We love this question.
It actually speaks to how much education needs to happen regarding CBD.
In fact, addiction is one of the shining spots in the research on CBD!
Not only is it safe but new studies (double-blind, placebo at that) are pointing to effects across a range of different addictions.
We've covered them in detail here:
- Research on CBD and addiction
- CBD and alcohol addiction
- CBD and cannabis addiction (yes, of all things)
- CBD and opioid addiction
- CBD and nicotine addiction
- CBD and cocaine addiction
There are others but those are the highlights.
Let's get to the question at hand though.
Is it safe to take CBD if you're an addict regardless of where you are in the recovery phase?
We'll dig into this question from all sides with some interesting notes along the way on what drives addiction (self-medication and dopamine).
These are the areas we'll cover:
- A quick recap of CBD and addiction
- CBD and neurotransmitter balance - dopamine, serotonin, glutamate for addicts
- CBD and cravings
- CBD and brain plasticity for addicts
- CBD safety for addicts
Let's get started!
A quick recap of CBD and addiction
Again, we really covered all our bases at our CBD and addiction review.
It's critical to look at if you really want to get into what modern research says around the causes of addiction.
Let's break it down into the key components that drive addiction:
- Self-medication (the initial reason a particular drug hits your button)
- Dopamine reinforcement
- Tolerance - the brain strikes back
- Withdrawals - brain rewiring around addiction pathway
- Why nicotine for some people?
- Or alcohol for others?
- Cannabis is addictive but only for about 10% of the population? Why?
This gets to the heart of addiction and we have to introduce a key concept...self-medication.
If a person drinks every day, they will likely become alcoholics due to the other elements above but why start drinking every day, to begin with?
When you dig deeper into addiction, you see that each addictive drug has two critical components:
- They juice up dopamine - the key player in our reward circuit
- The fill in gaps for powerful neurotransmitters that make us feel "right" when balanced and terribly wrong when not balanced
The latter is critical for an initial "liking" of a drug.
- Nicotine boosts acetylcholine - this is why people with schizophrenia and other mental health issues chain-smoke - see CBD and schizophrenia or CBD and acetylcholine
- Cocaine and stimulants boost glutamate, our brain's gas pedal and acetylcholine
- Benzos boost GABA- our brain's brake pedal - key to feeling calm
- SSRI's boost serotonin - our "feel good" master regulator (SSRIs are not technically addictive but good luck with the "serotonin discontinuation syndrome" as they call it
- Alcohol? Oh, it boosts GABA and serotonin. No wonder so many women start drinking when they lose their progesterone around age 40 and estrogen drops off at 46ish
- Opioids - boost our natural pain relievers which are also tied to a range of effects
- THC boosts anandamide - the "bliss module"
See what we mean? Each drug has a special key to a lock in the brain that's not getting used enough.
If you read through any of the reviews, we look at genes, history, etc to see how research ties these pathways to particular drugs.
It's estimated that 90% of cigarettes are smoked by a person with a diagnosed mental illness. That doesn't mean that all people that smoke are struggling with mental illness (it is addictive after all) but people with severe mental illness are smoking non-stop!
Nicotine after all would likely be better for ADHD than the amphetamines currently being used (see CBD and ADHD).
That's according to Harvard medical...read their review.
If a given drug fills a gap and you use it enough, dopamine finishes off the job.
Dopamine is best thought of as the "do that again" neurotransmitter.
It's critical to addiction to anything that motivates us to action! Hard work. Eating. Cocaine.
Addictive drugs hit dopamine like a hammer...much more than getting a good grade or a text from someone we're attracted to ever can.
This is the one-two punch of addiction.
Self-medication. Dopamine reinforcement.
The problem is that brain sees these spikes of very important players and panics.
It will actually decrease the receptors and activity for the given neurotransmitter (yes, the very one we may have been low in, to begin with).
This...is the basis for withdrawal and tolerance.
When the drug wears off, you're no worse off than when you started.
That's why it generally takes more and more a drug to get the same effect with continued use.
So….how does CBD figure into this process for addicts?
CBD and neurotransmitter balance - dopamine, serotonin, glutamate for addicts
The real beauty behind CBD is how it functions in the body.
All the drugs mentioned above will push a given pathway one way or another.
Increasing dose - increasing effect.
That's why you can overdose on them.
CBD affects key pathways in a very different way.
Technically, it's called a negative allosteric modulator.
That's just a fancy way to say that it acts like a feedback mechanism.
For example, most drugs cause a message to be sent from neuron to another. One direction.
CBD actually sends a message back the other way...from the receiving neuron!
- We're all set over here, slow down.
- We're running low, send more.
This occurs in very important pathways which should be familiar from our drug list above:
- Serotonin - our master regulator
- Dopamine - governed by serotonin
- GABA - the "brake" pedal and opposing force to glutamate
- Opioid receptors - pain modulators and "shapers" of behavior
Anandamide - part of our stress response buffer
With just the first three, you account for a great deal of very complicated interactions that govern how we feel.
Serotonin alone is the key pathway for all human behavior. Just that.
To really get into this for addicts, check out the following:
- CBD and serotonin pathway for addicts
- CBD and dopamine pathway for addicts
- CBD and glutamate pathway for addicts
You'll notice that they're highly related to mental health as well. It's all one big happy family!
This "feedback" effect is key to CBD's safety for addicts.
It's also why we don't see overdoses on CBD (tested up to 1500 mgs and even grams with very little side effect profile).
Let's take just powerful examples that are all over addiction.
One example from our CBD and serotonin review:
repeated treatment with low-dose CBD induces analgesia predominantly through TRPV1 activation, reduces anxiety through 5-HT1A receptor activation, and rescues impaired 5-HT neurotransmission under neuropathic pain conditions.
They basically looked at the effect of CBD after injury and chronic pain.
This setup can exhaust serotonin which controls our general pain sensitivity.
CBD reduced anxiety via the 5ht pathway. 5HT is short for serotonin!
Remember, after using a drug like alcohol, serotonin function will likely be low due to tolerance.
In fact, it may have been low to begin with which is why alcohol felt so "right".
Serotonin is key to depression, anxiety, impulsivity, reckless behavior, and just about every mental health issue and personality trait you can think of.
It's especially key to stress response (see tryptophan as a stress buffer).
The important word there is "rescue". Not boost or reduce.
Too much or too little serotonin is brutal. Depression, anger, or impulsivity on one side and suicidal thoughts, restlessness, etc on the other.
Balance. That's why a feedback mechanism like CBD is so important and it shows in the research.
Check out the following as examples:
CBD and depression
CBD and anxiety
CBD and weight
CBD and anger
What about dopamine, the linch pin for addiction?
Serotonin partially governs dopamine so that may be how CBD has its impact here but it definitely has an impact.
Dopamine is key to craving and what's called conditional place preference.
This means, the brain prioritizes what's important (technically to survival but it's been hijacked by the drug's potent effect on dopamine) and gives that "thing" preference in our focus.
The drug is all you can think about because of dopamine's effect.
Let's look at CBD's effect there.
CBD and cravings for addicts
We covered this in detail at our CBD and cravings review but some quick take aways.
There are lots of studies but just one that's very difficult...heroin addicts.
Acute CBD administration, in contrast to placebo, significantly reduced both craving and anxiety induced by the presentation of salient drug cues compared with neutral cues.
That's double-blind, placebo.
Essentially, when presented with cues (pictures of needles, paraphernalia, etc), the cravings were reduced in the CBD group but not the placebo group.
What about nicotine, a notoriously tough addiction with long term (decades later) cravings:
CBD in comparison to placebo, would attenuate AB, pleasantness of cigarette‐related stimuli, craving and withdrawal and not produce any side effects.
AB is short for attention bias….that trick of dopamine to narrow your attention's focus down to what's important (cigarettes in this case).
It even disrupted the pleasure and emotional association with the cues.
People, this is all dopamine.
Speaking of long term cravings for addicts, let's look at long term changes in the brain that addicts need to "unwind".
CBD and brain plasticity for addicts
This may be the most important part of this article.
It's one thing to right the ship on neurotransmitters but really beat an addiction, we have to literally remodel the brain.
The technical term is neurogenesis and it's addict best friend.
With enough use of a drug, the brain literally rewires to strengthen the addiction.
In our review of CBD versus benzos, we looked at studies where dopamine receptors were primed to respond more strongly to future exposure after benzo use.
This is why addicts can feel cravings decades later!
Those old pathways are still there...slowly drying up...but there.
In fact, neurogenesis was key to building the addiction to begin with.
What's interesting is that drugs of addiction can actually impair the ability of the brain to change!
Cocaine is especially good at this trick:
We found that cocaine, in addition to the changes it produces in the reward system, if taken in high doses, can attenuate the production and development of new neurons in the hippocampus, and reduce working memory.
It gets even more interesting.
Studles looked at depleting neurogenesis and seeing if that made subjects more susceptible to addiction and relapse:
Depleting adult dentate gyrus neurogenesis increases cocaine-seeking behavior
See...neurogenesis is the key to "dismantling" the addiction in our brains.
We can't put it better than this:
The normalization of drug-impaired neurogenesis or gliogenesis may help reverse neuroplasticity during abstinence, and thus may help reduce the vulnerability to relapse and aid recovery.
So...how does CBD affect this process?
Let's take a look behind the curtain of this process first.
Serotonin drives a pathway called BDNF (see CBD and BDNF). BDNF is your new best friend as an addict.
It's key to changing the brain for both addiction and mental health (remember, they two sides of the same coin).
In fact, SSRIs only work (when they do and till tolerance builds) by stoking this pathway for depression.
See how SSRIs actually work.
Here's the interesting thing...when you block CB1 activity (our brain's main endocannabinoid receptor), the BDNF activity goes away.
When you block BDNF, the effects on depression go away.
What about CBD on this pathway?:
Cannabidiol Induces Rapid and Sustained Antidepressant-Like Effects Through Increased BDNF Signaling and Synaptogenesis in the Prefrontal Cortex
In fact, when researchers block this effect of CBD on neurogenesis, look at what happens:
The pharmacological reduction of hippocampal neurogenesis attenuates the protective effects of cannabidiol on cocaine voluntary intake
Read that back over...it's revolutionary!
If you take away CBD's effect on neurogenesi, it can't reduce drug cravings and use.
See why this is so important!
We need to override the old addiction pathways in the brain (both chemical and literally physical) with new ones.
We wrote about CBD and brain repair to really get into it.
It also explains why there is research on CBD and every addictive drug we looked up.
Regardless of amphetamines or opioids or cannabis or alcohol...all very different initial pathways (glutamate/acetylcholine, opioid, anandamide, serotonin/GABA).
They share dopamine and they share brain remodeling.
This actually gives us some guidance on dosage for addicts which we'll look at later.
Let's first cut to the chase.
CBD safety for addicts
There is no research that shows a risk of CBD for any drug addiction that we can find.
In fact, CBD has shown positive effects across the board which hopefully are explained above.
Even its cousin, THC, is opposed by CBD both in terms of effects and addiction (see CBD and THC addiction).
Can CBD use affect how other drugs react?
This applies more to addictive medications like benzos...anything that uses the liver to metabolize.
The general rule is that CBD should be taken at least 4 hours away from other medications (work with your naturopath).
If the liver is busy with CBD, other medications that use the same pathway may be more or less available in the blood.
Let's look at practical questions for addicts.
We've covered generals safety for CBD here.
How much CBD for addicts
Research above actually provides some guidance.
We'll break down into two separate phases:
Initial period of withdrawal and stressful situations
Long term brain repair
The studies above on opioid cravings, etc generally look at about 600 mg...a higher amount.
This matches what we see across studies on mental health and even public speaking for people with social anxiety.
Generally, we see this in the first 10 days of quitting or relapse.
After that initial phase where the brain begins to restart the underlying pathway (serotonin, opioid, etc), we can then look at neurogenesis for long term changes.
Studies show that peaks at 300 mg per day.
Depending on how long a drug was used, this process of renormalizing these pathways generally show from 6-8 weeks.
Full normalization can go from 3 months to 1 year depending on severity, dosage, length of use, etc.
The goal with CBD is to significantly speed this process for addicts.
Other tools to look at along this vein:
Mindful meditation (see meditation and neurogenesis)
Exercise (boosts BDNF)
NAC - a powerful and safe additional tool to balance glutamate and inflammation (see NAC and addiction)
What about the type of CBD?
What type of CBD for addicts
There are some basic requirements to start with:
Organically grown hemp in the USA by an FDA registered farm
3rd party tested
No Heavy metals
We actually test ours twice since our whole family uses it.
No THC is critical since it actually makes other drugs (and food, music, etc) more pleasurable.
Then there's the question of CBD isolate versus CBD full spectrum.
All the research above and throughout the site (dozens of NIH studies) are based on CBD isolate, CBD by itself.
We went through the whole comparison of CBD isolate and full spectrum here.
More importantly, roughly 40-60% of the population has histamine issues and this goes up as we get older and for women.
Histamine is key to the allergy response but more importantly, its excitatory in the brain.
That's the wrong direction.
This is why you can feel extremely agitated when you have an allergic response.
Finally, we have to be able to afford these levels.
The key there is cost per mg of CBD.
We price our 6000mg bottle at the lowest cost per mg on the market before discounts up to 30%.
If you read the founder's story here, we've been there and we want make CBD as available to as many people as possible.
There's a CBD cost comparison review here.
Be well and take care of each other but take care of yourself first in order to do so.