Cannabis-based Medicines for Opioid Dependence
(08/31/2013) The increasing abuse of Percocet and other opiate drugs is also leading to an increase in heroin use, and skyrocketing amount of people seeking treatment for opiate dependence:
According to the Substance Abuse and Mental Health Services Administration, over 100,000 individuals were admitted to the emergency department for painkiller abuse, such as a Percocet overdose. By 2008, the number of admissions to the emergency department had almost doubled to over 300,000.
The Drug Abuse Warning Network issued a report in 2010 that detailed how the non-medical use of prescription pain relievers continues to be a public health issue in the United States that warrants serious concern.
Emergency Department visits involving oxycodone products, such as Percocet, increased by 152% between 2004 and 2008.
Treatments for opioid dependence with drugs such as methadone or conventional medications run the risk of making the patient addicted or dependent on the medication. Conventional treatments for opiate dependence can induce severe withdrawal symptoms if the medication is stopped abruptly. A great need remains for the development of non-opioid drug therapies that have less dependence and abuse liability.
Since about the 1970s THC showed promise as a treatment of opiate dependence and withdrawal. It is yet to be specifically included for existing medical marijuana laws, despite strong evidence for its benefits. The plant remains off the table because of its status as schedule I narcotic.
The use of Cannabis to treat drug dependence is an old idea. In the late 1800s the Lancet published an article on a fairly successful treatment for opiate addiction, available in the form of a Cannabis tincture. The use of this plant to treat substance abuse disorders also appears in ancient Indian texts and Ayurvedic literature. A recent survey of medical marijuana patients suggested that there is a significant population currently using it as an “exit drug” or as a substitute for Alcohol and other drugs. Intermittent marijuana use has been shown to improve retention in opiate dependence treatment programs.
The active ingredients in Cannabis interact with the endocannabinoid system within our body. This system consists of receptors, ligands (endocannabinoids), and proteins for synthesis and breakdown of endocannabinoids. Modern day researchers are studying these receptors and the natural THC-like compounds in our body for the treatment of various aspects of opiate dependence and withdrawal. For example, researchers in the laboratory of Dr. Aron Lichtman are studying a drug code named JZL-184. JZL-184 inhibits the proteins that breakdown endocannabinoids (i.e., a FAAH inhibitor), thus increasing the amount of endocannabinoids available to interact with receptors. In Lichtman's animal study, high doses of JZL-184 significantly blocked all signs of opioid withdrawal.
As more states pass laws allowing the use of medical marijuana, opiate addiction should be under consideration as a qualifying condition. In addition to potentially helping a severely afflicted group of people, this would greatly help researchers to overcome the barriers to studying Cannabis and refining the plant as a medicine. There is a great need for new effective treatments of opiate addiction that are: non-toxic, have a low addiction potential, and do not cause severe withdrawal symptoms in opiate dependent patients.
Recommended reading:
Here is a clinical study that I co-authored on medical marijuana and opioid use
Disclaimer: This article is intended for informational purposes only and does not constitute medical advice. Always consult a healthcare professional for medical diagnosis or treatment recommendations.
