Could CBD help opioid users overcome addiction?

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.

Over the past 20 years

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

due do drug overdose.

Yes, more than all the lives lost

in all the wars
this country has fought in.

The majority of these cases
are due to opioid drugs.

Sadly, while we're having
this very conversation,

at least one person will die
from a drug overdose,

and a child will be born
experiencing severe withdrawals

due to in utero opioid exposure.

Only recently have some
pharmaceutical companies

been held legally responsible
for the opioid crisis.

And compared to their
multibillion-dollar revenues,

the economic penalties
they're paying seem minuscule.

So let me as a question:

why does addiction
and the stigma of addiction

make it OK to undervalue human lives?

Ironically, I'm often asked
the opposite question.

Why should we care about "addicts?"

Sometimes I'm even shouted at

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

brought it on themselves.

They must be weak,

they lack any moral compass

and therefore don't deserve any help.

But if you know anything
about opioid addiction,

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

not that any addiction every really does.

These are mothers, fathers
and grandmothers.

They're teachers, business leaders,

cheerleaders, athletes,

nurses and bus drivers.

They're your brother or sister.

They represent every fiber
in the fabric of our society.

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

but a major cause of the current epidemic

is that medical overprescription
of opioid drugs

for the treatment of chronic pain.

And that is one thing
that makes this epidemic different.

This particular epidemic
was caused by doctors' prescriptions.

The cycle started when pharmaceutical
companies convinced physicians

that their patients
should not feel any pain.

Opioid makers claimed

that their very potent drugs
would not lead to addiction

unless individuals
were certain kinds of people

from certain kinds of communities.

Such disinformation,

compounded with clinicians'
limited education

and public ignorance about addiction,

is what created the epidemic.

So that's how we got here.

Now the question is:

how do you treat
a national opioid epidemic?

During an epidemic,

normally governments, clinicians
and scientists are brought together

to help the afflicted.

They develop new and even
unconventional treatment strategies

to rapidly address the condition.

That has not been the case
for the opioid epidemic.

However, the picture is changing.

We're beginning to see
more aggressive government actions.

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

HEAL stands for Helping
End Addiction Long-term,

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

through funding new treatment strategies.

The current treatment strategy
for opioid addiction

is the use of other opioids
such as methadone.

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

They're considered substitution therapy --

basically fighting fire with fire.

They have saved numerous lives,

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

Why?

These medications
are themselves addictive,

and therefore come
with many governmental regulations.

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

They must find an opioid clinic --

often far from home --

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

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

And it raises obvious questions as well.

For example: why is the treatment
of addiction disorders different

from other medical disorders?

With most other medical disorders,

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

Why do physicians treating their patients
with a substance use disorder

have limited treatment options?

No one ever says

that two to three treatments
are enough for cancer,

especially when it's not a cure.

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

Fighting fire with fire
is a reasonable strategy,

but what about using
a different form of fire --

a safer form of fire?

What about actually developing
a nonaddictive treatment

derived from another drug?

That has been my journey

towards trying to develop
a treatment for opioid addiction,

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

My journey started with studying cannabis,

the drug most people call marijuana.

In order to understand

how cannabis may connect
to combating the opioid epidemic,

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

and the politics.

Cannabis is a complex plant.

It's actually made up
of over 140 cannabinoids.

Cannabinoids are
active chemicals from the plant

that binds to cannabinoid
receptors in our bodies.

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

is THC,

which we scientists call
tetrahydrocannabinol.

Pretty simple, right?

But the politics
is a lot more complicated.

Attitudes towards cannabis

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

have dramatically changed over the years.

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

with the drug.

Cannabis is either
highly demonized or glorified.

On the demonized side,

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

the Drug Enforcement Agency --

meaning that cannabis is considered

to be a drug of the highest
abuse potential

and to have no medicinal value.

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

for the use of cannabis,

particularly among
young Black and brown men.

However, things are changing.

The pendulum is shifting
in the opposite direction.

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

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

from the list of schedule drugs.

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

Most research studies,
including some of my own,

focus on THC.

In fact, our animal research
has shown a negative relationship

between THC and opioid addiction.

However, as I mentioned,

the cannabis plant
has over 100 cannabinoids.

So THC was not the only one to study.

In examining another cannabinoid,

cannabidiol --

that is, CBD --

we were actually surprised
to see features relevant

to alleviating opioid
addiction-related behaviors.

So there my journey turned to CBD.

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

only a few years ago

to everywhere in society --

in your coffee in the morning,

your water at lunch

and your beer at dinner?

CBD comes from the cannabis plant,

but in contrast to THC that has the high,

CBD has no addictive properties.

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

but it is known that CBD
alters chemicals in the brain

that regulate emotions and anxiety.

Interestingly, giving CBD
to our animal models

that had a history
of self-administering heroin,

reduced their heroin-seeking behavior.

Specifically, CBD reduced heroin-seeking
triggered by environmental cues

that were previously
associated with the drug.

Let me say that again.

CBD reduced heroin-seeking
triggered by drug cues.

This is significant,

because craving is often triggered
by the memories of the cues

previously associated with drug use.

And craving is a matter
of life or death daily

for people with an opioid use disorder.

Simply put,

craving can lead to relapse

and death from overdose.

So reducing craving
is an important treatment strategy.

Getting results
from animal models like this

is actually the first critical step
in the FDA process

for developing new medications.

The next step:

human studies.

In our first human study,

we demonstrated that CBD is safe,

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

Next, to determine efficacy,

we conducted clinical trials

and made sure that both
the study investigators

and the study participants

were blind to the CBD
or the placebo substances.

The results from those studies
replicated the findings that we had

in the animal experiments.

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

in human heroin users.

What's more, our results demonstrated

that CBD reduced anxiety
associated with the drug use.

This is also significant because anxiety
is another critical factor

that triggers craving.

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

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

Another intriguing finding

was the CBD continued to decrease
craving and anxiety

even a week following its final use.

This aspect of prolonged efficacy
is very beneficial

for people taking any medication.

So the evidence is mounting.

CBD does show potential to reduce
critical features for opioid addiction

such as craving and anxiety.

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

The gold standard for medicine
established by the FDA

is large, clinical trials.

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

to conduct a large,
clinical trial with CBD

in people with an opioid use disorder.

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

CBD is now being investigated
for numerous medical conditions.

Also, during the past decade,

our society has seen an explosion of CBD.

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

They're even giving CBD to pets.

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

No.

Does it have potential medicinal benefits?

It does.

But the only way
to get definitive information

about CBD's full safety and efficacy

is through large, clinical trials.

So is it possible

that we could actually change the game

by taking this very familiar plant

and developing a nonaddictive,
FDA-approved medication

for opioid use disorder?

Absolutely.

That is why we're working
so hard right now

to develop a solution based on CBD.

For me,

the potential benefits
are obvious and also overwhelming.

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

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

But most of all,

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

that will otherwise be lost to opioids

in the next decade.

Thank you.

(Applause)