Category Archives: Addiction

The Use of Cannabis in Response to the Opioid Crisis: A Review of the Literature

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Nursing Outlook

“A staggering number of Americans are dying from overdoses attributed to prescription opioid medications (POMs). In response, states are creating policies related to POM harm reduction strategies, overdose prevention, and alternative therapies for pain management, such as cannabis (medical marijuana).

The purpose of this article is to examine state medical cannabis (MC) use laws and policies and their potential association with POM use and related harms.

Review of the current literature suggests states that implement MC policies could reduce POM associated mortality, improve pain management, and significantly reduce health care costs.

However, MC research is constrained by federal policy restrictions, and more research related to MC as a potential alternative to POM for pain management, MC harms, and its impact on POM related harms and healthcare costs should be a priority of public health, medical, and nursing research.”

http://www.nursingoutlook.org/article/S0029-6554(17)30286-5/fulltext?cc=y%3D

“The use of cannabis in response to the opioid crisis: A review of the literature. Review of the current literature suggests states that implement MC policies could reduce POM-associated mortality, improve pain management, and significantly reduce health care costs.” https://www.ncbi.nlm.nih.gov/pubmed/28993073

Can Cannabis be Considered a Substitute Medication for Alcohol?

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Logo of alcalc

“Substituting cannabis for alcohol may reduce drinking and related problems among alcohol-dependent individuals. Some even recommend prescribing medical cannabis to individuals attempting to reduce drinking.

While more research and improved study designs are needed to better identify the extent and impact of cannabis substitution on those affected by AUD, cannabis does appear to be a potential substitute for alcohol. Perhaps more importantly, cannabis is both safer and potentially less addictive than benzodiazepines and other pharmaceuticals that have been evaluated as substitutes for alcohol.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992908/

Preferences for Medical Marijuana over Prescription Medications Among Persons Living with Chronic Conditions: Alternative, Complementary, and Tapering Uses.

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Mary Ann Liebert, Inc. publishers

“Despite expanded legalization and utilization of medical cannabis (MC) internationally, there is a lack of patient-centered data on how MC is used by persons living with chronic conditions in tandem with or instead of prescription medications. This study describes approaches to use of MC vis-à-vis prescription medications in the treatment of selected chronic conditions.

RESULTS:

Participants described a range of approaches to using MC, including (1) as alternatives to using prescription or over-the-counter medications; (2) complementary use with prescription medications; and (3) as a means for tapering off prescription medications. Motives reported for reducing or eliminating prescription medications included concerns regarding toxicity, dependence, and tolerance, and perceptions that MC improves management of certain symptoms and has quicker action and longer lasting effects.

CONCLUSIONS:

MC appears to serve as both a complementary method for symptom management and treatment of medication side-effects associated with certain chronic conditions, and as an alternative method for treatment of pain, seizures, and inflammation in this population. Additional patient-centered research is needed to identify specific dosing patterns of MC products associated with symptom alleviation and produce longitudinal data assessing chronic disease outcomes with MC use.”

 https://www.ncbi.nlm.nih.gov/pubmed/28945457
http://online.liebertpub.com/doi/10.1089/acm.2017.0184

Maternal and infant outcomes following third trimester exposure to marijuana in opioid dependent pregnant women maintained on buprenorphine.

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Drug and Alcohol Dependence Home

“Analyses failed to support any significant relationship between marijuana use in the third trimester and a variety of maternal and infant outcomes.

Preliminary results indicate that marijuana exposure in the third trimester does not complicate the pregnancy or the delivery process.” https://www.ncbi.nlm.nih.gov/pubmed/28917206

http://www.drugandalcoholdependence.com/article/S0376-8716(17)30443-X/fulltext

Endocannabinoid mechanism in amphetamine-type stimulant use disorders: A short review.

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Journal of Clinical Neuroscience Home

“Recent evidence shows that the endocannabinoid system is involved in amphetamine-type stimulants (ATS) use disorders. To elucidate the role of the endocannabinoid system in ATS addiction, we reviewed results of studies using cannabinoid receptor agonists, antagonists as well as knockout model.

The endocannabinoid system seems to play a role in reinstatement and relapse of ATS addiction and ATS-induced psychiatric symptoms. The molecular mechanisms of this system remains unclear, the association with dopamine system in nucleus accumbens is most likely involved. However, the function of the endocannabinoid system in anxiety and anti-anxiety effects induced by ATS is more complicated.

These findings suggest that the endocannabinoid system may play an important role in the mechanism of ATS addiction and provide new idea for treating ATS addiction.”

https://www.ncbi.nlm.nih.gov/pubmed/28912087

http://www.jocn-journal.com/article/S0967-5868(17)30989-X/fulltext

Cannabidiol inhibits priming-induced reinstatement of methamphetamine in REM sleep deprived rats.

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Progress in Neuro-Psychopharmacology and Biological Psychiatry

“Methamphetamine (METH) is a widely abused and a severely addictive psychostimulant. Relapse is the main cause of concern when treating addiction. It could manifest after a long period of abstinence. Previous studies showed that there is a strong connection between sleep impairment and relapse.

Also, it has been reported that cannabidiol might be a potential treatment for drug craving and relapse. In this study, we used conditioned place preference (CPP) to investigate whether Cannabidiol (CBD), a phytocannabinoid, can prevent METH-induced reinstatement in Rapid Eye Movement Sleep Deprived (RSD) rats.

In conclusion, the administration of CBD 10μg/5μl effectively prevents METH-induced CPP, even in a condition of stress. CBD can be considered an agent that reduces the risk of the relapse; however, this requires more investigation.”

https://www.ncbi.nlm.nih.gov/pubmed/28870635

http://www.sciencedirect.com/science/article/pii/S027858461730218X?via%3Dihub

Cannabis use among two national samples of Aboriginal and Torres Strait Islander tobacco smokers.

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Drug and Alcohol Review

“There is a concern that cannabis use is an important barrier to reducing Aboriginal and Torres Strait Islander smoking.

We investigate the associations of cannabis use and tobacco smoking and quitting in two large national samples.

We did not find consistent evidence in this setting that cannabis use is an obstacle to quitting tobacco smoking.”

https://www.ncbi.nlm.nih.gov/pubmed/28868760

http://onlinelibrary.wiley.com/doi/10.1111/dar.12609/abstract

Rationale for cannabis-based interventions in the opioid overdose crisis.

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 Biomed Central

“North America is currently in the grips of a crisis rooted in the use of licit and illicit opioid-based analgesics. Drug overdose is the leading cause of accidental death in Canada and the US, and the growing toll of opioid-related morbidity and mortality requires a diversity of novel therapeutic and harm reduction-based interventions.

Research suggests that increasing adult access to both medical and recreational cannabis has significant positive impacts on public health and safety as a result of substitution effect. Observational and epidemiological studies have found that medical cannabis programs are associated with a reduction in the use of opioids and associated morbidity and mortality.

The growing body of research supporting the medical use of cannabis as an adjunct or substitute for opioids creates an evidence-based rationale for governments, health care providers, and academic researchers to consider the implementation and assessment of cannabis-based interventions in the opioid crisis.”

https://www.ncbi.nlm.nih.gov/pubmed/28821296

https:articles/10.1186/s12954-017-0183-9//harmreductionjournal.biomedcentral.com/

Effects of Legal Access to Cannabis on Scheduled II-V Drug Prescriptions

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“Legal access to cannabis may reduce the use of multiple classes of dangerous prescription medications in certain patient populations.”

http://en.ahau.findplus.cn/?h=articles&db=edselp&an=S1525861017304292

“Medical Cannabis and Reduced Prescription Use. 71% of medical cannabis program enrollees either ceased or reduced their use of scheduled prescriptions within 6 months of enrolling. The findings of this study indicate that once a patient enrolls in the medical cannabis program there is an increased likelihood that the patient will decrease their usage of scheduled medications. These medications include many drugs of abuse such as opiates, benzodiazepines, and sleeping medications.” http://markets.businessinsider.com/news/stocks/Medical-Cannabis-and-Reduced-Prescription-Use-1001600526

“Medical Cannabis and Reduced Prescription Use. Breakthrough Study Indicates Strong Association Between Medical Cannabis and Reduced Prescription Use.”  http://www.prnewswire.com/news-releases/medical-cannabis-and-reduced-prescription-use-300506774.html

“Effects of Legal Access to Cannabis on Scheduled II-V Drug Prescriptions. Legal access to cannabis may reduce the use of multiple classes of dangerous prescription medications in certain patient populations.”  https://www.ncbi.nlm.nih.gov/pubmed/28899660

“Legal access to cannabis may reduce the use of multiple classes of dangerous prescription medications in certain patient populations.” http://www.jamda.com/article/S1525-8610(17)30429-2/fulltext

Effects of Cannabidiol on Morphine Conditioned Place Preference in Mice.

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“This study sought to determine whether the cannabis constituent cannabidiol attenuates the development of morphine reward in the conditioned place preference paradigm.

Separate groups of mice received either saline or morphine in combination with one of four doses of cannabidiol using three sets of drug/no-drug conditioning trials. After drug-place conditioning, morphine mice displayed robust place preference that was attenuated by 10 mg/kg cannabidiol. Further, when administered alone, this dose of cannabidiol was void of rewarding and aversive properties.

The finding that cannabidiol blocks opioid reward suggests that this compound may be useful in addiction treatment settings.”

https://www.ncbi.nlm.nih.gov/pubmed/28793355

https://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-117838