Despite the growing indication for the utilisation of cannabis for its medicinal properties, there is ongoing concern for the potential of abuse of cannabis. Despite presenting a lower risk of dependence compared to some other drugs, like any substance it can be consumed in an unhealthy manner. This can cause an impact on physical, mental, social, and financial health.
What is Cannabis Use Disorder?
Evidence has suggested that the potency of tetrahydrocannabinol (THC) of street cannabis has been on the rise over the last few decades. THC is the cannabinoid compound with the cannabis plant which is associated with the euphoric effects desired by recreational users. It has been suggested that the daily use of high-THC cannabis is associated with a five-times higher risk of developing psychosis and an increased risk of developing a cannabis use disorder.
Cannabis use disorder is characterised by the continuation of cannabis use despite clinically significant impairment. This impairment can refer to psychological, physical, or social functioning. According to the European Monitoring Centre for Drugs and Drug Addiction (2018), the number of first-time clients citing cannabis as their primary drug at addiction services across Europe has increased by 76% in the last decade.
This makes the potential of cannabidiol (CBD) as a treatment for cannabis use disorder particularly interesting. A recently published study has built on past research in order to establish a safe and efficacious CBD dose for the treatment of cannabis use disorder.
What Methods Were Used?
The double-blind, placebo-controlled, randomised, adaptive trial, carried out at London’s Clinical Psychopharmacology Unit, was aimed at identifying an effective CBD dosage for the treatment of cannabis use disorder.
To measure the efficacy of varying CBD levels, participants were either given a placebo or one of the following doses: 200mg CBD; 400mg CBD; 800mg CBD. In order to measure the levels of cannabis use throughout the study, the researchers measured THC levels in urine samples, as well as the number of days per week that participants did not use cannabis.
What did They Find?
During the first trial period (between 28th May 2014, and 12th August 2015), 48 participants were randomly allocated one of the previously mentioned treatment plans. Following this treatment, doses of 200mg CBD were discontinued due to a lack of efficacy.
The second trial period (Between 24th May 2016, and 12th January 2017), saw the sample of 34 participants allocated to doses of 400mg CBD (12), 800mg CBD (11), or placebo (11). The results from this stage of the trial revealed that both doses of 400mg and 800mg CBD were more effective at reducing cannabis use compared to placebo. In addition, both CBD doses were found to be safe and well-tolerated among the patient sample.
How Does it Work?
There is evidence that CBD is able to modulate various neuronal circuits involved in drug addiction. It is thought that, through these interactions, CBD may suppress drug-seeking behaviours by reducing the release of ‘reward’ compounds – such as dopamine – within the body. Compounds such as dopamine and anandamide are released when we are exposed to some drugs, including cannabis.
The results showed that a reduction in cannabis use was maintained until the final follow-up in the patient group allocated 400mg CBD, whereas this was not so in the 800mg group. This indicates that the 400mg dose was the optimal treatment, but the reasons for this are not completely clear and require further investigation. CBD has also been evaluated as a therapeutic in other drug use disorders. Further research is warranted before entering clinical practice however as results have thus far been variable.