Researchers in the US have found that using cannabis with opioids does not increase the risk of addiction.
Findings from a new study suggest that CBD and THC might be safe for use with opioid pain medication, without increasing the risk of addiction.
Although more studies are needed, the results suggest that these compounds, found in cannabis, might be a low-risk way to reduce the dose of opioids needed to relieve pain.
The results show that CBD and THC do not enhance the rewarding effects of opioids, meaning that these compounds may not increase the risk for addiction when used in conjunction with opioid medications.
In the new study, the researchers gave rhesus monkeys the opportunity to choose a food reward or an injection of the opioid fentanyl.
They then tested whether CBD, THC or mixtures containing both compounds affected the number of times monkeys selected fentanyl over food.
They found that a wide range of doses of CBD or THC both alone or in a mixture did not increase or decrease the number of times they selected fentanyl.
Medical cannabis is often cited as an alternative pain reliever to opioid medication, with many patients finding they are able to reduce the number of opioids they are taking after being prescribed cannabis.
According to data from the Center for Disease Control, there were over 100,000 opioid-related deaths in America in the last 12 months.
Lawrence Carey, PhD, a postdoctoral fellow at the University of Texas Health Science Center, San Antonio, said: “There is intense interest in using medical marijuana in patients with chronic pain because compounds in marijuana like CBD and THC may produce pain relief themselves or enhance the pain-relieving effects of opioids.
“This means people could potentially use lower doses of opioids and still get relief from pain. Taking less pain medication could also lead to a lowered risk of addiction or physical dependence to opioids.”
He continued: “Giving the animals the opportunity to choose between a drug injection and a food reward helped us to somewhat replicate choices a human drug user may face, such as whether to spend money on drugs or food.
“Having the option of responding for food is also useful for studying drugs like THC that produce sedative effects. It helps demonstrate the animal is reallocating behaviour from drug to food choice instead of simply shutting down response for a drug due to sedation.”
The researchers are now conducting other studies to assess whether CBD and THC can decrease signs of opioid withdrawal and relapse.
“A big reason why people continue to take opioids after they become addicted is the appearance of withdrawal symptoms,” said Carey.
“We are using what we learned from this study to determine whether these doses — which didn’t alter choice for food or drug rewards — may help relieve opioid withdrawal or decrease relapse and drug seeking behavior following periods of abstinence.”
The researchers caution that opioid use disorder is a complex disease and there are many factors to consider when developing a drug to treat it.
Although this study indicates that THC and CBD do not increase the rewarding effects of opioids, they say that before applying these findings to people, it will be necessary to determine whether these treatments alter other pathological processes involved with opioid use and to better understand any risks that may be associated with their use.
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