The use of medicinal cannabis in the treatment of opioid use disorders: A systematic review

Authors

DOI:

https://doi.org/10.33448/rsd-v12i9.43224

Keywords:

Opiate Substitution Treatement; Opioid-Related Disorders; Canabinoids; Cannabis.

Abstract

The search for alternative treatments and different clinical uses of medicinal cannabis has shown significant growth in recent years. In this context, this study aims to evaluate the use of medicinal cannabis as a treatment for opioid use disorders. Through a systematic analysis, using the PubMed and Medline databases, a search was carried out, giving preference to clinical trials, meta-analyses and bibliographic reviews from the last 10 years, in animals and humans using the terms “cannabis”, “opioids”, “addiction” and “treatment”. Articles with the terms “smoker”, “smoking” and “pregnant” in the title or abstract were excluded, and ongoing studies were also excluded. A reduction in withdrawal symptoms was observed, with a prolonged effect and a good safety profile. Studies show positive preliminary results, however, they have small samples, without standardization of synthetic cannabinoids and their respective dosages. Therefore, studies with standardization of parameters and a larger sample number are necessary for assertive conclusions.

Author Biographies

Augusto Mendes Ferreira, Universidade Federal de Roraima

Medical Student at the Federal University of Roraima

Jullyana Sarah Magalhães Silva, Universidade Federal de Roraima

Doctor graduated from ITPAC-Porto Nacional, specialist in Family Medicine from the Federal University of Pará, resident of Gynecology and Obstetrics at HMI-RR, working in General Practice since 2017

Kaio Figueiredo da Silva Cruz, Universidade Federal de Roraima

Medical Student at the Federal University of Roraima

Marycassiely Rodrigues Tizolim, Universidade Federal de Roraima

Medical Student at the Federal University of Roraima

Washington Luiz Aquino de Souza Junior, Universidade Federal de Roraima

Doctor formed by Federal University of Roraima, Lato sensu postgraduate degree in Psychiatry, Lato sensu graduate studies in Geriatric Psychiatry, Lato sensu graduate studies in Child and Adolescent Psychiatry, Active in the field of Psychiatry since 2020

Gabrielle Mendes Lima, Universidade Federal de Roraima

Professor of Medicine at the Federal University of Roraima

References

Balu, A., Mishra, D., Marcu, J., & Balu, G. (2021). Medical cannabis certification is associated with decreased opiate use in patients with chronic pain: A Retrospective cohort study in delaware. Cureus. https://doi.org/10.7759/cureus.20240

Boehnke, K. F., Litinas, E., & Clauw, D. J. (2016). Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain. The Journal of Pain, 17(6), 739–744. https://doi.org/10.1016/j.jpain.2016.03.002

Campbell, G., Hall, W., & Nielsen, S. (2018). What does the ecological and epidemiological evidence indicate about the potential for cannabinoids to reduce opioid use and harms? A comprehensive review. International Review of Psychiatry, 30(5), 91–106. https://doi.org/10.1080/09540261.2018.1509842

Capano, A., Weaver, R., & Burkman, E. (2019). Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgraduate Medicine, 132(1), 56–61. https://doi.org/10.1080/00325481.2019.1685298

Degenhardt, L., Charlson, F., Stanaway, J., Larney, S., Alexander, L. T., Hickman, M., Cowie, B., Hall, W. D., Strang, J., Whiteford, H., & Vos, T. (2016). Estimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C, and hepatitis B: findings from the Global Burden of Disease Study 2013. The Lancet Infectious Diseases, 16(12), 1385–1398. https://doi.org/10.1016/s1473-3099(16)30325-5

Degenhardt, L., Peacock, A., Colledge, S., Leung, J., Grebely, J., Vickerman, P., Stone, J., Cunningham, E. B., Trickey, A., Dumchev, K., Lynskey, M., Griffiths, P., Mattick, R. P., Hickman, M., & Larney, S. (2017). Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. The Lancet. Global Health, 5(12), e1192–e1207. https://doi.org/10.1016/S2214-109X(17)30375-3

Estrela, C. (2018). Metodologia científica ciência, ensino, pesquisa. Artes Medicas.

Hurd, Y. L., Spriggs, S., Alishayev, J., Winkel, G., Gurgov, K., Kudrich, C., Oprescu, A. M., & Salsitz, E. (2019). Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial. American Journal of Psychiatry, 176(11), 911–922. https://doi.org/10.1176/appi.ajp.2019.18101191

Kathmann, M., Flau, K., Redmer, A., Tränkle, C., & Schlicker, E. (2006). Cannabidiol is an allosteric modulator at mu- and delta-opioid receptors. Naunyn-Schmiedeberg’s Archives of Pharmacology, 372(5), 354–361. https://doi.org/10.1007/s00210-006-0033-x

Laprairie, R. B., Bagher, A. M., Kelly, M. E. M., & Denovan-Wright, E. M. (2015). Cannabidiol is a negative allosteric modulator of the cannabinoid CB1 receptor. British Journal of Pharmacology, 172(20), 4790–4805. https://doi.org/10.1111/bph.13250

Lucas, P. (2012). Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain. Journal of Psychoactive Drugs, 44(2), 125–133. https://doi.org/10.1080/02791072.2012.684624

Lucas, P., & Walsh, Z. (2017). Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients. International Journal of Drug Policy, 42, 30–35. https://doi.org/10.1016/j.drugpo.2017.01.011

McKee, K. A., Hmidan, A., Crocker, C. E., Lam, R. W., Meyer, J. H., Crockford, D., Trépanier, A., Aitchison, K. J., & Tibbo, P. G. (2021). Potential therapeutic benefits of cannabinoid products in adult psychiatric disorders: A systematic review and meta-analysis of randomised controlled trials. Journal of Psychiatric Research, 140, 267–281. https://doi.org/10.1016/j.jpsychires.2021.05.044

Mechoulam, R., Peters, M., Murillo-Rodriguez, E., & Hanuš, Lumír O. (2007). Cannabidiol – Recent Advances. Chemistry & Biodiversity, 4(8), 1678–1692. https://doi.org/10.1002/cbdv.200790147

Meng, H., Page, M. G., Ajrawat, P., Deshpande, A., Samman, B., Dominicis, M., Ladha, K. S., Fiorellino, J., Huang, A., Kotteeswaran, Y., McClaren-Blades, A., Kotra, L. P., & Clarke, H. (2021). Patient-reported outcomes in those consuming medical cannabis: a prospective longitudinal observational study in chronic pain patients. Canadian Journal of Anesthesia/Journal Canadien D’anesthésie, 68(5), 633–644. https://doi.org/10.1007/s12630-020-01903-1

Morales, P., Hurst, D. P., & Reggio, P. H. (2017). Molecular targets of the phytocannabinoids: A complex picture. Progress in the Chemistry of Organic Natural Products, 103, 103–131. https://doi.org/10.1007/978-3-319-45541-9_4

Nutt, D., King, L. A., Saulsbury, W., & Blakemore, C. (2007). Development of a Rational Scale to Assess the Harm of Drugs of Potential Misuse. Lancet (London, England), 369(9566), 1047–1053. https://doi.org/10.1016/S0140-6736(07)60464-4

Prud’homme, M., Cata, R., & Jutras-Aswad, D. (2015). Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence. Substance Abuse: Research and Treatment, 9, SART.S25081. https://doi.org/10.4137/sart.s25081

Razdan, R. K., Dalzell, H. C., Herlihy, P., & Howes, J. F. (1976). Hashish. 16. Unsaturated side-chain analogs of DELTA.8-tetrahydrocannabinol with potent biological activity. Journal of Medicinal Chemistry, 19(11), 1328–1330. https://doi.org/10.1021/jm00233a014

Russo, E. B., & Marcu, J. (2017). Cannabis Pharmacology: The Usual Suspects and a Few Promising Leads. Cannabinoid Pharmacology, 80, 67–134. https://doi.org/10.1016/bs.apha.2017.03.004

Slivicki, R. A., Iyer, V., Mali, S. S., Garai, S., Thakur, G. A., Crystal, J. D., & Hohmann, A. G. (2020). Positive Allosteric Modulation of CB1 Cannabinoid Receptor Signaling Enhances Morphine Antinociception and Attenuates Morphine Tolerance Without Enhancing Morphine- Induced Dependence or Reward. Frontiers in Molecular Neuroscience, 13. https://doi.org/10.3389/fnmol.2020.00054

Strang, J., Volkow, N. D., Degenhardt, L., Hickman, M., Johnson, K., Koob, G. F., Marshall, B. D. L., Tyndall, M., & Walsh, S. L. (2020). Opioid use disorder. Nature Reviews Disease Primers, 6(1), 1–28. https://doi.org/10.1038/s41572-019-0137-5

Thakur, G., Nikas, S., & Makriyannis, A. (2005). CB1 Cannabinoid Receptor Ligands. Mini-Reviews in Medicinal Chemistry, 5(7), 631–640. https://doi.org/10.2174/1389557054368772

Vázquez, M., Guevara, N., Maldonado, C., Guido, P. C., & Schaiquevich, P. (2020). Potential Pharmacokinetic Drug-Drug Interactions between Cannabinoids and Drugs Used for Chronic Pain. BioMed Research International, 2020, 1–9. https://doi.org/10.1155/2020/3902740

Published

18/09/2023

How to Cite

FERREIRA, A. M. .; SILVA, J. S. M. .; CRUZ, K. F. da S. .; TIZOLIM, M. R. .; SOUZA JUNIOR, W. L. A. de; LIMA, G. M. . The use of medicinal cannabis in the treatment of opioid use disorders: A systematic review. Research, Society and Development, [S. l.], v. 12, n. 9, p. e8712943224, 2023. DOI: 10.33448/rsd-v12i9.43224. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/43224. Acesso em: 22 nov. 2024.

Issue

Section

Review Article