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Research on CBD’s potential to treat opioid addiction itself is even more preliminary, though growing. Yasmin Hurd, Ph.D., director of the Addiction Institute at Mount Sinai in New York City, for example, has shown that CBD reduces cravings for heroin, in both rats and humans.

Beamon’s experience illustrates one way patients and physicians are increasingly using CBD, not just to ease pain but also to see if the compound can reduce reliance on opioids. And researchers across the country are now studying whether CBD (alone or in combination with THC) could be a tool in the fight against the ongoing opioid crisis.

Beamon began using a CBD tincture, placing several drops under her tongue or mixed into drinks, several times a day. The results were “revolutionary,” she says. “I sleep through the night, finally, without waking up in pain.” What’s more, she is no longer reliant on opioids. “That’s a complete relief to me.”

CBD as a Pain Reliever

Enthusiasm for this research—along with anecdotal reports from patients—has prompted several states to allow some patients to substitute medical marijuana (CBD and/or THC) for opioids. In New York, patients enrolled in a certified treatment program for opioid use disorder, the technical term for opioid addiction, can now try marijuana as an alternative. “Adding opioid replacement as a qualifying condition for medical marijuana offers providers another treatment option, which is a critical step in combating the deadly opioid epidemic,” New York State Health Commissioner Howard Zucker, M.D., said in a statement.

Nika C. Beamon’s body has been through a lot. Nearly two decades spent battling a rare autoimmune disorder damaged her liver, stomach, pancreas, and spine, leaving her in crippling pain and often walking with a cane. After a slew of treatments—including surgery and steroid injections—failed to provide lasting relief, Beaman, a TV writer in New York City, found herself turning to prescription opioids.

How might CBD treat opioid addiction? “There’s a big controversy,” about that, says Hurd, at Mount Sinai. But one possibility is that it affects how brain cells that have been damaged by opioids communicate with each other, she says.

Philip Blair, M.D., a family physician in Vancouver, Wash., and a consultant for the CBD manufacturer Elixinol, says he has helped dozens of patients taper off opioids by substituting with CBD. He encourages them to go at their own pace, stretching out the time between opioid doses and slowly adding in CBD. “If they know they have something to rely on, to count on, to get back to normal and get them through this time period, they can do it,” he says.

Methods: Thirty inpatients (57% men) completed the Marijuana Quit Questionnaire (MJQQ) after completing acute heroin detoxification treatment in Saint Petersburg, Russia. The MJQQ collected data on motivations for quitting, withdrawal symptoms, and coping strategies used to help maintain abstinence during their most “serious” (self-defined) quit attempt made without formal treatment outside a controlled environment.

Background: Cannabis use is common among opioid-dependent individuals, but little is known about cannabis withdrawal in this population.

Results: At the start of their quit attempt, 70% of participants smoked cannabis at least weekly (40% daily), averaging [SD] 2.73 [1.95] joints daily; 60% were heroin dependent. Subjects with heroin dependence were significantly older at the start of their quit attempt (22.9 [3.6] vs. 19.1 [2.9] years), were significantly less likely to report withdrawal irritability/anger/aggression (22% vs. 58%), restlessness (0% vs. 25%), or physical symptoms (6% vs. 33%), or to meet diagnostic criteria for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) cannabis withdrawal syndrome (6% vs. 33%), and had shorter duration of abstinence (29.6 [28.7] vs 73.7 [44.1] months) than those without heroin dependence.

Conclusion: Cannabis users with opioid dependence are less likely to experience cannabis withdrawal, suggesting that opiate use may prevent or mask the experience of cannabis withdrawal. RESULTS should be considered preliminary due to small convenience sample and retrospective data.