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The exploration of CBD in the treatment of opioid abuse, addressing both the benefits and potential consequences in this alternative treatment method:

What Is CBD

CBD references Cannabidiol, a naturally occurring compound derived from the cannabis plant and able to be sourced from hemp. CBD differs from marijuana in that it is non-intoxicating and will not get you ”high.” It has been introduced as an aide in a variety of conditions, including sleep disturbances, anxiety disorders, arthritic pain and substance abuse, with various products currently on the market (Atakan Z., 2012). At this time CBD remains unregulated by the FDA, meaning that for those products on the market, the amount of CBD found within a given product may vary greatly in spite of labeling. The FDA serves to ensure that all claims within a given label are accurate, allowing the consumer to be certain of the dosage delivered and consistency within the product.  For this reason it is more important than ever to choose a trustworthy manufacturer, as switching products or brands will likely effect the amount of CBD being delivered. The recommended dosage varies and will depend upon the method chosen in which to deliver the CBD, the ailment being targeted and the rate of absorption. Clinical trials have prescribed CBD in dosages up to 1,200mg with minimal side effects, although you are likely to find dosages as low as 10mg in various vitamins and supplements. This can present as overwhelming when choosing to introduce CBD as a part of a treatment regiment, as many considerations come into play when choosing the most effective route for you.

Variations Of CBD

The three most common variations of CBD include full spectrum, isolate and broad spectrum, each offering differing benefits in a variety of methods. If passing a drug screen is a primary concern, isolate CBD is likely the best option to ensure no trace amounts of THC remain within the compound. However, full spectrum CBD and broad spectrum CBD remain the top choices in references to efficacy. Understanding the primary benefits of each variation and the efficacy of differing methods of delivery will assist in determining which route is most effective in the ailment being targeted. Below is a brief summary of the three variations (“CBD Information,” n.d.):

Full Spectrum CBD

Full spectrum CBD contains a full profile of what is considered to be beneficial cannabinoids. It contains trace amounts of THC (less than 0.3%) and will not get you “high.” While full spectrum CBD may not produce a euphoric effect, uncertainty remains as to whether or not it contains the ability to produce a positive drug screen effect. At this time testing for THC does not differentiate between THC obtained through illegal means versus legal means. However, because the whole plant is being utilized in this particular variation, it undergoes what is known as the “entourage effect” and is considered to be the most effective at this time when choosing CBD for various purposes. In other words, ingesting multiple components of the cannabis plant at a time is believed to increase the overall benefit.

Isolate CBD

Isolate references the act of isolating CBD concentrate from the remaining compounds within the cannabis plant. It undergoes a process that removes any remaining waxes or alternative cannabinoids, leaving it 99% pure CBD. This allows for relative certainty that no consumption of THC occurs and reduces any likelihood of failing a urine screen for THC. Thus, while a benefit exists in allowing for peace of mind, the resulting consequence is what is believed to be a less effective product at this time.

Broad Spectrum CBD

Broad spectrum CBD has best been described as a middle ground between full spectrum and isolate. It contains the benefits of a full profile of cannabinoids, but undergoes a refinement process during which time any traces of THC are removed. While this would appear to imply that broad spectrum CBD would be the preferred variation, the lack of FDA regulation makes it difficult to determine as to whether or not all THC has been removed from the product, as the manufacturers are not held accountable for any variations in advertised product.

Determining The Appropriate Delivery Route

Regardless of the variation of CBD chosen, multiple delivery methods exist, each offering various benefits. Common delivery routes of CBD include topicals, inhalation and oral methods. The route chosen is largely dependent upon the intended relief (VanDolah, H.J., Bauer, B.A., & Mauck, K.F., 2019). While topical use is best served for physical pain, inhalation and oral use would be better suited for mental health disorders or the treatment of substance abuse. When determining as to whether or not to choose inhalation or oral means, one must consider the length of time in which the supplement is to be used and the rate in which relief is sought.

Topicals

Topical use of CBD is regularly advertised as the use of lotions and creams. This is most effective when treating skin concerns such as inflammation or arthritic pain, as it allows for the product to be absorbed directly at the site of concern. Minimal amounts of CBD enter into the bloodstream with this method and thus, would not be the optimal choice when treating internal ailments or mental health concerns.

Inhalation

Inhalation of CBD primarily references the use of vape pens or dab pens and allows for the product to quickly enter the bloodstream, as it avoids any kind of metabolism. While this is the quickest method to deliver CBD, it also maintains the shortest effect, peaking within approximately 10 minutes and requiring more frequent use. The rate at which the product is effective would likely be best suited for managing anxiety, which can arise quickly and can be debilitating depending upon the severity. This may also be of beneficial consideration when addressing cravings related to opioid abuse, as time is of the essence when a craving arises.

Oral

Oral CBD consumption references oils as well as edibles currently on the market. This may include vitamins and supplements that advertise CBD in aiding in the management of ongoing anxiety, feelings of depression and sleep disturbances. Research has found that a full stomach increases the rate of absorption, while maintaining the product in your mouth for a period of time, either through swishing oil in your mouth or chewing a supplement, also allows for increased absorption in the capillaries. Thus, it can be deferred that swallowing a supplement whole would be the least effective method, as this avoids any immediate absorption and requires the body to entirely break down the product upon entry into the digestive tract. This particular method is expected to reach is maximum benefit between 1-6 hours and is perhaps the slowest route of delivery. However, it is considered to be the most effective use of CBD if being used as a long-term supplement.

CBD In The Treatment Of Opioid Abuse

As medical marijuana increases in popularity amongst states for the treatment of certain health conditions, the use of CBD has equally increased in popularity, with researches continuing to evaluate the efficacy. Unlike medical marijuana, the lack of euphoric effect in CBD, based upon the minimal or lack of THC, suggests that it may be a useful means in managing opioid concerns without substituting one drug for another. Little certainty is known at this time regarding the use of CBD in the treatment of opioid abuse, but with the increase in the opioid epidemic, this is becoming a highly desirable avenue for researchers.

Side Effects and Other Considerations

Primary concerns in utilizing CBD at this time as an effective treatment remain its lack of regulation, a need for further studies and unknown interactions with other medications. It is hypothesized that for those states that have legalized medical marijuana, an increased amount of resources have also gone into the exploration of CBD. Thus, if choosing CBD as an alternative treatment method, it may be best to consider the states current perspective on the usage, as well as the stance of the manufacturer producing the product. Experts warn that CBD should not be used to cure any ailment, but rather can serve as an aide, in conjunction with advice of an expert physician.

Resources

Atakan Z. (2012). Cannabis, a complex plant: different compounds and different

effects on individuals. Therapeutic Advances in Psychopharmacology, 2(6),

241–254. Retrieved from https://doi.org/10.1177/2045125312457586

CBD Information – The ultimate cannabidiol information guide: CBD 101. (n.d.).

Retrieved from https://healthyhempoil.com/cannabidiol/

VanDolah, H.J., Bauer, B.A., & Mauck, K.F. (2019, August 22). Clinicians’ guide to

cannabidiol and hemp oils. Retrieved from https://www.sciencedirect.com/science/article/pii/S0025619619300072