The Potential Use of Cannabidiol in the Treatment of Opioid Use Disorder: A Systematic Review

IF 3.1 3区医学 Q3 BIOCHEMISTRY & MOLECULAR BIOLOGY

Addiction Biology Pub Date : 2025-05-25 DOI:10.1111/adb.70047

Mahan Shafie, Kevin Ing, Yasna Rostam-Abadi, Jeremy Weleff, Mackenzie Griffin, Mohini Ranganathan, Ardavan Mohammad Aghaei, Nicholas Pratt, Melissa C. Funaro, Anahita Bassir Nia

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Abstract

Cannabidiol (CBD) has emerged as a potential treatment option for various psychiatric disorders, including substance use disorders. This systematic review is aimed at reviewing the evidence regarding the safety and efficacy of CBD as a therapeutic option in opioid use disorder (OUD) treatment in clinical and preclinical studies. We searched MEDLINE, Embase, PsycINFO, Scopus, Web of Science, CDSR and CENTRAL up to December 2023. We included original peer-reviewed human and animal studies evaluating CBD for OUD outcomes and excluded those that did not report OUD outcomes or used CBD solely with THC. The risk of bias was assessed with the Cochrane risk-of-bias tool for human studies and SYRCLE's tool for animal studies. Due to outcome heterogeneity, findings were presented using a qualitative synthesis. Four clinical studies (74 participants) and 16 preclinical studies met the inclusion criteria. The collective evidence from clinical and preclinical studies indicates that CBD holds promise as an adjunctive therapy for OUD with a well-tolerated profile during opioid use and withdrawal. Human clinical studies demonstrated a reduction in craving and alleviation of abstinence-induced anxiety. In preclinical studies, CBD has been shown to reduce withdrawal symptoms and diminish opioid-rewarding effects using the conditioned place preference paradigm, although the results are mixed, and not all preclinical studies reported these effects. The quality assessment for clinical studies indicated an overall evaluation of ‘some concerns’, while a notable level of ‘unclear’ risk was observed across the evaluated domains for preclinical studies. This systematic review highlights the potential of CBD as a beneficial treatment option for addressing cravings and anxiety symptoms during abstinence in individuals with OUD, based on findings from human studies. Continued research and clinical trials will be essential for further improving outcomes in OUD treatment using novel effective treatment approaches. Study limitations include the limited number of clinical studies, small sample size, short-term follow-up, lack of combination therapy and heterogeneity across preclinical studies.

Trial Registration

PROSPERO identifier: CRD42023401446

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大麻二酚在阿片类药物使用障碍治疗中的潜在应用：系统综述

大麻二酚（CBD）已成为各种精神疾病（包括物质使用障碍）的潜在治疗选择。本系统综述旨在回顾临床和临床前研究中CBD作为阿片类药物使用障碍（OUD）治疗选择的安全性和有效性的证据。我们检索了截至2023年12月的MEDLINE、Embase、PsycINFO、Scopus、Web of Science、CDSR和CENTRAL。我们纳入了评估CBD对OUD结果的原始同行评议的人类和动物研究，并排除了那些没有报告OUD结果或仅使用CBD与四氢大麻酚的研究。使用Cochrane人类研究的偏倚风险工具和sycle动物研究的偏倚风险工具评估偏倚风险。由于结果的异质性，研究结果采用定性综合。4项临床研究（74名受试者）和16项临床前研究符合纳入标准。来自临床和临床前研究的集体证据表明，CBD有望作为一种辅助治疗OUD，在阿片类药物使用和戒断期间具有良好的耐受性。人类临床研究表明，减少渴望和缓解戒断引起的焦虑。在临床前研究中，使用条件位置偏好范式，CBD已被证明可以减少戒断症状和减少阿片奖励效应，尽管结果好坏参半，并且并非所有临床前研究都报告了这些效果。临床研究的质量评估表明了对“一些问题”的总体评估，而在临床前研究的评估领域中观察到一个显著的“不清楚”风险水平。本系统综述强调了基于人类研究结果的CBD作为一种有益的治疗选择的潜力，用于解决OUD患者在戒断期间的渴望和焦虑症状。持续的研究和临床试验对于使用新的有效治疗方法进一步改善OUD治疗的结果至关重要。研究的局限性包括临床研究数量有限、样本量小、随访时间短、缺乏联合治疗以及临床前研究的异质性。试验注册PROSPERO标识符：CRD42023401446

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction Biology 生物-生化与分子生物学

CiteScore

8.10

自引率

2.90%

发文量

118

审稿时长

6-12 weeks

期刊介绍： Addiction Biology is focused on neuroscience contributions and it aims to advance our understanding of the action of drugs of abuse and addictive processes. Papers are accepted in both animal experimentation or clinical research. The content is geared towards behavioral, molecular, genetic, biochemical, neuro-biological and pharmacology aspects of these fields. Addiction Biology includes peer-reviewed original research reports and reviews. Addiction Biology is published on behalf of the Society for the Study of Addiction to Alcohol and other Drugs (SSA). Members of the Society for the Study of Addiction receive the Journal as part of their annual membership subscription.