cbd in substance abuse and withdrawal

The use of illegal drugs is a global problem. The most recent figures from 2018 indicate that 5.4 percent of the global population used illegal drugs in 2018, although the problem of illegal drug use and abuse varies from country to country.[1] Among Americans, 11.7 percent 12 and over use illegal drugs and 53 million or 19.4 percent of people 12 and over have used illegal drugs or misused prescription drugs (opioids; tranquilizers, sedatives and hypnotics; and stimulants) within the last year. Furthermore, there are over 70,000 drug overdose deaths in the U.S. each year.[2]

Illegal drugs are not the only problem relative to substance abuse. The National Institute on Alcohol Abuse and Alcoholism reports that about over 14 million adults in the U.S. struggle with alcohol use disorder (AUD) or alcoholism, which is actually a brain disorder.  Drinking excessively, including binge drinking and heavy alcohol use, over time increases the risk of AUD, although there are other factors, such as drinking at an early age as well as genetics and family history of alcohol problems and mental health conditions and a history of trauma.[3]

The latest figures on the annual cost of substance abuse in the U.S., including health care, crime, and lost work productivity at:[4]

  • Alcohol             $249 billion
  • Illicit Drugs             $193 billion
  • Prescription Opioids $78.5 billion

Treating Substance Abuse

Treatment for substance abuse includes the use of behavioral counseling along with medications to help re-establish normal brain function and decrease cravings. Other medications help treat depression or anxiety that may be contributing to a person’s addiction.

Medical devices also help treat withdrawal symptoms. One such medical device is NSS-2, an electronic simulation device, to help reduce opioid withdrawal symptoms. The device placed behind the ear sends electrical impulses to stimulate certain brain nerves.[5]

CBD’s Role in Substance Abuse and Withdrawal

CBD is one of the over 60 cannabinoids or naturally-occurring chemicals found in industrial hemp and marijuana. Cannabinoids interact with the body’s endocannabinoid system (ECS), which is made up of endocannabinoids or neurotransmitters that send chemical messages between neurons, the cells that transmit nerve impulses.  

The ECS stimulates and controls many of the body’s functions, such as sleep, memory, appetite and immune response. ECS acts to restore homeostasis or balance whenever something happens with those body functions. The ECS has CB1 and CB2 cannabinoid receptors in the brain and central nervous system.  When CBD interacts with these receptors, it can help the body achieve homeostasis, which studies indicate may in turn help to prevent and treat addiction by reducing cravings, help calm anxiety and improve mood, and provide potential relief from physical withdrawal symptoms.

While more research is needed, here are some studies that show how CBD can help with substance abuse by:

Lowering Anxiety

Anxiety can be an issue for people struggling with substance abuse and addiction. A 2011 study found that CBD was able to reduce Social Anxiety Disorder (SAD) among participants in a simulated public speaking test (SPST). Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in the speech performance of control patients, and significantly decreased alert levels in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group.[6]

The benefit of CBD for anxiety and other mood disorders may be attributable to its impact on the body’s serotonergic system, which is the system of serotonin transmitters that regulate sleep, mood, emotions appetite and more by interacting with 5-HTIA receptors that control serotonin levels in the brain and body.   One study that treated animals with CBD found that the cannabinoid enhanced both serotonergic and glutamate (a chemical that nerve cells use to send signals to other cells) cortical signaling through a 5-HTIA receptor-dependent mechanism.[7] 

Preventing Relapse 

Relapsing conditions are chronic among substance use disorders. To determine the anti-relapse impact of CBD, researchers administered a CBD patch once a day for seven days to animals who had self-administered cocaine and alcohol and displayed stress, elevated anxiety and impaired impulse control, which are characteristics in relapsing addicts. Following the end of the treatment, the relapse was deterred for up to five months although plasma and brain CBD levels remained detectable for only three days. CBD also reduced experimental anxiety and prevented the development of high impulsivity in the animals with a history of alcohol dependency. [8]

Withdrawal

When people stop taking the addictive substance, they may experience withdrawal symptoms, which can be both physical and mental. During withdrawal, people can experience nausea, insomnia and changes in appetite as well as irritability and restlessness. The problem is when the withdrawal symptoms take effect; people turn to the substance to look for relief.  One study on CBD and heroin withdrawal found that CBD helped to reduce both cravings and anxiety in heroin-abstinent individuals.[9]

 While research is ongoing, studies show promise in the use of CBD to lower stress and anxiety and aid withdrawal symptoms to begin to break the addiction cycle.

 

[1] Elfein, John, “Drug Use in the U.S. – Statistics & Facts,” Statista, February 9, 2021. https://www.statista.com/topics/3088/drug-use-in-the-us/
[2] “Drug Abuse Statistics” National Center for Drug Abuse Statistics,” Accessed March 12, 2021. https://drugabusestatistics.org/
[3] “Understanding Alcohol Use Disorder,” National Institute on Alcohol Abuse and Alcoholism,” Accessed March 12, 2021. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
[4] “Costs of Substance Abuse,” National Institute on Drug Abuse, Accessed March 12, 2021. https://archives.drugabuse.gov/trends-statistics/costs-substance-abuse
[5] “Treatment Approaches for Drug Addiction,” National Institute on Drug Abuse, Accessed March 12, 2021. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
[6] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219‐1226. doi:10.1038/npp.2011.6.  https://pubmed.ncbi.nlm.nih.gov/21307846/
[7] Linge R, Jiménez-Sánchez L, Campa L, Pilar-Cuéllar F, Vidal R, Pazos A, Adell A, Díaz Á. Cannabidiol induces rapid-acting antidepressant-like effects and enhances cortical 5-HT/glutamate neurotransmission: role of 5-HT1A receptors. Neuropharmacology. 2016 Apr;103:16-26. doi: 10.1016/j.neuropharm.2015.12.017. Epub 2015 Dec 19. PMID: 26711860. https://pubmed.ncbi.nlm.nih.gov/26711860/
[8] Gonzalez-Cuevas G, Martin-Fardon R, Kerr TM, et al. Unique treatment potential of cannabidiol for the prevention of relapse to drug use: preclinical proof of principle. Neuropsychopharmacology. 2018;43(10):2036-2045. doi:10.1038/s41386-018-0050-8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6098033/
[9] Yasmin L. Hurd, Sharron Spriggs, Julia Alishayev, Gary Winkel, Kristina Gurgov, Chris Kudrich, Anna M. Oprescu, and Edwin Salsitz,” American Journal of Psychiatry 2019 176:11, 911-922. https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2019.18101191