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Addiction is a brain disorder characterized by compulsive engagement in rewarding stimuli, despite adverse consequences. It is a condition that usually results when a person ingests a substance (e.g., alcohol, cocaine, nicotine) or engages in an activity (e.g., gambling, sex, shopping) that can be pleasurable but the continuation of which becomes compulsive and interferes with ordinary responsibilities and concerns, such as work, relationships, or health. Many times people who have developed an addiction may not be aware that their behavior is out of control and causing problems for themselves and others.
The word addiction is used in several different ways. One definition describes physical addiction. This is a biological state in which the body adapts to the presence of a drug so that drug no longer has the same effect, otherwise known as a tolerance. Another form of physical addiction is the phenomenon of overreaction by the brain to drugs (or to cues associated with the drugs). An alcoholic walking into a bar, for instance, will feel an extra pull to have a drink because of these cues.
Reports have shown that already patients are putting down their prescriptions and picking up cannabis. A survey done in 2016 and published in the International Journal of Drug Policy questioned 271 Canadian medical cannabis patients.
This survey found that 63 percent of patients use cannabis over prescription drugs. Of those, 30 percent admitted using cannabis over prescription painkillers. In terms of other drugs of addiction, 25 percent reported that they use cannabis over alcohol. 12 percent said they had replaced tobacco with cannabis, and 3 percent had given up other illicit drugs.
Other surveys in state-based cannabis programs have had similar findings. But, how do patients successfully kick their habits for cannabis? Here are the things to consider when using cannabis to treat addiction:
THC and CBD
These are the two primary cannabis compounds that are thought to be helpful in addiction treatment. Though, given the evidence thus far, one compound may be preferable to another. Both tetrahydrocannabinol (THC), the primary psychoactive in cannabis, as well as cannabidiol (CBD). Right now, CBD is the main topic of interest in addiction treatment.
Unlike THC, CBD does not provide a psychoactive “high.” Instead, it provides a non-euphoric mood boost and plenty of relaxation. A 2015 review suggests that CBD has potential as a therapy for addiction. In particular, the review cites evidence suggesting that CBD may help with opioid, cocaine, psychostimulant, and tobacco addiction. However, those concerned about the habit-forming and euphoric properties of THC may want to consider one-to-one strains or sticking with CBD alone.
As it turns out, a little goes a long way with cannabis. Both THC and CBD may effectively reduce addictive behaviors even in small doses. A 2004 study in rodents found that low doses of THC and CBD reduced learned habits associated with cocaine and amphetamine exposure. The study examined learned place preference. Both cocaine and amphetamine flood the brain with pleasure molecules.
In this study, rodents were conditioned to have a preference for a location due to a surge of feel-good brain chemicals. Treatment with low doses of THC (0.5 mg/kg) and CBD (5 mg/kg) successfully disconnected the learned reward from the behavior, indicating that the cannabinoids can help extinguish conditioned learning. This could be useful in the treatment of addiction.
Further research has found that a 5-milligram daily dose of CBD relieved conditioned heroin-seeking behavior in rodents for up to two weeks after the last administration. This is a good indication that CBD treatments may help at least certain kinds of addiction.
Integrating cannabis into holistic care
To successfully integrate cannabis into addiction recovery, physical, sociocultural, and psychological factors all need to be addressed. Throwing out the prescription bottles and picking up an ounce of cannabis may be effective in the short run, but the process can be made easier by making sure that you and your care team are addressing factors that fuel the addiction, rather than just making simple substitutions.
For example, poor diet can be contributing to pain and inflammation, leading to a greater need to turn to relief in the form of opiates or alcohol. Successfully treating addiction can mean looking at all areas of health and wellness, not simply focusing on medicating behaviors.
Cannabis and therapy
Oftentimes, major life stressors and traumas contribute to addiction. Counseling and behavioural therapy are thought to be helpful in addition and cannabis can be seen as a tool to make therapy more effective.
A human trial of 48 participants shows CBD may reduce learned fear. The cannabinoid engages with parts of the brain responsible for memory formation, though the active mechanisms are not entirely clear. The trial found that CBD treatment after a fearful event (an electric shock associated with a colored square) helped to prevent a fear associated with a particular color.
Similarly, early research suggests that CBD has potent anti-anxiety and antipsychotic properties, which could potentially make it useful in therapy sessions. While more research is needed, CBD seems to help people remain in a calm and relaxed state of mind during treatment.
CLINICAL STUDY RESOURCES: