Addiction is an ongoing societal issue in Canada and worldwide, and despite our quantum leaps in medicine, we still haven’t solved the mystery of addiction. Even the most effective treatments such as the Twelve-Step method don’t consistently produce long-term results.
To give some perspective on the matter, at least 20% of drinkers in Canada consume more than the recommended guidelines for maintaining a low-risk relationship with alcohol. Between 2015 and 2016, there were over 77,000 hospitalisations for alcohol in Canada — more than the amount of heart attack hospitalisations that year. In 2016, there were 2,861 deaths by opioids, and 16 hospitalisations a day caused by opioids.
On reflection, this is quite a substantial issue.
Cannabinoids such as CBD are being explored as addiction treatments, not necessarily because of their ability to “cure” the addictive personality, but to create fewer vulnerabilities during withdrawal. This is typically the focus of any treatment for addiction — can we minimise the chance of relapse caused by environmental pressures and vulnerabilities?
Because of CBD’s anxiolytic and antidepressant qualities — and by virtue of the fact that it is not addictive — it may help to minimise some of the risk factors of relapse during withdrawal. The research is still limited, but promising nonetheless.
Could CBD be a novel treatment for addiction? Let’s check it out.
Why is it so hard to treat addiction?
Decades of research have been poured into the topic of addiction, but has it all been in vain? Until now, drugs are still a matter of the “law” and not a matter of the health system. Which gives us a very good indication as to why it’s so hard to effectively treat addiction in the long term.
It gets even more complicated with addictions to tobacco and alcohol, which are socially accepted substances. Many people don’t even know that they are alcoholics simply because society makes it extremely acceptable to consume large amounts of alcohol. For alcohol and tobacco addiction, their ready availability and social acceptance make treatment difficult.
The cause of addiction is most often spoken about in biology in terms of brain activity and chemical signaling. However, in psychology, there is an acknowledgment of potential underlying mental health conditions, childhood trauma and socio-economic contexts that may contribute to addiction.
We can therefore see that there is already controversy in what defines addiction — is it a result of childhood trauma, or is it caused by chemical imbalances in the brain? If we don’t agree on what causes addiction, then it’s exponentially more difficult to treat.
Some treatment methods for addiction involve replacement therapy, as is the case with the Methadone program. Methadone is prescribed to heroin users trying to abstain from heroin use. However, Methadone itself is addictive and therefore poses other obstacles to long-term recovery. Conventional addiction treatments such as this kind of replacement therapy also make it harder to treat addiction, because they don’t typically bring us any closer to the root of the problem.
It’s also worth mentioning sobriety here. In the Twelve-Step method, participants have to vow to sobriety… for life. It’s for this reason that participants of the Twelve-Step method don’t entertain options such as CBD or other cannabinoids, as this would be breaking the vow of sobriety. With that said, many people boycott the Twelve-Step method because of this exact vow — “nothing, ever again” causes just as much anxiety as the addiction itself.
As we’ve just explored, there are endless nuances to the complex disease of addiction. These nuances are the crux of long-term recovery, but at the same time are the very reason that it’s so difficult to treat addiction.
Let’s see what the research has to say about CBD’s role in all of this.
CBD and addiction: the research.
The research into CBD and addiction is limited, and the area is only really just beginning to spark scientific curiosity. But there is evidence that CBD has a potential role to play in the treatment of addiction. It’s important to recognize that it’s highly unlikely CBD will cause any great change in the “addictive personality” or in the original cause of the addiction.
However, CBD may be able to assist in the withdrawal process. Users are most likely to relapse during the withdrawal period (which is why Methadone is typically used to treat heroin addiction), and CBD may pose a safe way to minimise relapse during and after withdrawal.
In a murine study from 2018, researchers gave transdermal CBD to rats with induced cocaine addiction. Researchers found that CBD reduced “context-induced” drug-seeking — the kind of drug-seeking brought on by stressful events, peer-pressure or anxiety. The researchers concluded by stating that CBD may help with certain vulnerabilities that expose a person to relapse.
The 2018 study corroborates a 2009 study on the same topic. Researchers of the 2009 study found that CBD didn’t necessarily reduce drug use immediately, but it reduced the likelihood of cue-induced drug-seeking. These are conditioned stimuli that cause a craving. These stimuli are different from person to person, depending on how their drug use was conditioned over time (some users always use before bed, for example). Essentially, CBD may be a weapon against cravings and stress-induced drug-seeking.
It’s thought that CBD reduces the likelihood of relapse by minimising some of the things that can lead a person to relapse, such as stress, anxiety, and depression. It’s also important that CBD isn’t hedonic in its own sense — it doesn’t get you high or reinforce the desire to be intoxicated. Stressful situations and the moments of habitual use (such as before bed, while talking on the phone, etc.) are the most common moments for users to relapse, and being able to minimise confounding factors during that sensitive time is essentially how CBD may be able to assist in addiction recovery.
Addiction needs treatment options more than ever.
As drugs slowly move out of the sphere of legislation, and more into the sphere of medicine, it’s extremely important for treatment methods to be explored. Institutionalization, “cold turkey”, and drug “replacement” therapy (such as Methadone) just aren’t going to cut it. Plus, now that we know addiction is very much affected by the context of the individual, it’s increasingly important to develop personalised programs that treat the individual as a whole, and the underlying causes.
There is a lot of demand for further research into CBD and its potential role in the treatment of addiction. Preclinical trials have shown a lot of promise, but there’s a long way to go until we fully understand how to implement this treatment alternative.