Opioid addiction and deaths from overdosing continue to rise in the United States despite efforts within the medical community to find a solution.
The opioid epidemic has become a serious public health crisis. Deaths from opioid overdoses continue to increase among all genders, races, and almost all adult age groups.
Many of these deaths are individuals taking opioid prescriptions. In 2017, data revealed that of the 47,600 opioid overdose deaths, 36% involved prescription opioids.
How did this happen?
In the 1990s, physicians were assured by pharmaceutical companies that opioids administered to manage pain weren’t addictive. As a result, the rate of prescribing opioids to treat pain increased, as did the rate of misuse. Unfortunately, by the time it became clear that prescription opioids were addictive, the problem was already well underway.
However, there is hope that cannabis products can provide a solution to the opioid crisis.
But with so many flashy headlines proclaiming CBD and cannabis as a potential cure-all, what is the truth? Can cannabis help with opioid addiction and pain management?
How Does Cannabis Work?
Medical marijuana contains cannabinoids. These components work in our bodies and brains. The two most studied are THC (tetrahydrocannabinol) and CBD. CBD is a cannabidiol found in marijuana plants and industrial hemp plants, which contain <0.3% of THC.
CBD has been growing in popularity since the 2018 Farm Bill passed, which legalized growing industrial hemp. While CBD is in medical marijuana, it doesn’t cause people to feel “high” like THC.
CBD and THC both appear to operate like neurotransmitters, which are chemical messengers that turn nerves on or off. They seem to work on different nerves within our endocannabinoid system.
Understanding how cannabinoids work in our bodies will help inform and guide research on potential medical applications. This information can also help researchers understand if both components are needed to treat a condition.
Can Cannabis Effectively Help Reduce Opioid Abuse?
Unfortunately, the answer is not straightforward.
The hope is that cannabis (both CBD and THC) can be used to wean people off of opioids since the brain systems cannabis and opioids work on interact with each other.
Evidence Supporting Cannabis’ Potential Use in Opioid Addiction
There is some scientific research suggesting that marijuana may help with side effects of opioid withdrawal. A 2018 review of the literature by Wiese and Wilson-Poe indicated that medical marijuana has shown promise as a treatment for acute opioid withdrawal. Additionally, early clinical trials indicate CBD may help reduce heroin craving.
A recent study in American Journal of Psychiatry found CBD reduced cue-induced cravings and anxiety in people recovering from heroin addiction. This study was a double-blind, randomized study, but also exploratory. It only assessed up to seven days after CBD treatment ended, and the CBD treatment only consisted of three days.
There is limited evidence that cannabis may help reduce neuropathic pain in some people. But, there’s not enough evidence for other types of pain at this time.
Overall, more research on CBD and cannabis is needed before concluding whether they can be used to decrease opioid relapse. But early studies are encouraging. They suggest that medical marijuana and CBD may be useful to help reduce harm and have potential as an alternative to help people decrease their opioid use.
There also is anecdotal evidence indicating that medical marijuana and CBD might be able to help taper people off prescription opioids successfully. An article by Consumer Reports tells the story of Nika C. Beaumon, who successfully used a CBD tincture to manage her pain instead of continuing with her prescription opioid.
Some states, including New York and Illinois, also allow patients to substitute medical marijuana (either CBD or THC varieties) for opioid prescriptions. These states feel this gives medical providers and patients additional treatment options to help combat the opioid crisis.
More Research Is Needed
Other scientists are urging caution.
They argue that current results are preliminary and more rigorous research, including randomized controlled trials, are needed. Early findings suggest cannabis may have medical applications in helping with pain management or opioid addiction treatment. But more time is required to evaluate their potential fully.
An article published in Missouri Medicine by Dr. Kenneth Finn also raised the concern that current research has used marijuana products unavailable to consumers in the United States. He calls for studying pain management using dispensary cannabis, which United States consumers can access.
There are too many unknown answers at this time to support using cannabis as a treatment. Limited randomized trials, only a few human studies, and types of cannabis used in studies are a few of the current research limitations.
People should follow their doctor’s recommendations for pain management and opioid addiction treatment, especially since tapering off of opioids can be dangerous. For patients who want to pursue CBD or medical marijuana as an alternative treatment for pain, they should work with a doctor to develop a treatment plan.
Controlling the Hype Surrounding CBD and Cannabis: Making Sense of What is Known
At present, there is strong evidence for medical uses of cannabis for a few medical conditions. The FDA has approved a CBD medication, Epidiolex, for treating rare forms of epilepsy. Two synthetic forms of THC—Marinol and Syndros—are also approved to treat weight loss in patients with AIDS.
More data is needed before drawing reliable conclusions regarding cannabis’ potential role in treating opioid addiction and pain.
Early research does indicate there is potential. But right now that’s all it is—potential.
While additional research is underway, the current published research has limitations that are important to keep in mind.
No research is perfect. There are always limitations.
That’s why science relies on a collection of studies before drawing conclusions.
It’s hard because this process takes time, and right now, the United States has a serious opioid crisis that needs to be solved.
These early studies are a vital step in furthering our understanding of the potential benefits of CBD and medical marijuana in helping treat opioid addiction. A variety of rigorous research is needed before jumping to conclusions too quickly and potentially ignoring current tested treatment options.
Yes, the opioid epidemic is a crisis – but let’s not repeat the mistake made in the 1990s that led us here.
Let’s proceed scientifically and responsibly.
The history of opioid addiction in the United States has demonstrated the value of being thorough before drawing conclusions.
So while the verdict is still unknown on whether cannabis can become a treatment option for opioid addiction, there is hope.