CBD Shows Promise for Patients With Marijuana Addiction
— Small but significant reductions in use observed in cannabis-tobacco smokers
by Elizabeth Hlavinka, Staff Writer, MedPage Today July 29, 2020
For patients with cannabis use disorder, cannabidiol (CBD) slightly reduced use in a phase II trial.
In a group of 82 patients with moderate to severe cannabis use, urinary 11-nor-9-carboxy-δ-9-tetrahydrocannabinol (THC-COOH):creatinine ratio declined by 94.21 ng/mL (95% interval estimate –161.83 to –35.56) for those given 400 mg CBD daily, reported Tom Freeman, PhD, of the University of Bath in England, and colleagues in The Lancet Psychiatry.
The CBD group also remained abstinent for 0.48 more days per week (95% interval estimate 0.15-0.82) compared with placebo at 4 weeks.
An 800-mg dose also decreased the THC-COOH creatinine ratio significantly (–72.02 ng/mL, 95% interval estimate –135.47 to –19.52). Abstinence from cannabis was not significantly increased, however (0.27 days per week, 95% interval estimate –0.09 to 0.64), compared with placebo.
Both doses were safe, with no serious adverse events recorded and no significant differences in the rate of other events in the placebo and either treatment arm, the researchers added. The most common side effect was migraine, which occurred in four and two patients in the 400-mg and 800-mg CBD groups, respectively.
“The effects of the cannabidiol doses tested are suggestive of an inverted-U dose-response curve,” Freeman and co-authors wrote. “From a treatment perspective, our findings indicate that cannabidiol doses ranging from 400 mg to 800 mg have the potential to reduce cannabis use in clinical settings, and that additional benefit is unlikely to be gained from doses exceeding 800 mg.”
Current treatment for cannabis use disorder, also known as marijuana use disorder, is limited to behavioral therapy. However, researchers are studying whether sleep medications such as zolpidem (Ambien) or anxiolytics like buspirone (BuSpar) can mitigate marijuana withdrawal, according to the National Institute on Drug Abuse.
Early phase trials have shown positive signals that certain pharmacologic agents could play a role in the treatment of cannabis use disorder, including naltrexone and long-acting fatty acid amide hydrolase inhibitors. CBD has also been associated with craving and anxiety reductions related to other addictions, such as heroin use disorder.
“CBD likely works through a completely different mechanism than THC and its effects are likely indirect and more complex than we know at the moment,” commented Ryan McLaughlin, PhD, of Washington State University in Pullman.
For example, some in vitro studies have indicated that CBD could influence the binding sites of THC — the psychoactive component of cannabis — making it less of a “good fit,” explained McLaughlin, who was not involved in this research.
The trial involved patients ages 16-60 who met diagnostic criteria for cannabis use disorder, confirmed with a urine drug screen, who wanted to quit in the next month but had failed to quit at least once. Pregnant or breastfeeding women were excluded, as were non-English speakers. All patients smoked tobacco with cannabis before enrollment.
Participants came in weekly during treatment, were followed up by telephone, and reminded by text messages to take their medication twice daily. All patients also received six 30-minute motivational interviewing sessions with psychologists.
Although the reductions in use observed in this study were relatively small, even participants in the placebo group went from having 1 to 2 days of abstinence per week at baseline to around 4 days of abstinence per week in the trial, commented Andrew J. Saxon, MD, of the University of Washington in Seattle, and also not involved in the trial.
“Thus, it seems that the behavioral intervention is having some impact and more than what the medication has,” Saxon told MedPage Today in an email.
The first stage of the trial evaluated a 200-mg CBD dose, but its efficacy was minimal, so patients originally randomized to this arm were reassigned.
Patients in the placebo group were slightly younger on average (age 25) than patients in the 400- or 800-mg CBD arms (age 27), the authors reported. Overall, the cohort included more than 70% males and had close to nine symptoms of cannabis use disorder symptoms at baseline.
Although the 400-mg CBD arm was associated with reduced urinary THC-COOH:creatinine and increased abstinence compared with placebo through the trial’s end at 12 weeks, the 800-mg treatment arm was similar to placebo in both outcomes after this longer follow-up, Freeman and co-authors reported.
Compared with placebo, 400-mg CBD also decreased the number of cigarettes smoked per week at 4 weeks and 12 weeks, although patients in this treatment group reported poorer sleep than those in the placebo group, the researchers noted. In addition, for patients on the 800-mg CBD dose, withdrawal and anxiety symptoms improved compared with placebo at 4 and 12 weeks.
The trial was not designed to show the magnitude of efficacy for CBD and has a relatively short treatment period, which are limitations, the authors wrote, adding that food consumption or other factors may play a role in CBD’s bioavailability.
Elizabeth Hlavinka covers clinical news, features, and investigative pieces for MedPage Today. She also produces episodes for the Anamnesis podcast. Follow
The study was funded by the UK Medical Research Council Developmental Pathway Funding Scheme award and the Society for the Study of Addiction.
Freeman reported having no competing interests; one co-author reported receiving funding from Spectrum Therapeutics.
Is CBD Addictive?
Kendra Cherry, MS, is an author and educational consultant focused on helping students learn about psychology.
Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Verywell / Theresa Chiechi
Because marijuana can be addictive, particularly when it is used heavily and at high doses, you might wonder if CBD addiction is also possible. CBD (cannabidiol) is one of the many compounds found in cannabis. Products containing CBD have grown in popularity in recent years, found in everything from gummy supplements to post-workout smoothies to CBD-infused pillows.
CBD’s burgeoning popularity has been fueled in part by the compound’s purported mental health-boosting properties. However, some people may hesitate to use such products for fear that CBD might have the same potential for addiction as cannabis.
This article discusses whether CBD addiction is something to worry about. It also covers some of the other possible concerns you might have when taking CBD.
Is CBD Addictive?
Drug addiction is defined as a compulsive need to use a substance and an inability to stop using it despite negative consequences.
Substances that lead to dependence and addiction affect the pleasure centers of the brain, often making it so that people need to consume a substance to avoid experiencing symptoms of withdrawal. In many cases, people may also need to use more and more of a drug in order to continue experiencing the same euphoric effects that they initially felt.
Tetrahydrocannabinol (THC) is the psychoactive compound in cannabis that produces the high associated with marijuana. When administered, THC travels to the brain via the bloodstream and attaches to the endocannabinoid receptors found in areas of the brain that are associated with things such as pleasure, movement, memory, and thought.
While cannabidiol also interacts with the body’s endocannabinoid system, CBD does not have the same intoxicating properties that THC has. Research suggests it has a good safety profile and is well tolerated at doses up to 600mg to 1,500 mg.
Unlike THC (tetrahydrocannabinol), CBD does not produce psychoactive effects. And while marijuana use can lead to dependence, current research suggests that CBD is not addictive.
According to the World Health Organization, in humans, CBD exhibits no effects indicative of any abuse or dependence potential…To date, there is no evidence of public health-related problems associated with the use of pure CBD.
A 2017 study published in the Journal of Drug and Alcohol Dependence suggested that CBD has the same potential for dependence as a placebo pill.
However, it is important to note that many CBD products may contain some level of THC. Federal law requires that hemp-derived CBD products contain less than 0.3% of THC. However, research has found that 70% of CBD products contain significantly more THC than their labels suggest.
While CBD is not addictive, THC is. Evidence suggests that people can develop a tolerance to THC and may experience withdrawal symptoms. Physical dependence on THC is more likely among people who use high-THC cannabis strains.
CBD Might Help Treat Addiction
Some evidence suggests that CBD may actually be helpful for treating drug addiction and addictive behaviors. For example, while the research is still scarce and preliminary, studies have found that CBD shows promise in the treatment of cocaine and methamphetamine addiction.
A 2015 review of available preclinical and clinical data found that CBD had therapeutic properties in the treatment of cocaine, opioid, and psychostimulant addiction. Evidence also indicated that it might have benefits in the treatment of tobacco and cannabis addiction.
A 2019 study found that cannabidiol might help reduce drug cravings, paranoia, impulsivity, and withdrawal symptoms associated with crack-cocaine addiction.
While promising, more research is needed to understand how CBD might be utilized for the treatment of substance use disorders.
Effects of CBD
While CBD does not have psychoactive properties, it does have a variety of effects. Its potential impact on mental health conditions such as anxiety and depression has been a specific point of interest for many.
In addition to mental health benefits, some research indicates that CBD might be helpful for reducing pain, relieving nausea, and treating inflammation. The World Health Organization also suggests that CBD may be helpful for treating conditions such as Alzheimer’s disease, arthritis, cardiovascular disease, and diabetes.
Some of the potential uses are listed below.
Research has found that CBD may help reduce seizures caused by epilepsy. A 2018 study of children and adults with treatment-resistant epilepsy found that the use of CBD was associated with reductions in the frequency and severity of seizures.
In 2018, the FDA approved Epidiolex, a CBD solution, for the treatment of rare, severe forms of epilepsy.
Research also suggests that CBD may be helpful for alleviating symptoms of anxiety. For example, one study found that cannabidiol was useful for reducing symptoms of generalized anxiety disorder (GAD), panic disorder, post-traumatic stress disorder (PTSD), and social anxiety disorder.
Studies also suggest that CBD may have potential in the treatment of depression. For example, one study found that CBD influences how the brain responds to serotonin, which may have an antidepressant-like effect.
What the Research Says
While CBD does not appear to be addictive and may have some benefits, one large-scale review concluded that there was not enough evidence to support the use of CBD as a treatment for mental health conditions.
This doesn’t mean that CBD might not be helpful. It means that more studies are needed to determine what CBD might treat, when it is best used, and what dosage people should take.
Side Effects and Other Concerns
Current evidence suggests that CBD use does not lead to addiction and that the substance may have a number of health benefits. However, it is also important to be aware that CBD does have some potential side effects.
Some side effects that may occur when taking CBD include:
- Changes in appetite
- Drug interactions
- Dry mouth
- Gastrointestinal problems
- Mood changes
Research indicates that CBD is generally well-tolerated up to doses of around 600 mg and as high as 1500 mg. However, it can often be difficult to determine how much CBD you are actually taking. According to one study, 43% of commercially-available CBD products contain substantially more cannabidiol than indicated on the label.
The National Center for Complementary and Integrative Health cautions that CBD may be harmful to some people. In some studies, the use of Epidiolex was linked to liver problems and drug interactions.
While such issues can be managed when taking a prescribed medication under doctor supervision, self-administered CBD could potentially have the same harmful effects, particularly since it can be difficult to determine how much CBD many products actually contain.
CBD products may also contain higher levels of THC than stated on the label. This can be concerning if you are trying to avoid THC.
While current evidence indicates that you won’t develop a CBD addiction, it is possible to have an adverse reaction to cannabidiol. Talking to your doctor first and starting with a low dose can reduce the risk of unwanted side effects.
A Word From Verywell
CBD doesn’t appear to be addictive, but that doesn’t mean that it is right for everyone. If you are thinking about trying CBD, discuss it with your doctor first. Be sure to tell your healthcare provider about any other medications you might be taking in order to prevent any potential drug interactions. Watch for side effects and don’t take more than the dose that your doctor recommends.
CBD for Addiction: Does Hemp Oil Help Reduce Drug Cravings?
CBD oil is a promising product to treat addiction and addresses the pain and discomfort from withdrawal.
We discuss how CBD oil is used to help drug users break the cycles of addiction.
There’s a whole gamut of drugs with addictive potential, wreaking havoc on the body. Drugs including Xanax, morphine, heroin, and cocaine are some of the most commonly abused drugs.
Drug withdrawals following addiction are extremely uncomfortable and sometimes deadly. Any compounds that can help relieve withdrawal symptoms or speed recovery times will ultimately improve the quality of life for recovering addicts.
We’ll look at the most common causes of addiction and how CBD can help, taking a look at some of the best CBD oils for treating addiction and withdrawal symptoms.
Let’s get into it.
MEDICALLY REVIEWED BY
Updated on October 20, 2021
Table of Contents
- What Causes Addiction?
- 1. Stimulant Addiction (Dopamine)
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What Causes Addiction?
Addiction is considered a psychological disorder involving a compulsive desire to do something that has negative impacts on the body.
Addiction is a disorder rooted in a special region in the brain called the reward center.
The reward center is responsible for habit formation and the development of instincts. It’s been useful for our survival as a species, but when it becomes dysfunctional it can cause a lot of damage.
We’ll get into this in more detail later on.
Dysfunctional Dopamine Levels is a Key Element of Addiction
One of the key features of addiction is a depletion in dopamine levels .
Surges of dopamine teach the brain to seek out more of that substance. Over time, the regular spikes of dopamine cause a rebound drop in the body’s ability to produce dopamine on its own. Users become hopelessly dependant on the drug to produce enough dopamine to feel “normal”. This is especially true regarding drugs such as MDMA, cocaine, or crack that exert most of its effects through the dopamine system.
Low dopamine levels are known to cause the following symptoms:
Best CBD Oils For Addiction
Types of Addiction & the Role of CBD
In order to discuss how CBD is used for treating addiction, we need to differentiate between the different types of addiction.
Addiction relies on the reward center in the brain.
This part of the brain is responsible for controlling our desire to repeat activities. When we eat a delicious meal at a new restaurant, the reward center releases a dose of oxytocin, making us feel euphoric. Our brain records that feeling, making us likely to return to the restaurant to order the item again. This is the beginning of habit formation.
Other types of addiction will still involve this system, though indirectly.
Most addictive drugs will target a specific receptor. It may block pain or force us into a relaxed state.
Over time, these drugs cause changes to the receptor, making them less sensitive to the drug. If this continues, we eventually reach a point where we can’t activate the receptors without substance stimulation. If we don’t take it, we experience varying levels of discomfort.
Here’s how CBD can help with different types of addiction:
1. Stimulant Addiction (Dopamine)
Stimulants including cocaine and crack are widely abused substances. They work on a set of dopamine receptors.
These drugs cause a surge of dopamine release and are among the most addictive compounds because of the important role dopamine plays in the reward center of the brain.
Once the reward center is activated, it releases a surge of oxytocin from the hypothalamus making us feel momentarily euphoric.
This system is designed to make us repeat activities or patterns that benefit us.
In the case of stimulant drugs such as cocaine, this system is stimulated synthetically, causing us to repeat the process to get another hit of oxytocin.
CBD is especially good for treating dopamine-related addictions while still using drugs. This is because CBD limits the release of dopamine from the basal ganglia where it’s produced .
Common Addictive Stimulants Include:
CBD & Stimulant Addiction
The main benefit CBD has towards stimulant addiction is its effects on dopamine.
CBD is highly complex and interacts with a number of other organ systems in the body connected through the nervous system. It’s shown to mediate the inhibition of dopamine in the basal ganglia .
This means that CBD is involved with regulating optimal dopamine levels by blocking its release when dopamine levels are too high. Other studies observed CBD’s inhibitory effect on dopamine release in animals.
This is useful for addictions because it lowers the release of dopamine while under the effects of the drug.
This means that in order to get the most benefit of CBD, you need to start taking it as you wean yourself off the drugs.
The CBD will lower the surge of dopamine, making the effects of the drug less severe, helping to gradually break free from the addictive grasp of these drugs.
In order to be successful with this, it’s imperative that you go through a detox or rehabilitation program. The CBD will help curb the desire to take the drugs, but won’t be enough to fix the underlying addiction.
2. Opioid Addiction
Opioids are the most commonly abused drugs.
Opioids work by activating a receptor in the spinal cord and brain used to numb the transmission of pain. It’s easy to become addicted to opioids because they start out with good intentions — to provide pain relief.
A pain signal will travel up the nerve and reach the spinal cord. Here, the message is transferred through a special gate.
You can think as border security when crossing over into a new country.
You need to first submit your documents for security to review. If something doesn’t match up, or if there are already too many people crossing the border, you will get denied entry.
The same concept applies to the opioid receptors. They measure how much pain transmission is passing through and will cap it when it becomes too much.
Taking an opioid is like building a giant wall across the border. It stops all flow of traffic — nobody can enter or leave, preventing the transmission of pain from ever making it to the brain.
We need to have at least some traffic flowing through to function properly. Over time, the border security guards get lazy. If the wall ever fails (you miss a dose of the drug), anybody and everybody will come rushing across the border. The guards aren’t skilled enough to stop them anymore, bringing on immense pain.
Opioid withdrawal symptoms:
In order to reverse opioid addiction, we need to taper off the drug slowly and allow the opioid receptors to regain their normal function.
Using our example from before, this would be like hiring new border security guards and spending a few weeks training them how to do their job.
CBD for Opioid Addiction
CBD offers unique benefits in terms of managing the symptoms of opioid addiction because it modulates the opioid receptor function indirectly .
This restores optimal opioid receptor levels and helps us recover faster.
Using the same analogy from before, CBD would be like hiring a professional border-security training coach to train the new recruits in less time.
In order to get the most out of CBD for this type of addiction, it should be taken while weaning off the drugs, and afterward for several weeks while going through the effects of withdrawal.
3. Benzodiazepine Addiction
Alcohol and benzodiazepines are very different but work through the effects of the neurotransmitter, GABA.
Benzodiazepines bind to the GABA receptor, which serves to amplify the effects of GABA itself.
GABA serves as the brake pedal for the nervous system.
It slows down hyperactivity in the nervous system. When nerves become overexcited, from stress, anxiety, or drug use, the nervous system needs to pump the brakes to calm down.
This system is also required for initiating sleep.
The main uses of benzodiazepines are to reduce anxiety and induce sleep. Common examples include Xanax, Klonopin, and Valium.
Like other drugs, when we take them in high amounts over long periods of time, they cause the receptors to become lazy.
Once dependence is formed, we’re unable to activate GABA without the drug and withdrawal symptoms set in.
Withdrawal symptoms of benzodiazepines:
Benzodiazepine withdrawal symptoms can last years. To get addicts off the drug, it’s important to have effective treatment options to make withdrawal bearable for sufferers.
CBD is useful for people undergoing benzodiazepine withdrawal for several reasons.
CBD for Benzodiazepine Addiction
CBD is useful for benzodiazepine addiction by preventing the re-uptake and destruction of GABA .
CBD inhibits the reabsorption of GABA, allowing it to exert its benefits for a longer period of time. This is useful for combating the negative effects of benzodiazepine addiction by increasing overall GABA concentrations in the brain.
As with other types of drug addictions, it’s important to use CBD with other addiction treatments.
Mindset changes, gradual weaning off the drug, and symptomatic support for withdrawal are all necessary for increased efficacy.
CBD merely supports the process, helping us return to a normal, non-addicted state quickly.
What’s the Recommended Dose of CBD?
Finding the right amount of CBD to use is going to involve some trial and error.
Depending on the severity of the addiction and sensitivity of the individual, they may need a lot (45 mg) or a little (4 mg) of CBD per day.
You can use our CBD dosage calculator to help find the right dose based on your weight.
For addictions to painkillers in combination with chronic pain, it’s likely that the higher range of the dose is needed.
Benzodiazepines will also likely need a higher dose to be effective.
For addictions to stimulants such as cocaine or MDMA, many users find doses in the 20 mg range most effective.
No matter what you’re using CBD for, the best way to start is to use a small dose (4 mg) and build up by 4 mg from there each day until you get the results you’re looking for.