Plentiful research and anecdotal evidence has suggested that cannabis could be a useful harm reduction tool to help folks wean off of other substances that are more addictive and harmful. While many studies have focused on cannabis to curb opioid use with some looking more broadly at stimulants, new research suggests that it could prove useful for those with crack use disorder (CUD).

In fact, the popular non-psychoactive medicinal cannabinoid CBD, or cannabidiol, seems to be the key element.

The study, published recently in the International Journal of Mental Health and Addiction, utilized a double-blind randomized clinical trial comparing CBD to three drugs commonly used to treat CUD: fluoxetine, valproic acid and clonazepam. Authors represent a number of Brazilian academic and official institutions, comprising various departments at the University of Brasília, the Brazilian Federal District’s secretary of health and forensic institute and the Federal University of São Paulo.

The research ultimately found that participants who took CBD had better health outcomes and fewer adverse effects compared to those who underwent traditional pharmaceutical options.

Monitoring Crack Use Over Time With CBD and Traditional Meds

Participants included adults in Brazil aged 18 to 65 who had used crack regularly over the past year and at least 20 times within the past month. The participants also had a desire to seek treatment for their CUD. Many of the participants used multiple drugs, but crack was noted by participants and the study team as their primary drug.

The initial participant group included 90 people, with 73 ultimately assigned to either the control of the CBD group over 10 weeks of treatment. Of this group, 34 participants completed at least half of the study and 25 completed it fully.

One group received 600 mg of CBD while the control group received a combination of the three traditional drugs. 

Researchers assessed crack use among participants once per week through a questionnaire, which asked about the frequency of crack use over the last seven days, the highest number of consecutive days without crack use, the average number of stones or grams used on days of use and the highest number of stones or grams used in a single day.

They also assessed adverse effects of the medications each week using a questionnaire, prompting participants to describe adverse effects if they happened. Additionally, researchers assessed physical health symptoms once per month, the intensity of cravings each week and collected weekly urine samples. 

CBD ‘Safe’ and ‘Tolerable’ Option with ‘Significantly’ Fewer Adverse Effects

While the study found that there were no significant variations in decrease of crack use or self-reported cravings between the control and CBD groups, researchers noted that CBD showed milder side effects than traditional medications, which could lead to diarrhea, constipation, nausea, dizziness, memory impairment and other outcomes.

The study notes that CBD seems to mitigate the primary symptoms reported by participants, including lack of appetite, difficulty in reducing crack use and the feeling of poor mental health. So, while CBD may not be more effective than standard medications, the study suggests it’s at least as effective as those options while offering fewer unwanted side effects. 

Additionally, researchers state that fewer adverse effects in CBD treatment could be beneficial in ensuring those looking to curb their crack use remain in treatment.

“CBD is a safe/tolerable product that presented significantly fewer adverse events compared to the control group,” the study conclusion states. “The CBD group performed better in more parameters than the control group, reducing crack use, not reducing food intake due to crack use, and greater improvements in self-rated health.”

The actual reasons CBD seems to help with CUD remains somewhat unclear, with researchers explaining that it is “difficult to outline the mechanism of action” behind the cannabinoid given its “broad spectrum of pharmacological properties” affecting a number of targets. Though they note that this “multiple-target action” could be an essential element, adding that “CBD decreases endocannabinoid receptor signaling and inhibits fatty acid amide hydrolase, which may reduce craving and decrease relapse rates in people with CUD.”

For future studies, researchers suggest a larger sample size and conducting similar trials with more intense screening and participant monitoring. They also state that results could be enhanced by reducing stress and environmental factors, improving emotional regulation, implementing strategies to better support individuals and potentially utilizing other cannabinoid compositions like full-spectrum CBD and/or THC.

“If so, this would be an important advance in the pharmacological treatment of stimulant use disorders,” authors conclude.

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