Cannabidiol as a Harm Reduction Strategy for People Who Use Drugs: A Rapid Review
Lindsay A. Lo, Caroline A. Maccallum, Kate Nanson, M. Koehn, Ian Mitchell, M. Milloy, Z. Walsh, F. Fehr
Canadian journal of psychiatry. Revue canadienne de psychiatrie June 27, 2023 DOI: 10.1177/07067437231183525 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized Peer reviewed |
|---|---|
| Population | Adults who use drugs |
| Intervention | Cannabidiol (CBD) |
| Topics | CBD |
| Key findings | The authors conclude that low-quality evidence suggests CBD may reduce drug cravings and other addiction-related symptoms and may have utility as an adjunct harm reduction strategy for people who use drugs. Available studies support CBD's potential to reduce drug-induced craving and anxiety in opioid use disorder, but the authors argue CBD monotherapy is likely not an adequate harm reduction strategy on its own. |
Abstract
Objective: The drug poisoning crisis throughout North America necessitates novel harm reduction approaches. Emerging evidence suggests that cannabidiol (CBD) may have some utility as a harm reduction modality for those with problematic substance use. This rapid review aimed to synthesize available evidence on CBD as a potential harm reduction tool for people who use drugs while providing clinical and research insights.
Method: A systematic search in EMBASE, MEDLINE, CENTRAL, and CINAHL was completed in July 2022. For inclusion, studies had to meet the following criteria: (1) drawn from an adult population of people who use drugs; (2) investigates CBD as an intervention for problematic substance use or harm reduction–related outcomes; (3) be published after the year 2000 and in English; and (4) be primary research or a review article. A narrative synthesis was used to group outcomes relevant to harm reduction and provide clinical and research insights.
Results: We screened 3,134 records, of which 27 studies (5 randomized trials) were included. The evidence remains limited, but available studies support the potential utility of CBD to reduce drug-induced craving and anxiety in opioid use disorder. There were low-quality studies suggesting that CBD may improve mood and general well-being of people who use drugs. Evidence suggests that CBD monotherapy may not be an adequate harm reduction strategy for problematic substance use but rather an adjunct to the standard of care.
Conclusion: Low-quality evidence suggests that CBD may reduce drug cravings and other addiction-related symptoms and that CBD may have utility as an adjunct harm reduction strategy for people who use drugs. However, there is a significant need for more research that accurately reflects CBD dosing and administration regimens used in a real-world context.