cannabidiol and Heroin-Dependence

Despite the staggering consequences of the opioid epidemic, limited nonopioid medication options have been developed to treat this medical and public health crisis. This study investigated the potential of cannabidiol (CBD), a nonintoxicating phytocannabinoid, to reduce cue-induced craving and anxiety, two critical features of addiction that often contribute to relapse and continued drug use, in drug-abstinent individuals with heroin use disorder.. This exploratory double-blind randomized placebo-controlled trial assessed the acute (1 hour, 2 hours, and 24 hours), short-term (3 consecutive days), and protracted (7 days after the last of three consecutive daily administrations) effects of CBD administration (400 or 800 mg, once daily for 3 consecutive days) on drug cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder. Secondary measures assessed participants' positive and negative affect, cognition, and physiological status.. Acute CBD administration, in contrast to placebo, significantly reduced both craving and anxiety induced by the presentation of salient drug cues compared with neutral cues. CBD also showed significant protracted effects on these measures 7 days after the final short-term (3-day) CBD exposure. In addition, CBD reduced the drug cue-induced physiological measures of heart rate and salivary cortisol levels. There were no significant effects on cognition, and there were no serious adverse effects.. CBD's potential to reduce cue-induced craving and anxiety provides a strong basis for further investigation of this phytocannabinoid as a treatment option for opioid use disorder.

Topics: Adult; Aged; Anxiety; Cannabidiol; Cognition; Craving; Cues; Double-Blind Method; Female; Heart Rate; Heroin Dependence; Humans; Hydrocortisone; Male; Middle Aged; Saliva; Young Adult

There remains debate regarding the impact of cannabis on neuropsychiatric disorders. Here, we examined the effects of cannabidiol (CBD), a nonpsychoactive constituent of cannabis, on heroin self-administration and drug-seeking behavior using an experimental rat model. CBD (5-20 mg/kg) did not alter stable intake of heroin self-administration, extinction behavior, or drug seeking induced by a heroin prime injection. Instead, it specifically attenuated heroin-seeking behavior reinstated by exposure to a conditioned stimulus cue. CBD had a protracted effect with significance evident after 24 h and even 2 weeks after administration. The behavioral effects were paralleled by neurobiological alterations in the glutamatergic and endocannabinoid systems. Discrete disturbances of AMPA GluR1 and cannabinoid type-1 receptor expression observed in the nucleus accumbens associated with stimulus cue-induced heroin seeking were normalized by CBD treatment. The findings highlight the unique contributions of distinct cannabis constituents to addiction vulnerability and suggest that CBD may be a potential treatment for heroin craving and relapse.

Topics: Animals; Cannabidiol; Cannabinoid Receptor Modulators; Conditioning, Psychological; Cues; Disease Models, Animal; Glutamic Acid; Heroin; Heroin Dependence; Limbic System; Male; Narcotic Antagonists; Narcotics; Neural Pathways; Nucleus Accumbens; Rats; Rats, Long-Evans; Receptor, Cannabinoid, CB1; Receptors, AMPA; Treatment Outcome; Ventral Tegmental Area

Mice were rendered morphine-dependent by the subcutaneous implantation of a pellet containing 75 mg of morphine base; 72 h after the implantation, the animals were injected intraperitoneally either with vehicle or with various doses of delta9-tetrahydrocannabinol, delta8-tetrahydrocannabinol, cannabidiol, cannabinol, or 11-hydroxy-delta8-tetrahydrocannabinol. Thirty minutes after injection of the cannabinoids, the antagonist, naloxone HC1, was administered to induce the stereotyped withdrawal jumping syndrome. The dose of naloxone needed to induce withdrawal jumping in 50% of the animals (ED50) was determined for each dose of the cannabinoids. All of the cannabinoids inhibited the naloxone-precipitated morphine abstinence as evidenced by an increase in the naloxone ED50. Two additional signs of morphine abstinence, defecation and rearing behavior, were also suppressed by the cannabinoids. The relative effectiveness of the cannabinoids in inhibiting morphine abstinence appeared to be in the following order: delta9-tetrahydrocannabinol greater than delta8-tetrahydrocannabinol greater than 11-hydroxy-delta8-tetrahydrocannabinol greater than cannabidiol greater than cannabinol. These data suggest that cannabinoids may be useful in facilitating narcotic detoxification.

Topics: Animals; Cannabidiol; Cannabinoids; Cannabinol; Dronabinol; Heroin Dependence; Humans; Male; Mice; Morphine Dependence; Naloxone; Substance Withdrawal Syndrome