New research shows cannabinoids inhibits opioid reward, could help ease overdose crisis

New research shows cannabinoids inhibits opioid reward, could help ease overdose crisis

Two recent studies indicate that cannabis could be a valuable tool for fighting the opioid epidemic.

Federal health minister Jane Philpott has described the opioid epidemic as the “greatest public health crisis we face in Canada.” One new study suggests cannabis could be effective in treating opioid addiction through substitution therapy, while another recent study links CBD to the inhibition of opioid rewards in the brain.

In 2016, a public health emergency was declared in British Columbia due to the alarming rate of drug overdose deaths stemming from widespread overuse of prescription opioid painkillers, and an influx of illicit narcotics laced with deadly fentanyl and carfentanil.

Cannabis as a substitute for opiates

A new study published in the Harm Reduction Journal examines a variety of established research on cannabis as a substitution therapy in the treatment of opioid addiction, and, based on the findings, suggests policy recommendations including the implementation of cannabis therapies to interrupt the addiction cycle at three stages: first as a treatment for chronic pain, before attempting opioid therapies; second as a substitution therapy for patients already using or addicted to opioids; and third, as “an adjunct therapy to methadone or suboxone treatment in order to increase treatment success rates.”

The study is authored by Philippe Lucas, graduate researcher with the Center for Addictions Research of British Columbia and VP of patient advocacy at Tilray, a Health Canada licensed cannabis producer. As was reported in a previous Lift News article, Lucas also led a team that conducted the largest ever survey of Canadian authorized medical cannabis users, with 32% of respondents having reported using cannabis as a substitution for opioids.

“Cannabis alone will not end opioid use disorder and associated morbidities and mortality,” cautions Lucas in the new study’s final remarks. But he also highlights the increasing need for innovative strategies to deal with the epidemic, concluding that “the growing body of research supporting the medical use of cannabis as an adjunct or substitute for opioids creates an evidence-based rationale for governments, health care providers, and academic researchers to seek the immediate implementation of cannabis-based interventions in the opioid crisis at the regional and national level, and to subsequently assess their potential impacts on public health and safety.”

CBD inhibits opioid reward

Another new study published earlier this month indicated a link between CBD use and decreased opioid reward in the brain. It builds upon a prior study which demonstrated that CBD produced a dose-dependent rise in the threshold frequency required for ICSS, or ‘intracranial self-stimulation’ (one of the brain mechanisms involved in opioid reward).

The new study, published in the journal Planta Medica and authored by a research team at the University of Mississippi, sought to compare cannabidiol’s effects on ICSS to its effects on conditioned place preference, or ‘CPP’ (an observational method for determining brain reward activity).

The team at U of M administered doses of morphine to subjects who were also administered doses of CBD, as well as a control group who were administered saline alongside the morphine instead of CBD. They found that subjects who had been administered CBD had a significant reduction in CPP scores, demonstrating reduced opioid reward.

While this study (and the previous ICSS study on which it builds) focused on lab mice as the subjects, a clinical trial is currently underway that seeks to study the medical effects of CBD in the treatment of opioid addiction in humans.

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