There are currently over 250 million cannabis users worldwide, and cannabis dependence is the most common drug use disorder, affecting more than 22 million people . In Europe, there is an increase in treatment demand for cannabis problems by 76%.
As previous research shows, cannabidiol (CBD) inhibits paranoid symptoms and cognitive impairment in cannabis users. Knowing that CBD can relieve psychotic symptoms and improve episodic memory in cannabis users, can it be used to treat the disorder itself?
Since there are no pharmacological treatments for this disorder, a group of researchers led by Dr. Tom Freeman from the University of Bath decided to study the potential of CBD as a novel drug for the condition.
The first trial of its kind
In this new study, which is the first clinical trial of its kind, the primary objective was to identify the most efficacious dose of CBD for reducing cannabis use. CBD was administrated to 82 volunteers that wanted to quit using cannabis but didn’t manage to do so in the past. The findings show that a daily intake of 400mg or 800mg of CBD helped people with cannabis use disorder to reduce their cannabis intake.
The trial was carried out in two stages. At each stage, the volunteers were split into equal groups and given a dose of CBD or placebo. They were administrated with two capsules of CBD or placebo twice a day for 4 weeks.
In the first stage, 48 people were randomly split into four groups, one of which received a placebo. The three other groups were given CBD at a dose of 200mg, 400mg, or 800mg. In addition to that, all participants had six counseling sessions designed to help them quit using cannabis by increasing their motivation.
Urine samples were taken each week to test for THC levels. Volunteers also reported the number of days they had not used cannabis that week. In this stage, the team found that 200mg of CBD did not work. They excluded 200mg from further investigations and recruited new volunteers for the next stage.
In the second stage, 34 new volunteers were randomly split into three groups. Eleven received the inactive substance, 12 received 400mg of CBD, and 11 received 800mg of CBD. The same methods were used to measure the amount of cannabis consumed, and the volunteers also received the same counseling.
The study found that CBD reduced the amount of cannabis used, which was verified by the urine samples. CBD also decreased the number of days per week that participants used cannabis. Most importantly, there was no difference in side-effects between CBD and placebo.
This study showed that prescribed CBD doses between 400mg and 800mg could treat cannabis use disorder, but further studies are still necessary.
In previous human case studies , CBD has been found to reduce self-reported cannabis use to non-use, and to reduced cannabis withdrawal, although the latter case study did find the subject to have relapsed after a 6-months follow up.
A path to non-usage
In a study in 2015, the patient was a 27-y-old male with a long-standing diagnosis of bipolar disorder and a daily addiction to marijuana use. The only change made to the patient’s treatment in this study was the addition of CBD oil with the dosage gradually decreasing from 24 to 18 mg.
With the use of the CBD oil, the patient reported being less anxious, as well as settling into a regular pattern of sleep. He also indicated that he had not used any marijuana since starting the CBD oil. With the decrease in the dosage to 18 mg, the patient was able to maintain his nonuse of marijuana. With a subsequent, gradual decrease in anxiety, the patient was able to maintain a regular sleeping schedule and get a more secure job.
In 2013, a case study was conducted on a 19‐year‐old girl who had a history of heavy and continued use of cannabis, smoking 4–8 cannabis cigarettes per day since the age of 13. She would spend virtually all her money, time, and effort to get the drug. In the clinical evaluation, she reported memory, concentration, and attention deficits that affected her academic and professional performance. The patient described that all her previous attempts to quit smoking cannabis were associated with increased anxiety, insomnia, loss of appetite, migraine, restlessness, irritability, nightmares, and sweating. The symptoms appeared between 4 and 6 days after cessation and disappeared when use was resumed.
She was hospitalized and treated with oral CBD in the following regimen: 300 mg on Day 1; CBD 600 mg on Days 2–10 (divided into two doses of 300 mg) and CBD 300 mg on Day 11. The study found that the absence of withdrawal symptoms over the first 10 days of cannabis interruption in a patient who had reported intense symptoms in four previous cessation attempts strongly suggests the efficacy of CBD against withdrawal symptoms. Unfortunately, the patient relapsed after six months.