Three consecutive days of oral cannabidiol (CBD) solution significantly reduced cravings and anxiety induced by drug cues in people with heroin use disorder who were abstinent from the drug, according to a study published online in The American Journal of Psychiatry.
The findings, researchers said, suggest a potential role for CBD as a treatment option for opioid abuse amid the current opioid epidemic.
“To address the critical need for new treatment options for the millions of people and families who are being devastated by this epidemic, we initiated a study to assess the potential of a nonintoxicating cannabinoid on craving and anxiety in heroin-addicted individuals,” said study first author Yasmin Hurd, PhD, of the Mount Sinai school of medicine and director of the Mount Sinai addiction institute in New York, New York. “The specific effects of CBD on cue-induced drug craving and anxiety are particularly important in the development of addiction therapeutics because environmental cues are one of the strongest triggers for relapse and continued drug use.”
After demonstrating CBD reduced the tendency to use heroin in animals with a history of heroin self-administration and finding it safe to use in humans, researchers conducted the double-blind trial in 42 men and women with heroin use disorder who were abstinent from the drug. Participants were randomly assigned 400 mg of an oral CBD solution, 800 mg of the oral CBD solution, or placebo over 3 consecutive days.
In contrast to placebo, people who received CBD demonstrated reduced cravings and anxiety up to 7 days after exposure to drug cues such as videos of people using intravenous and intranasal drugs or exposure to syringes, rubber ties, and other heroin-related paraphernalia. According to the study, CBD also reduced cue-induced physiological measures of heart rate and salivary cortisol levels.
The study found no significant effects on cognition and no serious adverse events.
“Our findings indicate that CBD holds significant promise for treating individuals with heroin use disorder,” Dr. Hurd said. “A successful nonopioid medication would add significantly to the existing addiction medication toolbox to help reduce the growing death toll, enormous health care costs, and treatment limitations imposed by stringent government regulations amid this persistent opioid epidemic.”
Hurd YL, Spriggs S, Alishayev J, et al. Cannabidiol for the reduction of cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder: a double-blind randomized placebo-controlled trial. The American Journal of Psychiatry. 2019 May 21;[Epub ahead of print].