CBD and Addiction RecoveryHyla Cass
Alcohol use, drug use, and overdoses are increasing to ever higher rates in the US and worldwide. At least 2.8 million died due to alcohol abuse this past year. The spending on illegal drugs this year has been $561,200,000 and rising.
The opioid crisis has been increasingly ravaging American homes, taking countless lives, plus collateral damage to their families, and has been declared a public health emergency by the federal government. I have worked in the field of addiction for decades and I am discouraged at the continued failure of conventional addiction treatment approaches. The pandemic has further accelerated the toll, with increased stress, poor diets, and an overwhelmed mental health care system. Regardless, the underlying issue of how we perceive of and treat addiction needs a reframe which I will be describing here.
The standard of care for addiction in the United States creates a revolving door of relapse, rehab, and more relapse. According to the National Institute on Drug Abuse, 85 percent of individuals relapse within a year of treatment. Moreover, two-thirds of individuals return to drug use within weeks of beginning addiction treatment. These programs often fail to treat the root cause of addiction and their clients continue to suffer. It doesn’t have to be that way as you will see.
An addiction is defined as the repeated use of a substance or behavior despite negative consequences. While that behavior is generally seen as a matter of “bad choices,” those of us with a more biological point of view see it as a reflection of an imbalance in brain chemistry, making it brain disease, not a disease of willpower.
Why do some people who tries a substance of abuse develop an addiction, while others don’t? Only eight to twelve percent of patients prescribed opioids develop an opioid use disorder. What’s the dividing line between these two groups, the one that says who can use a substance without compulsion and who cannot?
The issue is best dealt with at the level of the brain …brain chemistry, that is, not what you wish, think or will. While you need to have some commitment to improvement, this plus any psychological work, is easier and more effective when the brain is operating on all cylinders. A major root cause of addiction lies in the brain’s chemistry, so that is where all treatment should begin.
Due to genetics, stress, diet and other environmental conditions, individuals will experience a level of anxiety or depression. If they do not have the proper tools to cope with that emotional pain, they then seek to relieve it a substance, be it sugar, alcohol, cocaine or opiates. It could even be a behavior like shopping, gambling or porn.
We are built to seek pleasure and avoid pain. Substances of abuse provide the illusion of pleasure and pain relief to those who are most desperate for it, an illusion that eventually unravels into the suffering of addiction.
We can correct the underlying imbalance and end an addiction rather than simply trying to control it with will power from within, or with punishment from others for relapsing. We can accomplish this with diet, lifestyle, nutrients in the form of “neurotransmitter precursors,” and, increasingly, hemp oil extract/CBD.
I want to be clear that CBD is not addictive even though it comes from the cannabis plant. Quite the contrary, it’s able to weaken the power of addictions, fortifying the brain of the addicted individual and decreasing the allure of a drug. How does it work? Let me review the science behind biological approaches to addiction recovery, including CBD.
The Unbalanced Brain
Your brain cells communicate via chemical messengers called neurotransmitters that regulate all of your mental functions. The way these molecules move through your brain determines if you feel content or emotionally unstable and thus vulnerable to addiction. Neurotransmitters are influenced by a variety of factors including genetics, early trauma, stress, diet, and lifestyle, to mention a few.
Rebalancing the Brain
The specific nutrients supplied by a biologically-based approach to addiction can help with both the underlying conditions that create the addiction, and the way an addictive substance interacts with the brain. They nourish the brain, naturally creating the good feelings that the substance of abuse was artificially providing. Thus equipped with the raw materials of happiness, the brain can be released from the grip of addiction.
Here’s an example from an animal model. Lab rats were bred to be alcoholic, preferring alcohol to water. However, once they were given the right mix of amino acids, their alcoholism resolved. With their brains properly nourished, they no longer craved the missing nutrients and their addictions were remedied, no willpower or 12-step program needed!
The first step to restoring balance to the brain is proper nutrition. For anyone in the midst of addiction recovery, it is absolutely essential to eat a clean diet, removing or minimizing foods and beverages such as dairy, sugar, processed food (including processed meats), alcohol, chocolate, caffeine, industrial seed oils like canola oil, hydrogenated oil, gluten, excessive red meat, and artificial sweeteners. Replace them with a plant-based diet, rife with whole, organic, unprocessed foods, mostly fruits and vegetables. Eat three servings of protein a day, which can include fish and fowl, or plant sources for vegans. Eat fatty fish three times a week to provide omega-3 fatty acids for the cell membranes, or take fish oil capsules (or algae-based substitute).
Although a great first step, a change in diet alone is not generally enough to restore chemical balance to the brain. Targeted nutrients are the next step, starting with the amino acids that are the building blocks of neurotransmitters (chemical messengers) such as serotonin, glutamine, GABA (both a neurotransmitter and an amino acid), endorphins, and dopamine. When we supplement with amino acids along with vitamin and mineral cofactors, we can ensure that the brain has the raw materials it needs to balance itself.
This approach is based on the work of Kenneth Blum and followed by extensive development by Julia Ross who has trained many practitioners and treated numerous clients over the years in these protocols. See her most recent book, The Craving Cure.
Commonly recommend amino acids are:
- GABA, theanine, and taurine to enhance GABA, the calming and balancing neurotransmitter
- D,L – phenylalanine, tyrosine to enhance dopamine, the neurotransmitter of pleasure, focus, and concentration
- D- phenylalanine to enhance endorphins
- 5-HTP, L-tryptophan, the precursors for serotonin, for good mood, calm, better sleep and appetite control
- L-glutamine for control of cravings including for sugar and alcohol
- N-acetyl- cysteine (NAC) a detoxifier that helps remove metabolic waste and other toxic materials from the body; precursor to glutathione, the master antioxidant
The Endocannabinoid System
Enter endocannabinoid deficiency. The endocannabinoid system is your body’s mechanism for maintaining homeostasis and, as you might have guessed, is the system affected by cannabinoids. It checks in with all of your bodily systems, assesses what it needs, and adjust its function accordingly. Generally, the endocannabinoid system (ECS) helps your body to calm down, reducing stress, easing cellular communication, and allowing healing to take place. Endocannabinoid deficiency is associated with PTSD, anxiety, depression, migraines, and addiction, to mention a few conditions on a very long list. For more information on the endocannabinoid system, see my blog.
Hemp Oil Extract/CBD To The Rescue
Along comes what we conveniently refer to as CBD, but more correctly called hemp oil extract, a CBD-rich complex derived from the hemp plant, which is from cannabis. Really? Of course, cannabis is best known for being the source of a characteristic high from the popular cannabinoid, THC. However, the hemp plant with less than 0.3% THC, has been bred to have its long and hardy stalks and leaves, to make rope, paper, cloth and other durable materials.
And now, medicinal CBD! The extract from the stalks, leaves and flowers contains over 100 healing cannabinoids, aromatic medicinal terpenes which impart its taste and smell, and other nutrients, too. They all work together in the “entourage effect” to produce maximum healing benefit. Its limit of 0.3% tetrahydrocannabinol (THC) THC is not nearly enough to have a psychoactive effect, nor is it addictive. It is sold freely in all 50 states, and not in dispensaries like marijuana.
CBD acts upon the endocannabinoid system as a balancer or harmonizer, regulating neurotransmitter activity as needed. It runs your body with a steadying hand, like an orchestra conductor, skillfully creating harmony among all the neurotransmitters. It also works within and among such systems as hormonal, gastrointestinal, cardiovascular and immune systems with the goal of encouraging rest, reducing pain and stress, and enhancing mood and sleep.
CBD vs THC
While both CBD and THC are phytocannabinoids derived from the same cannabis sativa plant, they have different actions in the body.
One distinct difference is that THC, the psychoactive part of the cannabis plant that causes the characteristic high, can cause adverse reactions in susceptible individuals. In contrast, CBD actually counteracts the effects of THC, reducing the high. Due to the balancing effect of the CBD when occurring together in nature as they have for millennia, there were historically few reported adverse effects. However, with the minimal amount of CBD in current strains, there are far more problems than in the past. This is not your grandmother’s weed!
Currently bred for recreational purposes, marijuana has much higher levels of THC to increase the psychoactive effect. However, these high levels of THC unopposed by CBD can in some individuals lead to adverse reactions like irritability, anger, and even violence and psychosis. This more often occurs in first time users whose brains are not accustomed to it, and some people are simply more sensitive than others. Most likely such individuals are low in endocannabinoids, and this exposure to THC simply uncovers it.
The best antidote to an adverse reaction to THC is, in fact, a good dose of CBD both acutely and ongoing, to oppose the THC, and to begin to rebuild the ECS. The CBD molecule actually comes between the THC and the CB1 receptor, mitigating its influence. Unfortunately, the standard treatment for this problem in the emergency room is generally a shot of antipsychotic medication, accompanied by a diagnosis of psychosis or bipolar illness, and followed with a prescription for ongoing antipsychotic medication.
This can lead to other complications, and often dire consequences due to the long-term effects of these strong medications. I have seen college students treated this way having to drop out of school due to impaired cognition and concentration, depression, and other challenging symptoms.
The simpler and more organic solution would have been to give them CBD from the get-go. Or even if medication is indicated short term, its use should be re-evaluated after the initial emergency is over.
If the individual is fortunate enough to find a CBD- savvy practitioner, they can be safely weaned off the medications with the help of CBD and other healing nutrients. The CBD will help to rebuild their depleted ECS which may have even have contributed to their initial sensitivity to THC. Regardless, we need a robust ECS to function well, mentally, physically and emotionally.
Hemp Oil CBD Extract for Addiction
The ECS has receptors in the nucleus accumbens, the reward center of the brain, where CBD is able to balance dopamine levels. An imbalance of dopamine is associated with reward deficiency syndrome, which increases one’s propensity for addiction. CBD is quite literally going to one of the neurobiological sources of addiction and helping to correct it.
It doesn’t stop at dopamine. Other risk factors for addiction like PTSD and anxiety are thought to be associated with low ECS activity. Multiple studies have demonstrated CBD’s ability to improve anxiety and PTSD. Moreover, CBD can help repair damage to the brain caused by chronic substance abuse.
Multiple studies have shown that CBD can reduce cue-based drug-seeking behavior in those recovering from opioid and cocaine addictions. A randomized, double-blind, placebo-controlled trial found that CBD reduced cravings and anxiety when participants in recovery from heroin addiction were faced with cues for substance abuse.
In the case of morphine, one study showed that CBD’s effect on the serotonin receptor made morphine feel less rewarding, and it has been borne out in subsequent studies.
As mentioned earlier, rats with alcohol or cocaine self-administration histories in one trial received transdermal CBD at 24 hr intervals for 7 days and were tested for stress response, impulsivity, and anxiety. The result was: they stopped their drug and alcohol seeking, and their “mood” and behavior normalized. Moreover, these positive results lasted up to 5 months although, plasma and brain CBD levels remained detectable only for 3 days.
For those recovering from nicotine dependency, CBD made environmental cues feel less pleasant. One study found that CBD helped smokers reduce their smoking by 40 percent. This effect was variably maintained after the subject stopped using CBD. I’d say in those cases, just continue taking the CBD.
A healthy ECS is needed to prevent addiction. This is what I mean when I say CBD fortifies the brain. At the level of the neuron, it makes the brain more resistant to cravings, while addressing some of the underlying causes of addiction
Safety of CBD
CBD can be used effectively and safely for the conditions described above- and more! Side effects are rare, generally sleepiness, diarrhea and weight loss due to diminished appetite. This is opposed to the munchies and weight gain of THC. CBD also has a much better side effect profile than prescription medications commonly used to treat addiction.
Even when used long term, CBD is not addictive. Instead of masking symptoms, as medications do, CBD addresses the problem at its root cause—the imbalance due to a lack of circulating endocannabinoids in the ECS. People who use CBD don’t develop tolerance, so there’s no need to increase the dose, nor are there withdrawal symptoms when it is discontinued.
Even though CBD has a good safety profile, if you are taking medication, you should check with your doctor before using it. Both CBD and most pharmaceuticals are detoxified by the liver’s cytochrome P450 enzyme system. As a result, certain medications, including chemotherapy agents, anti-epilepsy drugs, and the blood thinner coumadin may be affected. In some cases, you just have to reduce the drug dose. For a list of potential drugs that may interact with CBD, click here. However, we have found that doses of CBD under 100 mg a day generally do not interfere with medications. Or even, consider lowering the medication dose rather than avoiding CBD.
How to Use CBD
Unlike both medical and recreational marijuana, you don’t have to go to a dispensary to buy CBD. It’s legal and available in retail stores and online. The only legal issue is its relationship to THC which is still a Schedule One drug with the FDA, despite the US government’s holding a patent on its medicinal use.
The 2018 Farm Bill separated hemp from THC but there is still legal confusion, issue of its crossing state lines, and questions as to whether or not it can be called a nutritional supplement. Despite all this, CBD sales are increasing across the country, as more and more people discover its benefits.
To avoid any issues around the federal regulations which are being sorted out in the courts, CBD products are often labeled “hemp oil extract.” I actually use that term in my own product since it contains other natural ingredients such as cannabinoids, terpenes, and other beneficial phytochemicals, and not simply CBD. Look for the phytocannabioid content on the label to determine the amount of CBD per dose.
CBD or full spectrum hemp oil extract (with less than 0.3% THC) can be further divided into broad spectrum with zero THC, full spectrum with less than 0.3% THC, and pure CBD isolate. You can check out my blog about the differences.
If taken over time, this trace amount of THC can accumulate in the fat cells, and can possibly show up in a drug test. Those who are subject to THC testing like military, law enforcement, and competitive athletes, should use a THC- free product.
For dosing, follow label instructions, starting low and gradually titrating upward till you get the desired result. I have instructions on my website as well. Dosing is very individual! If you have questions, you can consult a health care specialist who has experience prescribing CBD. More and more integrative medicine practitioners are learning about and prescribing CBD in their practices. Or check here.
CBD is available for oral use in tincture, sprays, gummies and capsules. There also lotions, creams and other topicals that are useful for arthritis, migraine and other painful conditions, and skin ailments such as acne and psoriasis. There are some excellent and effective products, with varying amounts of research.
Purity and Quality
Look for a non-GMO full spectrum product that can produce a certificate of analysis from an independent lab that has verified the product’s content and confirmed that it is free of toxins such as mold, pesticides and heavy metals.
For anyone struggling with addiction, I highly recommend hemp oil extract as a safe way to support and facilitate recovery. For further reading you can check out my various blogs and also www.drcass.com blogs.
- Alcohol Statistics (2021) https://www.worldometers.info/alcohol
- Drug Statistics (2021) https://www.worldometers.info/drugs/
- Cannabidiol inhibits the reward-facilitating effect of morphine: involvement of 5-HT1A receptors in the dorsal raphe nucleus.
- Cannabidiol, a nonpsychotropic component of cannabis, inhibits cue-induced heroin seeking and normalizes discrete mesolimbic neuronal disturbances.
- Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial | American Journal of Psychiatry
- Opioid Overdose Crisis
- CBD reduced cocaine seeking when presented with stress and with cue https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6098033/
- CBD helped with smoking cessation as long as participants kept taking CBD https://www.ncbi.nlm.nih.gov/pubmed/23685330
- CBD reduced pleasantness of nicotine use cues https://www.ncbi.nlm.nih.gov/pubmed/29714034
- CBD counteracts effects of THC https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740396/
- CBD reduces marijuana withdrawal symptoms https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444130/ | https://www.ncbi.nlm.nih.gov/pubmed/23095052
- Daily (high potency) marijuana use correlated with first time psychotic break (no causality determined) https://www.webmd.com/mental-health/news/20190320/can-high-potency-pot-make-you-psychotic#2 | https://www.psychiatrictimes.com/substance-use-disorder/cannabis-induced-psychosis-review
- CBD makes drug-seeking behavior and relapse with alcohol and cocaine less likely in rats https://www.nature.com/articles/s41386-018-0050-8
- Genetic predisposition to PTSD https://www.hsph.harvard.edu/news/press-releases/molecular-genetic-evidence-ptsd-heritability/