Could CBD help opioid users overcome addiction?
-
0:01 - 0:04Over the past 20 years
-
0:04 - 0:07more than 800,000 people
have died in the United States -
0:07 - 0:10due do drug overdose.
-
0:10 - 0:13Yes, more than all the lives lost
-
0:13 - 0:16in all the wars
this country has fought in. -
0:17 - 0:20The majority of these cases
are due to opioid drugs. -
0:22 - 0:25Sadly, while we're having
this very conversation, -
0:25 - 0:28at least one person will die
from a drug overdose, -
0:28 - 0:33and a child will be born
experiencing severe withdrawals -
0:33 - 0:37due to in utero opioid exposure.
-
0:37 - 0:39Only recently have some
pharmaceutical companies -
0:39 - 0:43been held legally responsible
for the opioid crisis. -
0:43 - 0:46And compared to their
multibillion-dollar revenues, -
0:46 - 0:50the economic penalties
they're paying seem minuscule. -
0:51 - 0:53So let me as a question:
-
0:54 - 0:57why does addiction
and the stigma of addiction -
0:58 - 1:00make it OK to undervalue human lives?
-
1:01 - 1:05Ironically, I'm often asked
the opposite question. -
1:05 - 1:08Why should we care about "addicts?"
-
1:08 - 1:10Sometimes I'm even shouted at
-
1:10 - 1:14by people who think that anyone
who suffers from a substance use disorder -
1:14 - 1:15brought it on themselves.
-
1:15 - 1:16They must be weak,
-
1:16 - 1:18they lack any moral compass
-
1:18 - 1:20and therefore don't deserve any help.
-
1:21 - 1:25But if you know anything
about opioid addiction, -
1:25 - 1:28you know that this population
does not fit that stereotype -- -
1:28 - 1:31not that any addiction every really does.
-
1:32 - 1:35These are mothers, fathers
and grandmothers. -
1:35 - 1:38They're teachers, business leaders,
-
1:38 - 1:39cheerleaders, athletes,
-
1:39 - 1:41nurses and bus drivers.
-
1:41 - 1:43They're your brother or sister.
-
1:44 - 1:48They represent every fiber
in the fabric of our society. -
1:50 - 1:54Yes, each person came to addiction
in a different way, -
1:54 - 1:57but a major cause of the current epidemic
-
1:57 - 2:00is that medical overprescription
of opioid drugs -
2:00 - 2:02for the treatment of chronic pain.
-
2:02 - 2:06And that is one thing
that makes this epidemic different. -
2:06 - 2:10This particular epidemic
was caused by doctors' prescriptions. -
2:11 - 2:16The cycle started when pharmaceutical
companies convinced physicians -
2:16 - 2:18that their patients
should not feel any pain. -
2:19 - 2:20Opioid makers claimed
-
2:20 - 2:24that their very potent drugs
would not lead to addiction -
2:24 - 2:27unless individuals
were certain kinds of people -
2:27 - 2:28from certain kinds of communities.
-
2:29 - 2:31Such disinformation,
-
2:31 - 2:33compounded with clinicians'
limited education -
2:33 - 2:35and public ignorance about addiction,
-
2:35 - 2:37is what created the epidemic.
-
2:38 - 2:40So that's how we got here.
-
2:41 - 2:42Now the question is:
-
2:42 - 2:45how do you treat
a national opioid epidemic? -
2:47 - 2:48During an epidemic,
-
2:48 - 2:51normally governments, clinicians
and scientists are brought together -
2:52 - 2:53to help the afflicted.
-
2:53 - 2:57They develop new and even
unconventional treatment strategies -
2:57 - 2:59to rapidly address the condition.
-
3:00 - 3:03That has not been the case
for the opioid epidemic. -
3:03 - 3:06However, the picture is changing.
-
3:06 - 3:09We're beginning to see
more aggressive government actions. -
3:09 - 3:14For example, the NIH recently started
a new initiative called HEAL. -
3:14 - 3:17HEAL stands for Helping
End Addiction Long-term, -
3:17 - 3:21and it's designed to accelerate research
for pain management and addiction -
3:22 - 3:25through funding new treatment strategies.
-
3:25 - 3:29The current treatment strategy
for opioid addiction -
3:29 - 3:32is the use of other opioids
such as methadone. -
3:33 - 3:38These few medications have been used
during the past 50 years. -
3:38 - 3:41They're considered substitution therapy --
-
3:41 - 3:44basically fighting fire with fire.
-
3:45 - 3:48They have saved numerous lives,
-
3:48 - 3:51yet they're not used
by many who still need them. -
3:52 - 3:54Why?
-
3:54 - 3:56These medications
are themselves addictive, -
3:56 - 4:00and therefore come
with many governmental regulations. -
4:00 - 4:04Hundreds of thousands of people
must be strictly monitored each day. -
4:05 - 4:07They must find an opioid clinic --
-
4:07 - 4:09often far from home --
-
4:09 - 4:11take their meds and then
try to make it into work. -
4:12 - 4:17Obviously, that is not the most effective
treatment strategy for an epidemic. -
4:18 - 4:21And it raises obvious questions as well.
-
4:22 - 4:25For example: why is the treatment
of addiction disorders different -
4:25 - 4:27from other medical disorders?
-
4:27 - 4:29With most other medical disorders,
-
4:29 - 4:32a nonaddictive, prescribed medication
is picked up at the pharmacy. -
4:34 - 4:37Why do physicians treating their patients
with a substance use disorder -
4:37 - 4:40have limited treatment options?
-
4:40 - 4:41No one ever says
-
4:41 - 4:43that two to three treatments
are enough for cancer, -
4:43 - 4:45especially when it's not a cure.
-
4:48 - 4:52And that brings us
to that 200 billion-dollar problem. -
4:54 - 4:58Fighting fire with fire
is a reasonable strategy, -
4:58 - 5:01but what about using
a different form of fire -- -
5:01 - 5:04a safer form of fire?
-
5:04 - 5:07What about actually developing
a nonaddictive treatment -
5:07 - 5:09derived from another drug?
-
5:10 - 5:12That has been my journey
-
5:12 - 5:15towards trying to develop
a treatment for opioid addiction, -
5:15 - 5:18and it's taken me in some
really surprising directions. -
5:19 - 5:22My journey started with studying cannabis,
-
5:22 - 5:25the drug most people call marijuana.
-
5:25 - 5:27In order to understand
-
5:27 - 5:30how cannabis may connect
to combating the opioid epidemic, -
5:30 - 5:35first it helps to understand a little bit
about the science behind the drug -
5:35 - 5:37and the politics.
-
5:38 - 5:40Cannabis is a complex plant.
-
5:40 - 5:44It's actually made up
of over 140 cannabinoids. -
5:44 - 5:46Cannabinoids are
active chemicals from the plant -
5:46 - 5:49that binds to cannabinoid
receptors in our bodies. -
5:49 - 5:53The potent psychoactive cannabinoid
that leads to the reward -- the high -- -
5:53 - 5:55is THC,
-
5:55 - 5:58which we scientists call
tetrahydrocannabinol. -
5:58 - 5:59Pretty simple, right?
-
6:00 - 6:03But the politics
is a lot more complicated. -
6:04 - 6:06Attitudes towards cannabis
-
6:06 - 6:09and the amount of THC
that's considered safe to consume -
6:09 - 6:12have dramatically changed over the years.
-
6:12 - 6:16In fact, this country's had
a roller-coaster relationship -
6:16 - 6:17with the drug.
-
6:17 - 6:20Cannabis is either
highly demonized or glorified. -
6:20 - 6:22On the demonized side,
-
6:22 - 6:25cannabis was deemed
a Schedule I drug by the DEA -- -
6:25 - 6:27the Drug Enforcement Agency --
-
6:27 - 6:30meaning that cannabis is considered
-
6:30 - 6:33to be a drug of the highest
abuse potential -
6:33 - 6:35and to have no medicinal value.
-
6:36 - 6:41Moreover, the Schedule I label
led to the mass, biased arrest -
6:41 - 6:42for the use of cannabis,
-
6:42 - 6:45particularly among
young Black and brown men. -
6:45 - 6:47However, things are changing.
-
6:47 - 6:50The pendulum is shifting
in the opposite direction. -
6:50 - 6:56Today, cannabis is legal for medical
or recreational use in most states. -
6:56 - 6:59And a bill is even being considered
in Congress to remove cannabis -
6:59 - 7:01from the list of schedule drugs.
-
7:02 - 7:05We've also seen a great increase
in cannabis research. -
7:06 - 7:09Most research studies,
including some of my own, -
7:09 - 7:11focus on THC.
-
7:12 - 7:16In fact, our animal research
has shown a negative relationship -
7:16 - 7:18between THC and opioid addiction.
-
7:19 - 7:21However, as I mentioned,
-
7:22 - 7:25the cannabis plant
has over 100 cannabinoids. -
7:25 - 7:27So THC was not the only one to study.
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7:28 - 7:31In examining another cannabinoid,
-
7:31 - 7:32cannabidiol --
-
7:32 - 7:34that is, CBD --
-
7:34 - 7:36we were actually surprised
to see features relevant -
7:36 - 7:40to alleviating opioid
addiction-related behaviors. -
7:41 - 7:44So there my journey turned to CBD.
-
7:46 - 7:49So what's this CBD that has moved
from virtual obscurity -
7:49 - 7:51only a few years ago
-
7:51 - 7:53to everywhere in society --
-
7:53 - 7:54in your coffee in the morning,
-
7:54 - 7:56your water at lunch
-
7:56 - 7:57and your beer at dinner?
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7:59 - 8:01CBD comes from the cannabis plant,
-
8:01 - 8:06but in contrast to THC that has the high,
-
8:06 - 8:09CBD has no addictive properties.
-
8:10 - 8:13We're still trying to figure out
how CBD fully works, -
8:13 - 8:16but it is known that CBD
alters chemicals in the brain -
8:16 - 8:19that regulate emotions and anxiety.
-
8:20 - 8:23Interestingly, giving CBD
to our animal models -
8:23 - 8:26that had a history
of self-administering heroin, -
8:26 - 8:28reduced their heroin-seeking behavior.
-
8:29 - 8:35Specifically, CBD reduced heroin-seeking
triggered by environmental cues -
8:35 - 8:37that were previously
associated with the drug. -
8:38 - 8:39Let me say that again.
-
8:39 - 8:44CBD reduced heroin-seeking
triggered by drug cues. -
8:44 - 8:46This is significant,
-
8:46 - 8:50because craving is often triggered
by the memories of the cues -
8:50 - 8:52previously associated with drug use.
-
8:52 - 8:56And craving is a matter
of life or death daily -
8:56 - 8:59for people with an opioid use disorder.
-
8:59 - 9:00Simply put,
-
9:00 - 9:02craving can lead to relapse
-
9:02 - 9:04and death from overdose.
-
9:05 - 9:09So reducing craving
is an important treatment strategy. -
9:11 - 9:14Getting results
from animal models like this -
9:14 - 9:17is actually the first critical step
in the FDA process -
9:17 - 9:19for developing new medications.
-
9:20 - 9:22The next step:
-
9:22 - 9:24human studies.
-
9:25 - 9:26In our first human study,
-
9:26 - 9:29we demonstrated that CBD is safe,
-
9:29 - 9:32even though individuals taking it
had also consumed a potent opioid. -
9:33 - 9:37Next, to determine efficacy,
-
9:37 - 9:38we conducted clinical trials
-
9:38 - 9:41and made sure that both
the study investigators -
9:41 - 9:43and the study participants
-
9:43 - 9:47were blind to the CBD
or the placebo substances. -
9:48 - 9:52The results from those studies
replicated the findings that we had -
9:52 - 9:54in the animal experiments.
-
9:54 - 9:59So now we know that CBD can reduce
craving triggered by environmental cues -
9:59 - 10:02in human heroin users.
-
10:02 - 10:05What's more, our results demonstrated
-
10:05 - 10:09that CBD reduced anxiety
associated with the drug use. -
10:11 - 10:15This is also significant because anxiety
is another critical factor -
10:15 - 10:16that triggers craving.
-
10:18 - 10:23Importantly, CBD also reduced
the levels of the stress hormone cortisol -
10:23 - 10:27that is often elevated when addicted
individuals are exposed to drug use. -
10:29 - 10:31Another intriguing finding
-
10:31 - 10:35was the CBD continued to decrease
craving and anxiety -
10:35 - 10:38even a week following its final use.
-
10:38 - 10:42This aspect of prolonged efficacy
is very beneficial -
10:42 - 10:45for people taking any medication.
-
10:46 - 10:49So the evidence is mounting.
-
10:49 - 10:53CBD does show potential to reduce
critical features for opioid addiction -
10:53 - 10:55such as craving and anxiety.
-
10:57 - 11:00But we're still not at the end of the road
for medication development. -
11:00 - 11:05The gold standard for medicine
established by the FDA -
11:05 - 11:07is large, clinical trials.
-
11:08 - 11:12Recently, I was fortunate enough
to be given that rare opportunity -
11:12 - 11:14to conduct a large,
clinical trial with CBD -
11:14 - 11:16in people with an opioid use disorder.
-
11:17 - 11:21And that study is expected to continue
for at least another two years. -
11:22 - 11:26CBD is now being investigated
for numerous medical conditions. -
11:27 - 11:28Also, during the past decade,
-
11:28 - 11:32our society has seen an explosion of CBD.
-
11:32 - 11:36It's being put into drink, food,
wellness and skincare products. -
11:37 - 11:39They're even giving CBD to pets.
-
11:41 - 11:44So is CBD a wonder drug
as now touted by many? -
11:45 - 11:47No.
-
11:47 - 11:50Does it have potential medicinal benefits?
-
11:50 - 11:52It does.
-
11:52 - 11:54But the only way
to get definitive information -
11:54 - 11:57about CBD's full safety and efficacy
-
11:57 - 11:59is through large, clinical trials.
-
12:02 - 12:05So is it possible
-
12:05 - 12:08that we could actually change the game
-
12:08 - 12:11by taking this very familiar plant
-
12:11 - 12:15and developing a nonaddictive,
FDA-approved medication -
12:15 - 12:17for opioid use disorder?
-
12:19 - 12:21Absolutely.
-
12:21 - 12:23That is why we're working
so hard right now -
12:23 - 12:25to develop a solution based on CBD.
-
12:26 - 12:27For me,
-
12:29 - 12:33the potential benefits
are obvious and also overwhelming. -
12:34 - 12:38It means helping to give families
back their mother or father. -
12:39 - 12:43It means having your child
graduate from high school or college. -
12:44 - 12:46But most of all,
-
12:46 - 12:51it means helping to save many
of the hundreds of thousands of lives -
12:51 - 12:54that will otherwise be lost to opioids
-
12:54 - 12:55in the next decade.
-
12:55 - 12:56Thank you.
-
12:56 - 12:59(Applause)
- Title:
- Could CBD help opioid users overcome addiction?
- Speaker:
- Yasmin Hurd
- Description:
-
Could CBD, a chemical compound found in the cannabis plant, help treat opioid addiction? Neuroscientist Yasmin Hurd discusses why current treatment strategies, such as methadone, aren't enough to end the opioid epidemic -- and shares how CBD could help reduce the cravings and anxiety associated with drug use and relapse, potentially providing a new, safe and nonaddictive therapy.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 13:13
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