Cannabis for Opioid Use Disorder

This trial explores whether cannabis can reduce the urge to use opioids in individuals with opioid use disorder. Participants will stay at the University of Kentucky Hospital for about six weeks and try different treatments, including cannabis and opioids. The study will compare the effects of real cannabis versus a placebo (a substance with no active drug) to determine any differences. The trial seeks individuals with moderate to severe opioid use disorder who experience withdrawal symptoms and are willing to stay in the hospital for the study's duration. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants a chance to be among the first to receive this potentially groundbreaking treatment.

Studies have shown that cannabis might help reduce opioid use and improve outcomes for people with opioid use disorder. Research suggests it can lessen withdrawal symptoms and lower the chances of misusing opioids. Access to cannabis has also been linked to fewer opioid prescriptions and overdose deaths.

Cannabis is generally well-tolerated in terms of safety, though some people might experience side effects like dizziness or dry mouth. Importantly, using cannabis does not seem to increase the risk of returning to non-medical opioid use for those in treatment.

Cannabis is unique in the treatment of opioid use disorder because it offers a new mechanism of action that could potentially reduce dependency by interacting with the body's endocannabinoid system. Unlike traditional treatments such as methadone or buprenorphine, which are opioid agonists that work by partially activating opioid receptors, cannabis might help manage cravings and withdrawal symptoms without directly interacting with these receptors. Researchers are excited about this approach as it could provide a novel pathway to manage opioid dependence with potentially fewer side effects and a lower risk of addiction.

This trial will compare active cannabis with placebo cannabis for opioid use disorder. Research on cannabis for opioid use disorder has shown mixed results. Some studies suggest that medicinal cannabis might help reduce cravings and withdrawal symptoms, potentially lowering opioid use by 25%. However, other research indicates that people who use cannabis may be more likely to use opioids and start using them later on. Evidence also suggests that opening cannabis dispensaries can lead to fewer opioid prescriptions. Despite these findings, many studies show no clear impact of cannabis on treatment outcomes like relapse or adherence to a treatment plan.¹³⁴⁶⁷