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← Could CBD help opioid users overcome addiction?

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Showing Revision 9 created 10/21/2020 by Erin Gregory.

  1. Over the past 20 years
  2. more than 800,000 people
    have died in the United States
  3. due do drug overdose.
  4. Yes, more than all the lives lost
  5. in all the wars
    this country has fought in.
  6. The majority of these cases
    are due to opioid drugs.
  7. Sadly, while we're having
    this very conversation,
  8. at least one person will die
    from a drug overdose,
  9. and a child will be born
    experiencing severe withdrawals
  10. due to in utero opioid exposure.
  11. Only recently have some
    pharmaceutical companies

  12. been held legally responsible
    for the opioid crisis.
  13. And compared to their
    multibillion-dollar revenues,
  14. the economic penalties
    they're paying seem minuscule.
  15. So let me as a question:
  16. why does addiction
    and the stigma of addiction
  17. make it OK to undervalue human lives?
  18. Ironically, I'm often asked
    the opposite question.

  19. Why should we care about "addicts?"
  20. Sometimes I'm even shouted at
  21. by people who think that anyone
    who suffers from a substance use disorder
  22. brought it on themselves.
  23. They must be weak,
  24. they lack any moral compass
  25. and therefore don't deserve any help.
  26. But if you know anything
    about opioid addiction,
  27. you know that this population
    does not fit that stereotype --
  28. not that any addiction every really does.
  29. These are mothers, fathers
    and grandmothers.
  30. They're teachers, business leaders,
  31. cheerleaders, athletes,
  32. nurses and bus drivers.
  33. They're your brother or sister.
  34. They represent every fiber
    in the fabric of our society.
  35. Yes, each person came to addiction
    in a different way,
  36. but a major cause of the current epidemic
  37. is that medical overprescription
    of opioid drugs
  38. for the treatment of chronic pain.
  39. And that is one thing
    that makes this epidemic different.
  40. This particular epidemic
    was caused by doctors' prescriptions.
  41. The cycle started when pharmaceutical
    companies convinced physicians

  42. that their patients
    should not feel any pain.
  43. Opioid makers claimed
  44. that their very potent drugs
    would not lead to addiction
  45. unless individuals
    were certain kinds of people
  46. from certain kinds of communities.
  47. Such disinformation,
  48. compounded with clinicians'
    limited education
  49. and public ignorance about addiction,
  50. is what created the epidemic.
  51. So that's how we got here.
  52. Now the question is:

  53. how do you treat
    a national opioid epidemic?
  54. During an epidemic,
  55. normally governments, clinicians
    and scientists are brought together
  56. to help the afflicted.
  57. They develop new and even
    unconventional treatment strategies
  58. to rapidly address the condition.
  59. That has not been the case
    for the opioid epidemic.
  60. However, the picture is changing.
  61. We're beginning to see
    more aggressive government actions.
  62. For example, the NIH recently started
    a new initiative called HEAL.
  63. HEAL stands for Helping
    End Addiction Long-term,
  64. and it's designed to accelerate research
    for pain management and addiction
  65. through funding new treatment strategies.
  66. The current treatment strategy
    for opioid addiction

  67. is the use of other opioids
    such as methadone.
  68. These few medications have been used
    during the past 50 years.
  69. They're considered substitution therapy --
  70. basically fighting fire with fire.
  71. They have saved numerous lives,
  72. yet they're not used
    by many who still need them.
  73. Why?
  74. These medications
    are themselves addictive,
  75. and therefore come
    with many governmental regulations.
  76. Hundreds of thousands of people
    must be strictly monitored each day.
  77. They must find an opioid clinic --
  78. often far from home --
  79. take their meds and then
    try to make it into work.
  80. Obviously, that is not the most effective
    treatment strategy for an epidemic.
  81. And it raises obvious questions as well.

  82. For example: why is the treatment
    of addiction disorders different
  83. from other medical disorders?
  84. With most other medical disorders,
  85. a nonaddictive, prescribed medication
    is picked up at the pharmacy.
  86. Why do physicians treating their patients
    with a substance use disorder
  87. have limited treatment options?
  88. No one ever says
  89. that two to three treatments
    are enough for cancer,
  90. especially when it's not a cure.
  91. And that brings us
    to that 200 billion-dollar problem.

  92. Fighting fire with fire
    is a reasonable strategy,
  93. but what about using
    a different form of fire --
  94. a safer form of fire?
  95. What about actually developing
    a nonaddictive treatment
  96. derived from another drug?
  97. That has been my journey
  98. towards trying to develop
    a treatment for opioid addiction,
  99. and it's taken me in some
    really surprising directions.
  100. My journey started with studying cannabis,

  101. the drug most people call marijuana.
  102. In order to understand
  103. how cannabis may connect
    to combating the opioid epidemic,
  104. first it helps to understand a little bit
    about the science behind the drug
  105. and the politics.
  106. Cannabis is a complex plant.

  107. It's actually made up
    of over 140 cannabinoids.
  108. Cannabinoids are
    active chemicals from the plant
  109. that binds to cannabinoid
    receptors in our bodies.
  110. The potent psychoactive cannabinoid
    that leads to the reward -- the high --
  111. is THC,
  112. which we scientists call
  113. Pretty simple, right?
  114. But the politics
    is a lot more complicated.

  115. Attitudes towards cannabis
  116. and the amount of THC
    that's considered safe to consume
  117. have dramatically changed over the years.
  118. In fact, this country's had
    a roller-coaster relationship
  119. with the drug.
  120. Cannabis is either
    highly demonized or glorified.
  121. On the demonized side,
  122. cannabis was deemed
    a Schedule I drug by the DEA --
  123. the Drug Enforcement Agency --
  124. meaning that cannabis is considered
  125. to be a drug of the highest
    abuse potential
  126. and to have no medicinal value.
  127. Moreover, the Schedule I label
    led to the mass, biased arrest
  128. for the use of cannabis,
  129. particularly among
    young Black and brown men.
  130. However, things are changing.
  131. The pendulum is shifting
    in the opposite direction.
  132. Today, cannabis is legal for medical
    or recreational use in most states.
  133. And a bill is even being considered
    in Congress to remove cannabis
  134. from the list of schedule drugs.
  135. We've also seen a great increase
    in cannabis research.

  136. Most research studies,
    including some of my own,
  137. focus on THC.
  138. In fact, our animal research
    has shown a negative relationship
  139. between THC and opioid addiction.
  140. However, as I mentioned,
  141. the cannabis plant
    has over 100 cannabinoids.
  142. So THC was not the only one to study.
  143. In examining another cannabinoid,
  144. cannabidiol --
  145. that is, CBD --
  146. we were actually surprised
    to see features relevant
  147. to alleviating opioid
    addiction-related behaviors.
  148. So there my journey turned to CBD.
  149. So what's this CBD that has moved
    from virtual obscurity

  150. only a few years ago
  151. to everywhere in society --
  152. in your coffee in the morning,
  153. your water at lunch
  154. and your beer at dinner?
  155. CBD comes from the cannabis plant,
  156. but in contrast to THC that has the high,
  157. CBD has no addictive properties.
  158. We're still trying to figure out
    how CBD fully works,
  159. but it is known that CBD
    alters chemicals in the brain
  160. that regulate emotions and anxiety.
  161. Interestingly, giving CBD
    to our animal models

  162. that had a history
    of self-administering heroin,
  163. reduced their heroin-seeking behavior.
  164. Specifically, CBD reduced heroin-seeking
    triggered by environmental cues
  165. that were previously
    associated with the drug.
  166. Let me say that again.
  167. CBD reduced heroin-seeking
    triggered by drug cues.
  168. This is significant,
  169. because craving is often triggered
    by the memories of the cues
  170. previously associated with drug use.
  171. And craving is a matter
    of life or death daily
  172. for people with an opioid use disorder.
  173. Simply put,
  174. craving can lead to relapse
  175. and death from overdose.
  176. So reducing craving
    is an important treatment strategy.
  177. Getting results
    from animal models like this

  178. is actually the first critical step
    in the FDA process
  179. for developing new medications.
  180. The next step:
  181. human studies.
  182. In our first human study,
  183. we demonstrated that CBD is safe,
  184. even though individuals taking it
    had also consumed a potent opioid.
  185. Next, to determine efficacy,
  186. we conducted clinical trials
  187. and made sure that both
    the study investigators
  188. and the study participants
  189. were blind to the CBD
    or the placebo substances.
  190. The results from those studies
    replicated the findings that we had
  191. in the animal experiments.
  192. So now we know that CBD can reduce
    craving triggered by environmental cues

  193. in human heroin users.
  194. What's more, our results demonstrated
  195. that CBD reduced anxiety
    associated with the drug use.
  196. This is also significant because anxiety
    is another critical factor
  197. that triggers craving.
  198. Importantly, CBD also reduced
    the levels of the stress hormone cortisol
  199. that is often elevated when addicted
    individuals are exposed to drug use.
  200. Another intriguing finding
  201. was the CBD continued to decrease
    craving and anxiety
  202. even a week following its final use.
  203. This aspect of prolonged efficacy
    is very beneficial
  204. for people taking any medication.
  205. So the evidence is mounting.

  206. CBD does show potential to reduce
    critical features for opioid addiction
  207. such as craving and anxiety.
  208. But we're still not at the end of the road
    for medication development.
  209. The gold standard for medicine
    established by the FDA
  210. is large, clinical trials.
  211. Recently, I was fortunate enough
    to be given that rare opportunity
  212. to conduct a large,
    clinical trial with CBD
  213. in people with an opioid use disorder.
  214. And that study is expected to continue
    for at least another two years.
  215. CBD is now being investigated
    for numerous medical conditions.
  216. Also, during the past decade,
  217. our society has seen an explosion of CBD.
  218. It's being put into drink, food,
    wellness and skincare products.
  219. They're even giving CBD to pets.
  220. So is CBD a wonder drug
    as now touted by many?

  221. No.
  222. Does it have potential medicinal benefits?
  223. It does.
  224. But the only way
    to get definitive information
  225. about CBD's full safety and efficacy
  226. is through large, clinical trials.
  227. So is it possible

  228. that we could actually change the game
  229. by taking this very familiar plant
  230. and developing a nonaddictive,
    FDA-approved medication
  231. for opioid use disorder?
  232. Absolutely.
  233. That is why we're working
    so hard right now
  234. to develop a solution based on CBD.
  235. For me,

  236. the potential benefits
    are obvious and also overwhelming.
  237. It means helping to give families
    back their mother or father.
  238. It means having your child
    graduate from high school or college.
  239. But most of all,
  240. it means helping to save many
    of the hundreds of thousands of lives
  241. that will otherwise be lost to opioids
  242. in the next decade.
  243. Thank you.

  244. (Applause)