Addiction is a very widespread disease of civilization. It concerns both illegal substances (cocaine, heroin, methamphetamine, etc.) and legal substances (alcohol, tobacco) or even prescription substances (opioids, sedatives, hypnotics, etc.).
Treatment with CBD
Among the substances in cannabis, cannabidiol (CBD) has attracted the attention of experts, as current research shows that it has beneficial effects in the treatment of neurological diseases such as epilepsy, multiple sclerosis and Parkinson’s or Alzheimer’s disease. In addition, there is a large body of evidence that CBD promotes cognitive processes and the formation of new neurons and has anxiolytic, antidepressant, antipsychotic and neuroprotective effects. This suggests a potential the usefulness of cannabidiol in the treatment of not only neuropsychiatric diseases but also substance dependence.1
There are many preclinical and clinical studies showing that CBD can reduce the risk of relapse and enhance motivation and abstinence for a variety of drugs, including alcohol, opioids (morphine, heroin), cannabinoids (THC), nicotine, and psychostimulants (cocaine, amphetamine).
Experts believe that the “anti-addiction” effect of CBD is through regulation of the dopaminergic, opioidergic, serotoninergic and endocannabinoid systems, as well as hippocampal neurogenesis.
Specifically nand opioid receptors delta and mi, CBD acts as a negative allosteric modulator. That is, it reduces their ability to bind to the endorphin or opioid molecule. This effect is likely the reason for CBD’s therapeutic success in treating addiction. Further, there is evidence that CBD may partially activate the dopamine D2 receptor, which could play a role in its antipsychotic efficacy.
But the anti-inflammatory effects of cannabidiol are also important. The addictive state generally manifests itself as an inflammatory state in the brain. CBD therefore provides immediate relief when administered in the right way. 2
- Is CBD a panacea? Cannabis Magazine 20
Nicotine addiction
Older studies have already shown that smokers who use CBD specifically reduce cigarette consumption significantly (by 40%).1
Preclinical studies suggest that it is by influencing the endocannabinoid system that nicotine addiction can be treated. 2 In laboratory animals, CBD administration reduced the symptoms of withdrawal syndrome.3
There are more than two million smokers in the Czech Republic. A total of 20% of all deaths in this country are due to the effects of smoking, including cardiovascular disease (heart and blood vessel disease), cancer and respiratory disease.
Alcohol addiction
The findings of countless studies indicate that CBD can help reduce alcohol consumption in individuals suffering from alcoholism.1 The positive thing about cannabidiol treatment is that it has no addiction potential and is generally very well tolerated.2
Interestingly, according to some studies, CBD can also help treat neurodegeneration caused by excessive alcohol use, even transdermally, in the form of CBD gel.3
Experimental studies have found that CBD reduces overall drinking rates in animal models by reducing ethanol intake, motivation to drink ethanol, relapse, anxiety, and impulsivity.4 In addition, CBD reduces alcohol-related liver steatosis and fibrosis by reducing lipid accumulation, stimulating autophagy, modulating inflammation and reducing oxidative stress. CBD also reduces alcohol-induced brain damage and prevents neuronal loss through its antioxidant and immunomodulatory properties. 5
Also notable is the suggestion that CBD may be helpful in treating alcoholism in a number of ways. For example, CBD may directly affect specific brain mechanisms underlying alcohol dependence, thereby influencing alcohol consumption.
Even more remarkable is the hypothesis that CBD may influence alcohol dependence symptoms through its effects in the digestive, immune and central nervous systems, collectively known as the microbiota-gut-brain axis (MGBA).6
There is preclinical data that cannabinoids, including CBD, can have beneficial effects on the gastrointestinal and immune systems, for example, they can reduce intestinal permeability, regulate gut bacteria and reduce inflammation. Alcohol has the opposite effect in this regard.
- Cannabidiol as a new candidate in the pharmacotherapy of alcohol dependence: A systematic review 2019
Opioid addiction
CBD not only counteracts anxiety, depression, inflammation, and pain, but it also reduces opioid cravings, which is a very important withdrawal symptom after opioid withdrawal. In addition, CBD has been shown in several clinical studies to be well tolerated without significant side effects.
A growing body of evidence suggests that CBD could be used in opioid detoxification to alleviate both acute and long-term symptoms associated with opioid withdrawal. However, most of the existing evidence is based on either preclinical studies and/or small clinical trials. 1
Sub-studies suggest that cannabidiol in the brain inhibits the reward mechanism that is linked to the use of opioids such as morphine. However, this effect was not seen with cocaine use. 2
Specific studies confirm that acute administration of CBD can prevent bingeing and relapse in heroin users.3 Another important finding is that cannabidiol treatment does not have negative effects on methadone substitution treatment, quite the opposite.4
However, the current “opioid crisis” in developed countries is not only about illicit substances such as heroin or fentanyl, but also about prescription opioid analgesics. Thanks to its analgesic and other effects, cannabis (including THC) can dramatically reduce the consumption of opioids (up to 78 %) and improve the quality of life of patients and public health, as shown in major studies. 5
Therapeutic cannabis (especially with higher THC content) is also used in the Czech health care system to treat pain. The pioneer in this field is algesiologist Radovan Hřib, MD, from the St. Anne’s University Hospital in Brno. 6
Amphetamine addiction
Preclinical studies suggest that CBD may be a useful alternative to prevent relapse in amphetamine addiction.1
CBD is known to be involved in neurogenesis (the formation of new neurons). It is precisely because of these neuroprotective properties that it is being considered as a suitable agent for improving mental performance in patients chronically exposed to psychostimulants, including ethamphetamine. 2
Cocaine addiction
New studies suggest that CBD may be used in the adjunctive treatment of cocaine addiction by acting on the reward system, cocaine consumption, behavioural responses, anxiety, neuronal proliferation and liver protection.1
However, small human studies have not yet shown a reduction in craving or relapse after CBD administration. In mice, for example, there was a reduction in anxiety and normalisation of motor and somatic symptoms. 2
Gambling addiction
Gambling is one of the most widespread modern addictions with major social consequences. As CBD has shown some efficacy in the treatment of ADHD, its potential in the treatment of behavioural disorders such as gambling is also being explored. 1
Cannabis addiction
According to many testimonies and isolated case studies, it appears that CBD can play a significant role in the withdrawal from the narcotic cannabinoid tetrahydrocannabinol (THC). It reduces withdrawal symptoms, anxiety and dissociation symptoms. 1
According to several studies and numerous personal testimonies, CBD reduces the acute effects of THC, such as overly intense experiences or psychotic effects. This seems to be due to the fact that CBD partially occupies the same receptors as THC. 2
- Cannabidiol in the treatment of withdrawal symptoms after cannabis withdrawal 2013
Another substance from cannabis in the treatment of addiction: beta-caryophyllene
Another safe compound from cannabis, beta-caryophyllene, also shows promise in treating addiction. This is a terpene that is unique in that it acts on endocannabinoid receptors.
According to new studies, beta-caryophyllene may reduce the motivation to use and craving for nicotine,1 cocaine2 and methamphetamine3 (methamphetamine).
