CBD is everywhere. It’s in dog treats and bath bombs and hair gels and all manner of edibles, vapeables, and drinks, and people are using it to treat everything from epileptic seizures to gout, depression, and pain during butt stuff. But despite its near ubiquity in parts of the world (every storefront in Brooklyn is now mandated to sell CBD), there haven’t been all that many robust studies on what CBD can actually do, and the popularity of CBD is more based on anecdote (and savvy marketing) than evidence.
That, however, is changing. This week the American Journal of Psychiatry published a randomized, placebo-controlled study on how CBD could impact cravings and anxiety for heroin users, and the findings are promising.
For this study, researchers at New York’s Mount Sinai Hospital recruited 42 heroin users from social services groups, rehabs, and halfway houses. The average participant had been using heroin for 13 years and none were on medication like methadone or buprenorphine. Participants agreed not to use heroin during the duration of the study and were then divided into three groups. One group was given 400 milligrams of CBD, one was given 800 milligrams, and one was group was given a placebo.
During the trial, participants were exposed to both neutral and drug-related triggers. A neutral trigger, for example, might be a three-minute video of nature scenes. A drug-related trigger might be a video of someone shooting up. Researchers then measured the participants' vital signs, cravings, and anxiety, and the found the those who took CBD had significantly reduced cravings and anxiety compared to those who took the placebo. What’s more, the reductions lasted a week after the final dose of CBD, suggesting there could be longer-term benefits.
"Our findings indicate that CBD holds significant promise for treating individuals with heroin use disorder," Yasmin Hurd, the study's lead author and the director of the Addiction Institute at Mount Sinai, said in a statement. "A successful non-opioid 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."
Now, the study does have limitations: The trial was only two weeks long and there were only 42 participants, so there were only about 14 subjects in each group. The researchers also didn't report the effect sizes, which may be concerning. But still, this study lends credence to the idea that cannabinoids may be helpful for opioid cessation.
While this study specifically looked at CBD, a non-psychoactive element of cannabis, other studies have looked at how real weed helps too. A 2017 study, for instance, found that chronic pain patients used fewer opioids when they had access to medical marijuana. Researchers at the University of New Mexico looked at two groups of patients: One group was enrolled in a medical cannabis program, the other was not, and after five years of analyzing patients' prescription activity, researchers found that those who enrolled in the medical marijuana program didn't just show significantly reduced opioid use, they also showed significant reductions in the use of other prescription drugs like benzodiazepines, which are prescribed for anxiety.
"[The study] basically suggests that cannabis may be more effective in not only treating patients on certain classes of prescription drugs like opiates, but perhaps a broader spectrum of controlled medications," study lead author Jacob Miguel Vigil told me in an interview shortly after it was published. "People coming off heroin are managing to bridge their withdrawals through cannabis," Vigil told me. "I hear it all the time. All the time."
Currently, the so-called gold standard for opioid treatment involves medications like methadone and suboxone, which relieve opioid cravings while blocking euphoric effects. Still, these drugs can be incredibly difficult to get. Methadone providers, for instance, are strictly regulated by both state and federal laws, which requires that patients show up in person to get their doses, even if the clinic is miles or hours away. It’s a pain in the ass, and it’s a barrier for people who want to get clean. CBD, however, isn't regulated by the FDA, and while there is ample evidence that some CBD products are bullshit, the real stuff isn't all that hard to get. This isn't to say that CBD is a replacement for methadone or suboxone—that was well beyond the scope of the Mt. Sinai study—but it could still be a useful tool for those who want to get clean. At a time when tens of thousands of Americans are dying from opioid overdoses each year, any treatment that shows results should be taken seriously.