What to know about CBD for opioid withdrawal

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People who take opioids consistently over a long period, then stop taking them abruptly can experience withdrawal symptoms. This is true regardless of whether a person is using the medication to treat pain, another health issue, or if they have opioid use disorder (OUD).

The withdrawal symptoms can be debilitating, and they are generally the most intense for the first 1–2 weeks. However, they may linger for months. And inadequate management of opioid withdrawal can lead to poor outcomes. It may, for example, lead to unsafe opioid use and overdose.

The 2021 research involved an in-depth review of 44 investigations into the use of CBD for various other medical conditions, such as anxiety, pain, and insomnia.

One study in the review found that the compound mitigated opioid cravings in people with OUD who had already stopped opioid use. The researchers also found that CBD reduced:

• anxiety
• depression
• insomnia
• pain
• muscle spasms
• nausea and vomiting
• blood pressure

Most of these symptoms may also occur during opioid withdrawal.

This theoretically means — though it was not directly studied — that doctors could consider adding CBD to opioid withdrawal treatment plans to reduce withdrawal symptoms. However, studying the effects of CBD on opioid withdrawal directly and defining the best dosages and formulations require more research.

Research from 2018 notes that CBD’s effects on pain and opioid withdrawal symptoms may be beneficial, either as an alternative or an add-on to current treatment. Details are below.

Pain relief

CBD and other compounds in the cannabis plant from which it derives have pain relieving properties. People who take opioids for chronic pain may decrease their opioid use by 40–60% if they also take cannabis. Since people who do so report fewer side effects of cannabis than of opioids, this is an advantage.

Avoiding higher doses could lead to safer use of opioids. Higher doses are more likely to cause respiratory depression and overdose, among other negative effects.

Reduction of opioid withdrawal symptoms

Medications for OUD treatment, such as methadone (Methadose), buprenorphine (Subutex), and buprenorphine-naloxone (Suboxone), help reduce opioid withdrawal symptoms.

However, stigma associated with OUD can prevent people from accessing addiction treatment services. These also introduce legal and logistical challenges to obtaining the medications.

And while some medications for OUD reduce opioid withdrawal symptoms, getting through this phase of the treatment remains challenging.

These and other factors might lead a person to pursue other treatments.

Research into the effectiveness of cannabis for opioid withdrawal is inconsistent. But studies that focus specifically on CBD for this purpose suggest that it helps ease cravings and limits the rewarding effects of various drugs that can cause substance use disorders.

Furthermore, oral CBD doses of 400 and 800 milligrams appear safe and tolerable. The research from 2018 found no intensified effects of the opioid fentanyl when the researchers administered it with CBD. The authors conclude that CBD has “great therapeutic potential” for helping with opioid withdrawal but that more studies are necessary.

Findings indicate that CBD can cause:

• Dose-related liver damage: The risk of this damage increases when a person takes CBD with certain other medications.
• Sedation: This effect may diminish with time, but taking CBD with medications that have sedating effects may severely depress breathing.
• Increased suicidal thoughts and behavior: For someone who takes CBD, any changes in mood or behavior require a doctor’s evaluation.

Doctors do not recommend CBD for people with:

• allergies to CBD or sesame oil
• a history of substance use disorder
• depression or suicidal thoughts

In addition, as the FDA warns, research has not proven that CBD is safe, and determining its long-term effects requires further studies. It also notes that CBD products may contain contaminants, pesticides, and bioactive chemicals.

Medications for OUD remain the gold-standard of treatment, as they are the options proven to reduce overdose and death.

However, researchers continue to investigate other options.

Acupuncture

A 2018 meta-analysis evaluated the effectiveness of acupuncture or electroacupuncture as an OUD treatment, compared with no treatment.

After reviewing nine studies with a total of 1,063 participants, the authors concluded that compared with no treatment or sham acupuncture, acupuncture and electroacupuncture may reduce opioid cravings. Still, they add, further studies are necessary.

Opioids are a group of drugs that include pain relief medications and substances such as heroin. The opioid overdose crisis refers to the widespread harmful use of both prescription and nonprescription opioids.

By 2017, the United States Department of Health and Human Services had declared it a public health emergency.

From April 2020 to April 2021, there were 75,673 deaths due to opioid overdoses. This was an increase from the 56,064 opioid overdose deaths observed in the 12 months prior.

The following resources provide help for people with use disorders or addiction:

• The Substance Abuse and Mental Health Service Administration offers this toll-free helpline: (800) 662-HELP (4357).
• The National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism offer support and education services.
• HealthFinder.gov can help a person contact state and county health departments. They can provide information about substance abuse and help connect people with public treatment services and private treatment programs.

A study exploring the use of CBD for anxiety, insomnia, and pain indicate that the compound may be useful in treating opioid withdrawal symptoms.

That said, the FDA has not approved CBD for this purpose. It warns that research has not yet concluded whether CBD is safe.

Medications for OUD, such as Suboxone and Methadose, are the gold-standard approach to treatment. They are the only treatments proven to reduce overdose deaths. Anyone wishing to try an alternative option might consider acupuncture.