Diagnosis Research: Addiction

Addiction is a widespread disease of civilization. It affects both illegal substances (cocaine, heroin, methamphetamine, etc.) and legal substances (alcohol, tobacco) or even those provided by prescription (opioids, sedatives, hypnotics, etc.).

Treatment with CBD

Among the substances in cannabis, cannabidiol (CBD) is of particular interest to experts. According to current research, it has beneficial effects in the treatment of neurological diseases such as epilepsy, multiple sclerosis, and Parkinson's and Alzheimer's diseases. In addition, there is a large body of evidence that CBD supports cognitive processes and the formation of new neurons and has anxiolytic, antidepressant, antipsychotic and neuroprotective effects. This suggests the potential usefulness of cannabidiol in the treatment of not only neuropsychiatric diseases, but also addiction to addictive substances .

There are many preclinical and clinical studies that demonstrate that CBD can reduce the risk of relapse and enhance motivation and abstinence from various drugs, including alcohol, opioids (morphine, heroin), cannabinoids (THC), nicotine, and psychostimulants (cocaine, amphetamine).

Experts believe that the "anti-addictive" effect of CBD occurs through the regulation of the dopaminergic, opioidergic, serotoninergic and endocannabinoid systems, as well as hippocampal neurogenesis.

Specifically, CBD acts as a negative allosteric modulator on the delta and mu opioid receptors. This means that it reduces their ability to bind to an endorphin or opioid molecule. This effect is likely responsible for CBD's therapeutic success in treating addiction. There is also evidence that CBD can 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. Addiction generally manifests itself as an inflammatory state in the brain. Therefore, when administered correctly, CBD provides immediate relief.

Resources

1. The role of cannabidiol in therapeutic intervention for substance addictions (2021)
2. Is CBD a panacea? Cannabis Magazine 20
3. Šulcová, Alexandra: Cannabidiol for the treatment of neuroinflammation and addiction. Cannabis and science, 2021

Nicotine addiction

Older studies have shown that smokers who use CBD specifically reduce their cigarette consumption significantly (by 40%).

Preclinical studies suggest that influencing the endocannabinoid system may be a treatment for nicotine addiction. In laboratory animals, CBD administration reduced withdrawal symptoms.

There are more than two million smokers in the Czech Republic. A total of 20% of all deaths in our country are caused by the consequences of smoking, which include cardiovascular diseases (diseases of the heart and blood vessels), cancer and respiratory diseases.

Resources

1. Cannabidiol reduces cigarette consumption in tobacco smokers (2013)
2. The endogenous cannabinoid system modulates nicotine reward and addiction (2008)
3. New insights into the role of the endocannabinoid system and natural cannabinoids in nicotine addiction (2021)
4. Cannabidiol reduces withdrawal syndrome in nicotine-dependent rats (2021)

Alcohol addiction

The findings of countless studies indicate that CBD can help reduce alcohol consumption in individuals suffering from alcoholism. The positive thing about cannabidiol treatment is that it has no addictive potential and is generally very well tolerated.

Interestingly, according to some studies, CBD can also help treat neurodegeneration caused by excessive alcohol use, even transdermally, in the form of CBD gel.

Experimental studies have found that CBD reduces overall alcohol drinking in animal models by reducing ethanol intake, motivation to drink ethanol, relapse, anxiety, and impulsivity. 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.

There are also notable considerations that CBD may be helpful in treating alcoholism in multiple ways. For example, CBD may directly affect specific brain mechanisms behind alcohol addiction, thereby influencing alcohol consumption.

Even more remarkable is the hypothesis that CBD may influence symptoms of alcohol dependence through its effects in the digestive, immune, and central nervous systems, collectively known as the microbiota-gut-brain axis (MGBA).

There is preclinical evidence that cannabinoids, including CBD, may have beneficial effects on the gastrointestinal and immune systems, such as reducing intestinal permeability, regulating gut bacteria, and reducing inflammation. Alcohol has the opposite effect.

Resources

1. Effects of THC and CBD on alcohol use among concurrent alcohol and cannabis users (2021)
2. Cannabidiol as a new candidate in the pharmacotherapy of alcohol dependence: A systematic review (2019)
3. Transdermal administration of cannabidiol reduces neurodegeneration caused by excessive alcohol drinking in a rat model (2013)
4. Cannabidiol attenuates hepatic steatosis, metabolic dysregulation, inflammation, and damage caused by alcohol consumption (2017)
5. Therapeutic prospects of cannabidiol in alcohol dependence and liver and brain damage (2019)
6. Cannabinoids and the microbiota-gut-brain axis: Newly discovered effects of cannabidiol and its potential use in the treatment of alcoholism (2020)

Opioid addiction

CBD not only works to combat anxiety, depression, inflammation, and pain, but it also reduces opioid cravings, which is very important for managing withdrawal symptoms after opioid withdrawal. In addition, CBD has been shown to be well-tolerated in several clinical studies 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 withdrawal symptoms, but most of the existing evidence is based on either preclinical studies and/or small clinical trials.

Partial studies suggest that cannabidiol inhibits the reward mechanism in the brain that is linked to the use of opioids such as morphine. However, this effect was not seen in the case of cocaine use.

Specific studies confirm that acute administration of CBD can prevent craving and relapse in heroin users. It is also important to note that cannabidiol treatment does not have negative effects on methadone substitution treatment, in fact, the opposite.

The current "opioid crisis" in developed countries, however, does not only concern illegal substances such as heroin or fentanyl, but also opioid analgesics obtained with a medical prescription. Cannabis (including THC), thanks to its analgesic and other effects, allows for a drastic reduction in opioid consumption (up to 78%) and an increase in the quality of life of patients and public health, as shown by large studies.

In the treatment of pain, medicinal cannabis (especially with a higher THC content) is also used in the Czech healthcare system. A pioneer in this field is algesiologist MUDr. Radovan Hřib from the Brno University Hospital at St. Anne's.

Resources

1. Supportive treatment of opioid withdrawal syndrome with the non-opioid drug cannabidiol (2021)
2. Cannabidiol prevents the rewarding effects of morphine (2013)
3. Cannabidiol, a non-psychotropic component of cannabis, inhibits heroin seeking after cue exposure (2009)
4. Cannabidiol in reducing craving and anxiety in abstinent heroin-dependent individuals (2019)
5. Impacts of cannabis use during stabilization in methadone maintenance treatment (2013)
6. Cannabis significantly reduces prescription opioid use and improves quality of life: Results of a large prospective study (2021)
7. Interview with MUDr. Radovan Hřib: Those who want, find a way

Amphetamine addiction

Preclinical studies suggest that CBD may be a useful alternative for preventing relapse in amphetamine addiction.

CBD is known to be involved in neurogenesis (the formation of new neurons). It is precisely because of these neuroprotective properties that it is considered a suitable means of improving mental performance in patients chronically exposed to psychostimulants, including methamphetamine.

Resources

1. Cannabidiol prevents amphetamine relapse and modulates D1 and D2 receptor levels in mesocorticolimbic brain regions in rats (2021)
2. Cannabidiol promotes neurogenesis in the dentate gyrus during the abstinence period in rats after chronic methamphetamine exposure (2021)

Cocaine addiction

New studies suggest that CBD may be used in the adjunctive treatment of cocaine addiction, as it affects the reward system, cocaine consumption, behavioral responses, anxiety, neuronal proliferation, and liver protection.

However, small human studies have not yet shown a reduction in craving or relapse after CBD administration. In mice, for example, anxiety was reduced and motor and somatic symptoms were normalized.

Resources

1. Evaluating the potential use of cannabidiol in the treatment of cocaine dependence: A systematic review (2020)
2. Cannabidiol modulates behavioral and gene expression changes induced by spontaneous cocaine withdrawal (2021)
3. Cannabidiol (CBD) attenuates memories of cocaine environments in mice (2020)

Gambling addiction

Gambling is a widespread modern addiction with major social impacts. As CBD has shown some efficacy in treating ADHD, its potential in treating behavioral disorders such as gambling is also being explored.

Resources

1. A Criteria-Based Approach to Research Domains in Gambling Addiction and Behavioral Addictions: Decision Making, Response Inhibition, and the Role of Cannabidiol (2021)

Cannabis addiction

According to many testimonies and isolated case studies, CBD appears to play a significant role in helping people recover from addiction to the intoxicating cannabinoid tetrahydrocannabinol (THC). It reduces withdrawal symptoms, anxiety, and dissociation symptoms.

According to several studies and numerous personal testimonies, CBD reduces the acute effects of THC, such as overly intense experiences or psychotic effects. This is likely due to the fact that CBD partially occupies the same receptors as THC.

Resources

1. Cannabidiol in the treatment of withdrawal symptoms after cannabis cessation (2013)
2. How does cannabidiol (CBD) affect the acute effects of delta-9-tetrahydrocannabinol (THC) in humans? A systematic review (2019)

Another cannabis compound in addiction treatment: beta-caryophyllene

Another safe compound from cannabis that shows promise in treating addiction is beta-caryophyllene, 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 nicotine, cocaine, and methamphetamine (pervitin).

Resources

1. β-Caryophyllene, a food terpenoid, attenuates nicotine intake and seeking in rodents (2020)
2. Beta-caryophyllene attenuates cocaine addiction-associated behaviors by activating PPARα and PPARγ (2021)
3. β-Caryophyllene, an FDA-approved dietary supplement, attenuates methamphetamine-taking and seeking behaviors (2021)