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Copyright © 2019 Natural Medicines (www.naturalmedicines.com)
July 2019

CBD for opioid withdrawal?

Cannabidiol (CBD) is everywhere. Despite confusing legal status and limited supportive evidence, it’s being used for a growing list of conditions – including opioid withdrawal. What should you tell your patients about CBD?

It's important to tell your patients that CBD can be purchased in two different ways - as a Rx drug (Epidiolex) or as a supplement. Rx CBD is only approved for the treatment of specific seizure disorders. It has also been studied for opioid withdrawal, but the evidence is limited. A small study shows that taking Epidiolex for 3 days can reduce cravings and anxiety in people with heroin use disorder who are not using any other treatments. But it's unclear if it can prevent relapse. For now, Epidiolex is not approved for this indication.

CBD is also available in supplements, and there has recently been a surge in the availability of these products. Let your patients know that, for now, CBD does not meet the definition of a dietary supplement according to the U.S. Food and Drug Administration (FDA). Because of this, the FDA has sent and continues to send warning letters to companies that market CBD products as dietary supplements or that sell foods containing CBD. Furthermore, it’s important to remind your patients that CBD can cause side effects and can interact with drugs. CBD inhibits CYP2C9 and 2C19, and might raise levels of drugs like amitriptyline, clobazam, valproic acid, and warfarin. CBD can also cause drowsiness and diarrhea. For more details, check out our recently updated monograph.

Keep in mind that while CBD can legally be included in cosmetic products (e.g., creams), these products have never been clinically evaluated and are unlikely to be beneficial for opioid withdrawal.

The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2019 Natural Medicines Inc. Commercial distribution or reproduction prohibited. Natural Medicines is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.