WEBVTT

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Over the past 20 years

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more than 800,000 people
have died in the United States

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due do drug overdose.

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Yes, more than all the lives lost

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in all the wars
this country has fought in.

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The majority of these cases
are due to opioid drugs.

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Sadly, while we're having
this very conversation,

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at least one person will die
from a drug overdose,

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and a child will be born
experiencing severe withdrawals

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due to in utero opioid exposure.

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Only recently have some
pharmaceutical companies

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been held legally responsible
for the opioid crisis.

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And compared to their
multibillion-dollar revenues,

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the economic penalties
they're paying seem minuscule.

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So let me as a question:

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why does addiction
and the stigma of addiction

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make it OK to undervalue human lives?

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Ironically, I'm often asked
the opposite question.

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Why should we care about "addicts?"

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Sometimes I'm even shouted at

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by people who think that anyone
who suffers from a substance use disorder

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brought it on themselves.

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They must be weak,

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they lack any moral compass

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and therefore don't deserve any help.

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But if you know anything
about opioid addiction,

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you know that this population
does not fit that stereotype --

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not that any addiction every really does.

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These are mothers, fathers
and grandmothers.

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They're teachers, business leaders,

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cheerleaders, athletes,

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nurses and bus drivers.

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They're your brother or sister.

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They represent every fiber
in the fabric of our society.

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Yes, each person came to addiction
in a different way,

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but a major cause of the current epidemic

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is that medical overprescription
of opioid drugs

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for the treatment of chronic pain.

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And that is one thing
that makes this epidemic different.

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This particular epidemic
was caused by doctors' prescriptions.

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The cycle started when pharmaceutical
companies convinced physicians

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that their patients
should not feel any pain.

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Opioid makers claimed

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that their very potent drugs
would not lead to addiction

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unless individuals
were certain kinds of people

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from certain kinds of communities.

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Such disinformation,

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compounded with clinicians'
limited education

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and public ignorance about addiction,

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is what created the epidemic.

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So that's how we got here.

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Now the question is:

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how do you treat
a national opioid epidemic?

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During an epidemic,

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normally governments, clinicians
and scientists are brought together

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to help the afflicted.

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They develop new and even
unconventional treatment strategies

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to rapidly address the condition.

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That has not been the case
for the opioid epidemic.

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However, the picture is changing.

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We're beginning to see
more aggressive government actions.

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For example, the NIH recently started
a new initiative called HEAL.

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HEAL stands for Helping
End Addiction Long-term,

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and it's designed to accelerate research
for pain management and addiction

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through funding new treatment strategies.

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The current treatment strategy
for opioid addiction

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is the use of other opioids
such as methadone.

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These few medications have been used
during the past 50 years.

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They're considered substitution therapy --

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basically fighting fire with fire.

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They have saved numerous lives,

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yet they're not used
by many who still need them.

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Why?

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These medications
are themselves addictive,

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and therefore come
with many governmental regulations.

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Hundreds of thousands of people
must be strictly monitored each day.

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They must find an opioid clinic --

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often far from home --

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take their meds and then
try to make it into work.

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Obviously, that is not the most effective
treatment strategy for an epidemic.

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And it raises obvious questions as well.

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For example: why is the treatment
of addiction disorders different

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from other medical disorders?

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With most other medical disorders,

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a nonaddictive, prescribed medication
is picked up at the pharmacy.

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Why do physicians treating their patients
with a substance use disorder

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have limited treatment options?

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No one ever says

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that two to three treatments
are enough for cancer,

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especially when it's not a cure.

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And that brings us
to that 200 billion-dollar problem.

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Fighting fire with fire
is a reasonable strategy,

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but what about using
a different form of fire --

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a safer form of fire?

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What about actually developing
a nonaddictive treatment

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derived from another drug?

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That has been my journey

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towards trying to develop
a treatment for opioid addiction,

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and it's taken me in some
really surprising directions.

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My journey started with studying cannabis,

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the drug most people call marijuana.

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In order to understand

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how cannabis may connect
to combating the opioid epidemic,

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first it helps to understand a little bit
about the science behind the drug

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and the politics.

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Cannabis is a complex plant.

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It's actually made up
of over 140 cannabinoids.

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Cannabinoids are
active chemicals from the plant

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that binds to cannabinoid
receptors in our bodies.

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The potent psychoactive cannabinoid
that leads to the reward -- the high --

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is THC,

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which we scientists call
tetrahydrocannabinol.

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Pretty simple, right?

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But the politics
is a lot more complicated.

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Attitudes towards cannabis

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and the amount of THC
that's considered safe to consume

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have dramatically changed over the years.

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In fact, this country's had
a roller-coaster relationship

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with the drug.

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Cannabis is either
highly demonized or glorified.

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On the demonized side,

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cannabis was deemed
a Schedule I drug by the DEA --

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the Drug Enforcement Agency --

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meaning that cannabis is considered

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to be a drug of the highest
abuse potential

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and to have no medicinal value.

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Moreover, the Schedule I label
led to the mass, biased arrest

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for the use of cannabis,

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particularly among
young Black and brown men.

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However, things are changing.

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The pendulum is shifting
in the opposite direction.

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Today, cannabis is legal for medical
or recreational use in most states.

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And a bill is even being considered
in Congress to remove cannabis

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from the list of schedule drugs.

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We've also seen a great increase
in cannabis research.

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Most research studies,
including some of my own,

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focus on THC.

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In fact, our animal research
has shown a negative relationship

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between THC and opioid addiction.

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However, as I mentioned,

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the cannabis plant
has over 100 cannabinoids.

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So THC was not the only one to study.

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In examining another cannabinoid,

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cannabidiol --

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that is, CBD --

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we were actually surprised
to see features relevant

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to alleviating opioid
addiction-related behaviors.

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So there my journey turned to CBD.

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So what's this CBD that has moved
from virtual obscurity

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only a few years ago

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to everywhere in society --

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in your coffee in the morning,

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your water at lunch

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and your beer at dinner?

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CBD comes from the cannabis plant,

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but in contrast to THC that has the high,

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CBD has no addictive properties.

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We're still trying to figure out
how CBD fully works,

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but it is known that CBD
alters chemicals in the brain

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that regulate emotions and anxiety.

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Interestingly, giving CBD
to our animal models

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that had a history
of self-administering heroin,

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reduced their heroin-seeking behavior.

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Specifically, CBD reduced heroin-seeking
triggered by environmental cues

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that were previously
associated with the drug.

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Let me say that again.

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CBD reduced heroin-seeking
triggered by drug cues.

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This is significant,

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because craving is often triggered
by the memories of the cues

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previously associated with drug use.

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And craving is a matter
of life or death daily

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for people with an opioid use disorder.

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Simply put,

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craving can lead to relapse

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and death from overdose.

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So reducing craving
is an important treatment strategy.

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Getting results
from animal models like this

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is actually the first critical step
in the FDA process

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for developing new medications.

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The next step:

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human studies.

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In our first human study,

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we demonstrated that CBD is safe,

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even though individuals taking it
had also consumed a potent opioid.

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Next, to determine efficacy,

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we conducted clinical trials

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and made sure that both
the study investigators

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and the study participants

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were blind to the CBD
or the placebo substances.

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The results from those studies
replicated the findings that we had

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in the animal experiments.

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So now we know that CBD can reduce
craving triggered by environmental cues

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in human heroin users.

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What's more, our results demonstrated

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that CBD reduced anxiety
associated with the drug use.

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This is also significant because anxiety
is another critical factor

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that triggers craving.

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Importantly, CBD also reduced
the levels of the stress hormone cortisol

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that is often elevated when addicted
individuals are exposed to drug use.

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Another intriguing finding

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was the CBD continued to decrease
craving and anxiety

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even a week following its final use.

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This aspect of prolonged efficacy
is very beneficial

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for people taking any medication.

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So the evidence is mounting.

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CBD does show potential to reduce
critical features for opioid addiction

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such as craving and anxiety.

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But we're still not at the end of the road
for medication development.

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The gold standard for medicine
established by the FDA

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is large, clinical trials.

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Recently, I was fortunate enough
to be given that rare opportunity

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to conduct a large,
clinical trial with CBD

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in people with an opioid use disorder.

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And that study is expected to continue
for at least another two years.

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CBD is now being investigated
for numerous medical conditions.

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Also, during the past decade,

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our society has seen an explosion of CBD.

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It's being put into drink, food,
wellness and skincare products.

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They're even giving CBD to pets.

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So is CBD a wonder drug
as now touted by many?

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No.

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Does it have potential medicinal benefits?

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It does.

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But the only way
to get definitive information

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about CBD's full safety and efficacy

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is through large, clinical trials.

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So is it possible

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that we could actually change the game

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by taking this very familiar plant

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and developing a nonaddictive,
FDA-approved medication

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for opioid use disorder?

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Absolutely.

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That is why we're working
so hard right now

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to develop a solution based on CBD.

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For me,

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the potential benefits
are obvious and also overwhelming.

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It means helping to give families
back their mother or father.

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It means having your child
graduate from high school or college.

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But most of all,

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it means helping to save many
of the hundreds of thousands of lives

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that will otherwise be lost to opioids

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in the next decade.

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Thank you.

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(Applause)