The following information is presented for educational purposes only. Medical Marijuana Inc. provides this information to provide an understanding of the potential applications of cannabidiol. Links to third party websites do not constitute an endorsement of these organizations by Medical Marijuana Inc. and none should be inferred.
Heroin addiction affects about 4.2 million Americans aged 12 or older. Studies have shown cannabis can reduce the withdrawal symptoms associated with heroin abstinence and increase the rate of successful recovery.
Overview of Heroin Addiction
Heroin is a highly addictive opioid drug that produces a euphoric sensation. Once heroin enters the brain, it converts back into morphine and binds to opioid receptors, which are involved in the body’s pain and reward perception.
Abusing heroin can cause various serious health conditions, including infectious diseases like hepatitis and HIV and spontaneous abortion. Those who chronically use heroin can develop liver or kidney disease, collapsed veins, infections of the heart lining and valves, abscesses, constipation and gastrointestinal cramping and pulmonary complications. Fatal overdose can also occur. A heroin overdose typically is associated with a breathing suppression that prevents oxygen from reaching the brain, which can cause permanent brain damage or death.
Chronic heroin use leads to physical dependence and the body adapts to the drug’s presence. Reducing or stopping use abruptly causes severe withdrawal symptoms, including restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, kicking movements and goose bumps. The treatment approach for heroin addiction typically consists of detox, counseling, therapy, medical intervention and support groups. During the detox period, the patient will experience withdrawal symptoms.
Findings: Effects of Cannabis on Heroin Addiction
Evidence suggests that cannabis can help heroin, opioid and alcohol addicts in their road to recovery by serving as a substitute to lower urges and withdrawal symptoms (Walsh, et al., 2016) (Lucas, et al., 2012). One study found that a THC prescription medication reduced the severity of opioid withdrawals. The study also found that 32% of regular marijuana smokers experienced significantly lower ratings of insomnia and anxiety (Bisaga, et al., 2015). An animal study found that chronic THC treatments significantly reduced the withdrawals associated with morphine withdrawal (Valverde, et al., 2001). A survey found that using cannabis helped to curb cravings for alcohol and as a substitute for more potent drugs, like cocaine (Reiman, 2009).
Cannabis can also potentially help treat heroin addiction by acting as an effective substitute. Research shows that cannabinoids modulate the brain’s reward systems that are involved in opioid addiction (Oliere, Joliette-Riopel, Potvin & Jutras-Aswald, 2013). However, cannabis doesn’t have the physical addictive components that opiates, like heroin, do. Therefore, addicts can use cannabis to gradually reduce their use of heroin. One study found that rats given CBD were markedly less likely to self-administer heroin after a two week abstinence period. The researchers concluded that, “CBD may be a potential treatment for heroin craving and relapse” (Ren, et al., 2009). Another animal study found that THC administration through injection was effective at suppressing behavioral, biochemical and molecular dependence to morphine (Morel, Giros & Dauge, 2009).
Cannabis has shown to increase the rate of heroin addiction recovery. In one study, regular cannabis smokers were more likely to complete the 8-week treatment trial (Bisaga, et al., 2015). Other studies have found similar results. In one, cannabis users were better able to stick with their naltrexone pill treatments for opioid addiction (Raby, et al., 2009). Another study also found that moderate cannabis users, who were also diagnosed with ADHD, had greater cocaine treatment retention rates compared to non-users and regular users (Aharonovich, et al., 2006).
States That Have Approved Medical Marijuana for Heroin Addiction
Currently, no states have approved medical marijuana for the treatment of heroin addiction. However, in Washington DC, any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment. In addition, a number of other states will consider allowing medical marijuana to be used for the treatment of heroin addiction with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
Recent Studies on Cannabis’ Effect on Heroin Addiction
Bachhuber, M.A., Saloner, B., Cunningham, C.O., and Barry, C.L. (2014). Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010. JAMA Internal Medicine, 174(10), 1668–1673. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392651/.
Bisaga, A., Sullivan, M.A., Glass, A., Mishlen, K., Pavlicova, M., Haney, M., Raby, W.N., Levin, F.R., Carpenter, K.M., Mariani, J.J., and Nunes, E.V. (2015, September 1). The effects of dronabinol during detoxification and the initiation of treatment with extended release naltrexone. Drug and Alcohol Dependence, 154, 38-45. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536087/.
DrugFacts: Heroin. (2014, October). National Institute on Drug Abuse. Retrieved from http://www.drugabuse.gov/publications/drugfacts/heroin.
Heroin Addiction. (n.d.). Addictions.com. Retrieved from http://www.addictions.com/heroin/.
Li, J.X., Koek, W., and France, C. P. (2012). Interactions between delta9-tetrahydrocannabinol and heroin: self-administration in rhesus monkeys. Behavioural Pharmacology, 23(8), 754–761. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916935/.
Lucas, P., Reiman, A., Earleywine, M., McGowan, S.K., Oleson, M., Coward, M.P. and Thomas, B. (2012). Cannabis as a substitute for alcohol and other drugs: A dispensary-based survey of substitution effect in Canadian medical cannabis patients. Addiction Research and Theory, Early Online, 1-8. Retrieved from http://www.tandfonline.com/doi/full/10.3109/16066359.2012.733465?needAccess=true.
Maldonado, R., Valverde, O., and Berrendero, F. (2006, April). Involvement of the endocannabinoid system in drug addiction. Trends in Neurosciences, 29(4), 225-32. Retrieved from http://www.cell.com/trends/neurosciences/abstract/S0166-2236(06)00025-7?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0166223606000257%3Fshowall%3Dtrue.
Morel, L.J., Giros, B., and Dauge, V. (2009, October). Adolescent exposure to chronic delta-9-tetrahydrocannabinol blocks opiate dependence in maternally deprived rats. Neuropsychopharmacology, 34(11), 2469-76. Retrieved from http://www.nature.com/npp/journal/v34/n11/full/npp200970a.html.
Olière, S., Jolette-Riopel, A., Potvin, S., & Jutras-Aswad, D. (2013). Modulation of the Endocannabinoid System: Vulnerability Factor and New Treatment Target for Stimulant Addiction. Frontiers in Psychiatry, 4, 109. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780360/.
Prud’homme, M., Cata, R., and Jutras-Aswad, D. (2015). Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence. Substance Abuse: Research and Treatment, 9, 33–38. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444130/.
Raby, W. N., Carpenter, K. M., Rothenberg, J., Brooks, A. C., Jiang, H., Sullivan, M., Bisaga, A., Corner, S., and Nunes, E. V. (2009). Intermittent Marijuana Use Is Associated with Improved Retention in Naltrexone Treatment for Opiate-Dependence. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 18(4), 301–308. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2753886/.
Reiman, A. (2009). Cannabis as a substitute for alcohol and other drugs. Harm Reduction Journal, 6, 35. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2795734/.
Ren, Y., Whittard, J., Higuera-Matas, A., Morris, C.V., and Hurd, Y.L. (2009, November 25). Cannabidiol, a nonpsychotropic component of cannabis, inhibits cue-induced heroin seeking and normalizes discrete mesolimbic neuronal disturbances. Journal of Neuroscience, 29(47), 14764-69. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829756/.
Valverde, O., Noble, F., Beslot, F., Dauge, V., Fournie-Zaluski, M.C., and Roques, B.P. (2001, May). Delta9-tetrahydrocannabinol releases and facilitates the effects of endogenous enkephalins: reduction in morphine withdrawal syndrome without change in rewarding effect. European Journal of Neuroscience, (13)9, 1816-24. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1046/j.0953-816x.2001.01558.x/full.
Walsh, Z., Gonzalez, R., Crosby, K., S Thiessmen, M., Carroll, C., and Bonn-Miller, M.O. (2016, October 12). Medical cannabis and mental health: A guided systematic review. Clinical Psychology Review, 51, 15-29. Retrieved from http://www.sciencedirect.com/science/article/pii/S0272735816300939.