if there is a chance of it interacting with any prescription medications.
“What I tell people generally is that there’s about a 50-50 likelihood that it will work, we really have to make sure that we’re working up to a good dose and giving it a good try.” says Arnsten.
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