August 30th is international Overdose Awareness Day. It is one of the largest campaigns to raise awareness of overdose, acknowledge the stigma to those who have been lost, and to the families and friends who grieve. Substance abuse is common even in the smallest Canadian towns, and it continues to grow with no signs of slowing down. CBD has shown some promising results in the treatment of substance abuse and should be considered as a conjunctive therapy in addictions programs.
What we know about the role of the endocannabinoid system and substance use
The CB1 and CB2 receptors are involved with common neurobiological mechanisms which underlie drug addiction. It assists with the rewarding effects of cannabis, nicotine, alcohol, cocaine, and opiates in the mesocorticolimbic dopaminergic pathways. These receptors are also involved in drug-seeking behaviors which participate in the initiation, maintenance of drug consumption, compulsion, and loss of behavioral control. In other words, the endocannabinoid system has been found to play a critical role in substance addiction. Although, it should be noted that research is still determining the exact mechanisms involved.
Through research, genetic tools have been developed to identify CB1 receptors and its affiliated endocannabinoid, anandamide (AEA) as potential targets for drug addiction. Research and studies using the CB1 receptor have already taken place, but poor side effects such as slower motor skills, incoordination and drowsiness were witnessed. In a 2018 study, the research highlighted the role of the CB2 receptors in the addictive properties of different substances and had shown promise as a target area for therapeutic approaches. Alterations in the CB2 receptors may be involved in substance abuse with opioids, alcohol, and cocaine.
CBD and Substances
Alcohol
Alcohol abuse has been linked with those who have been diagnosed with PTSD and Major Depressive Disorder who are not receiving psychological or mental health support. At Canada House, we audited a sample of 50 patients diagnosed with PTSD and/or MDD who reported consuming more than 24 alcohol beverages in one week. These same patients decreased their alcohol intake to a couple times per week, or none with the introduction of CBD therapy over a 1–2-year period.
Dozens of clinical studies demonstrate the changes in brain chemistry with increased alcohol intake, creating stronger psychological symptoms in the PTSD/MDD or the anxious patient. Yet, through observing patient data, once we introduce cannabis therapy, our patients decreased or discontinued the use of alcohol.
CBD is slowly being introduced for various purposes in alcoholism. Studies have found reduce alcohol-related steatosis, alcohol consumption, relapse, fibrosis in the liver, oxidative stress, alcohol-related brain damage, and organ damage. Most studies are pre-clinical or experimental and have not yet been fully researched. What we do have, shows strong support as an option for CBD as a treatment option for alcoholism.
Cocaine
Currently there are no pharmaceuticals availiable to help treat cocaine addictions like there are for alcohol and opiates. Yet, cocaine and methamphetamine are highly addictive psychostimulants commonly abused causing seizures, stroke, mood disturbances, heart attack and acute liver injuries. But research in the last 5 years encompassing CBD and cocaine use, are showing we may have a natural plant option available. CBD has reversed toxicity seizures caused by cocaine, behavioral sensitization induced by amphetamines and decreased both the motivation and drug seeking behavior. Observational studies also showed CBD reduced problems related to withdrawal, craving, impulsivity, and paranoia.
Opiates
Since January 2016 to December 2020, Canada reported over 21, 000 opiate toxicity related deaths. That is an average of 17 deaths per day. CBD is more suitable for long-term and frequent use, and for the most part does not interfere with daily functionality. It is being actively researched and CBD may help reduce reliance on opiates, and addiction. Cannabis and Cannabinoid Research observed 61 patients out of a group of 180 who had been using opioids to help with lower back pain. Many of the participants were able to gradually stop their opioid use over an average of six years or reduce their dependence on opioids. Some addiction programs within Canada have been referring their patients to Canada House during active opiate treatment programs, with great success. CBD causes a different level of sensitization response than opiate receptors, helping patients lower their dose of opiates.
In the matter of using THC and CBD for addiction and withdrawal, like any substance it is recommended to do it with oversight of a medical professional. The process can be daunting to do it alone, involving family, friends and a medical team helps ensure high success rates and less risk of relapse. Do not suffer in silence, if you have questions regarding cannabinoid therapy and substance use contact your closest Canada House Clinic for more information.