The Benefits of Using CBD with Your Opioid Recovery are Many
CBD has gotten a lot of attention in the media lately. In fact, it’s hard to go anywhere without someone talking about how CBD helped them with pain, anxiety, depression, aches, sleep and even relationships. But what about using CBD as part of your opioid recovery? Will it help?
The quick answer is “yes” due to the fact that CBD provides so many different benefits. Truth is, It’s hard to imagine anyone not receiving tremendous benefits by using CBD, recovery or not.
The following article was originally written and published by Mo Perry at ExperienceLife.com. Be sure to read more of Mo’s posts while your’e there, as her writing is exceptional.
What is CBD? Our integrative-health experts explain how cannabidiol works to relieve pain, anxiety, and more.
When Jessica Smith (not her real name) began taking anxiety medication, it relieved her symptoms but came with some unwelcome sexual side effects like decreased libido.
A 38-year-old writer and theater artist in Minneapolis, Smith took the pills after a traumatic event triggered symptoms of PTSD, including insomnia, a racing mind, loss of appetite, and weight loss. After a year, she halted the meds, and her anxiety symptoms returned. She struggled to fall asleep and stay asleep — and when she did doze, she suffered nightmares.
Then she heard about the health benefits of a plant-derived compound called cannabidiol, or CBD.
“I picked up a bottle and took a dose under my tongue right before bed,” Smith recalls. “Within 20 minutes, I noticed my racing mind quieting. It also helped with my sleep.”
She used CBD nightly for a few months, until her anxiety waned; then she took it about once a week.
“The thing about CBD is that, unlike traditional anxiety meds that you have to take daily, you can just take it when you need it,” she says. “I feel like I have more control, and I’ve had no other side effects.”
Smith’s experience is not unique. Substantial anecdotal evidence suggests that CBD is a safe and effective remedy for a wide variety of conditions, including anxiety, chronic pain, and autoimmune disorders — and the scientific research to support it continues to grow.
The Endocannabinoid System
To understand CBD, it helps to first understand the human endocannabinoid system, or ECS. This complex system involves signaling molecules called endocannabinoids (which the body produces), their receptors, and a handful of enzymes that synthesize and break down the molecules.
The ECS is a fairly recent discovery. Researchers identified it in the 1990s when, while exploring the physiological effects of cannabis, they noticed endocannabinoids interacting with the same receptors as the cannabis molecules.
Cannabinoid receptors exist throughout the body: in the brain, gastrointestinal tract, reproductive system, heart, blood cells, muscles, and elsewhere. The body’s own endocannabinoids engage with these receptors to affect a wide range of physiological functions, including appetite, memory, movement, and pain.
The ECS is responsible for two basic activities, explains Michael Moskowitz, MD, author of Medical Cannabis. The first is modulating energy and well-being. The second is nudging the body back to homeostasis in the face of stress, injury, or disease. Because of this governing role, the ECS is sometimes referred to as the “master regulatory system.”
In her book, Healing With CBD, Eileen Konieczny, RN, cites the work of endocannabinoid researcher Robert Melamede, PhD, and writes, “You can think of the ECS as the taskmaster that is constantly multitasking, adjusting, and readjusting the complex network of molecular thermostats that control our physiological tempo.”
“The ECS is more responsible for maintaining balance and health than any other system,” Moskowitz notes. “We’re still learning about the full extent of its function, but we’re beginning to understand that the ECS is the most important system for controlling disease in the animal kingdom.”
CBD Versus THC
Enter CBD. The Cannabis sativa plant species, which includes both hemp and marijuana, contains at least 113 known phytocannabinoids, chemical compounds that mimic and stimulate the endocannabinoids that are naturally produced by the human body. The two most abundant phytocannabinoids are also the most studied: tetrahydrocannabinol (THC), which produces the intoxicating effects typically associated with cannabis, and cannabidiol (CBD).
THC and CBD are present to varying degrees in both marijuana and hemp plants, along with a wide variety of phytochemicals, including other cannabinoids, flavonoids, and terpenes. These molecules give certain strains of cannabis their unique therapeutic and experiential properties, as well as a distinct aroma. Most strains of marijuana have more THC than CBD, while industrial hemp (used to make clothing, rope, and seed oils) contains only trace amounts of THC and a higher proportion of CBD.
CBD can be derived from both hemp and marijuana, but makers of any products that are nationally available will extract it almost exclusively from hemp. Hemp-derived CBD products are legally required to contain less than 0.3 percent of THC — far below a level that would deliver a high. Still, even hemp-derived CBD products may have enough THC to be detected by a drug test.
Unlike THC, CBD is nonintoxicating, though it does affect the brain in other ways. Evidence suggests it can ease anxiety, in part, by interacting with the brain’s serotonin and GABA receptors. One recent study found that a single 600 mg dose of CBD could reduce psychosis symptoms by modulating activity in relevant areas of the brain. In fact, when taken in conjunction with THC, CBD actually mitigates THC’s psychoactive effects.
THC directly interacts with the brain’s most common type of cannabinoid receptor, the CB1, which is what causes the high. CBD works differently. It interacts with CB2 receptors, which operate throughout the nervous and immune systems.
“These receptors are responsible for CBD’s pain-relieving and anti-inflammatory effects and play a role in autoimmune disorders and regulating blood sugar,” says integrative holistic physician Rav Ivker, DO, author of Cannabis for Chronic Pain. CBD also helps inhibit an enzyme that breaks down anandamide, one of the body’s endocannabinoids known as the “bliss molecule.”
Ultimately, CBD works by supporting the body’s own endocannabinoid system, explains integrative physician Robert Rountree, MD. “It enhances what should be working properly in the first place.”
The Entourage Effect
Whether sourced from hemp or marijuana, the CBD molecule is the same. But researchers are beginning to realize it doesn’t operate in isolation.
“It’s a mistake to focus on THC and CBD alone,” explains Rountree. “They are two chemicals out of hundreds in Cannabis sativa, and they all seem to work in concert with each other.”
This chemical collaboration is often referred to as the “entourage effect” or “ensemble effect.” Phytocannabinoids, such as cannabinol and cannabichromene, are anti-inflammatory agents, while cannabigerol has antibacterial effects. Still others (out of the 113 that researchers have identified so far) exhibit antispasmodic, antidiabetic, and antifungal powers.
“Each phytocannabinoid has its own properties,” explains Moskowitz. “They overlap in the conditions and symptoms they treat, but they each go about it in a unique way. That’s the synergistic effect — the sum of all the components working together is greater than the parts.”
In theory, “full-spectrum” or “whole-plant” CBD products contain the complete range of phytochemicals in the plant from which they were derived. But Moskowitz notes that these descriptors are unregulated: “‘Full-spectrum’ is a term with no standardization, and people throw it around,” he says.
Ideally, as phytocannabinoid research advances, the best labels for CBD products will indicate not just verified levels of CBD (and THC, when applicable) but other medically active cannabinoids as well. “It would be a major boon for people to understand that it’s more than just these two compounds,” says Moskowitz.
Rountree expects that researchers will begin to cultivate strains of Cannabis sativa plants to enhance specific phytocannabinoids and their particular therapeutic effects. “We’re putting so much emphasis on CBD right now that we forget there’s a whole range of phytocannabinoids and chemicals that regulate and affect the ECS,” he notes. “The future will be much more focused on the whole entourage.”
The entourage effect helps explain why some conditions, including pain and ulcerative colitis, seem to respond better to a combination of CBD and THC. But full-spectrum CBD without any THC still packs a therapeutic punch.
“You can receive all the anti-inflammatory effects of CBD and boost the endocannabinoid system without touching the psychoactive properties of THC,” says Tiffany Lester, MD, medical director of Parsley Health San Francisco.
Choosing the Right CBD
At this writing, CBD’s legal and regulatory status remains in flux, so consumers must proceed with caution. One 2017 review of 84 CBD products sold online found that nearly 70 percent published misleading claims about CBD levels. Some had more than the label suggested, others less. About 21 percent of the products contained some THC.
Reputable CBD manufacturers (such as Charlotte’s Web and CV Sciences) subject their label claims to third-party testing.
Finding products made with organically grown hemp is also critical. Hemp is a bioaccumulator, meaning it absorbs heavy metals and chemicals from soil. Those toxins can become concentrated in “medicinal” doses of CBD.
Although the market is bursting with CBD products, ranging from bath bombs to gummy bears, experts agree that, to maximize the therapeutic benefits, CBD is best approached and used as a medicine. Capsules, oral sprays, and edibles with clearly labeled levels of CBD are solid options if they’re offered by a reputable supplier.
Sublingual tinctures — with droppers that let you calibrate the dose to the milligram — provide the most dosage control. Look for a CBD oil delivered in a healthy fat, such as coconut or MCT oil.
Determining the Ideal Dose
“The key to using CBD effectively, as with any medicine, is consistency and dosage,” says Ivker, noting that determining the right dose often requires some experimentation. Because clinical research on CBD is in its infancy, most of what’s known about effective dosages is based on anecdotal evidence.
What little we do know suggests that an effective dosage ranges widely from person to person, even for similar symptoms and conditions. Konieczny recommends recording symptoms, dose, time and method of delivery, and response.
Practitioners typically advise CBD users to “start low and go slow.” Moskowitz advises beginning with about 5 mg a day and noting how you feel. “Increase as needed until you start noticing improvement in your symptoms,” he says. “As your symptoms start to get under control, you can back off again and use less.”
Women who are pregnant or breastfeeding should steer clear of any cannabis products, and those taking prescription medications should consult with their healthcare provider to ensure they avoid potentially harmful drug interactions: At high doses, CBD can interact with an enzyme in the liver that affects how certain drugs are metabolized.
But for most, low to moderate doses of CBD seem to be safe. Even high doses of hundreds of milligrams don’t carry the same risks as many over-the-counter and pharmaceutical drugs, though they may cause sleepiness, changes in appetite, and digestive upset.
There are no known instances of toxic or fatal overdoses. A comprehensive 2011 survey of clinical studies on CBD, as well as a 2017 follow-up, confirmed its favorable safety profile for humans, though it also noted that more research is needed on the effects of long-term use.
Safe and effective, CBD is an appealing option as a natural, plant-based remedy for a wide range of conditions. It’s important, however, to talk with your healthcare provider before trying it.
“We don’t yet have the research to fully support CBD’s use as a treatment of many health conditions,” notes Lester, adding that she’s hopeful that will change in the near future as the stigma surrounding cannabis continues to fade.
How Effective Is CBD for Anxiety, Epilepsy, Digestive Disorders, Cancer and Pain?
The treatment of seizure disorders — particularly Lennox–Gastaut syndrome and Dravet syndrome, which often respond poorly to medication — represents one of the most promising and scientifically supported uses of cannabidiol (CBD).
The story of 6-year-old Charlotte Figi, who suffered from intractable epilepsy, brought national attention to CBD’s potential as a seizure-disorder treatment when it was featured in the 2013 CNN documentary series Weed by neurosurgeon and medical correspondent Sanjay Gupta, MD. Charlotte was the first of many children successfully treated for severe seizure disorders with a high-CBD medical-marijuana product, which was later christened Charlotte’s Web in her honor.
Epidiolex, a drug that treats rare and severe forms of epilepsy, is currently the only FDA-approved CBD medicine available in the United States. Clinical trials showed that patients who took Epidiolex experienced fewer seizures compared with those who received a placebo. The most common side effects included fatigue, suppressed appetite, and diarrhea. CBD may interact with anti-epileptic drugs, though, so consult with your doctor before trying any CBD-based treatment.
“Reducing anxiety may be CBD’s strongest therapeutic benefit,” says integrative holistic physician Rav Ivker, DO. Researchers in Brazil found that study participants who consumed a (notably large) 600 mg dose of CBD reported a significant decrease in social anxiety before delivering a public speech. Brain scans supported their reports by showing antianxiety blood-flow patterns.
While CBD can ease anxiety, phytocannabinoids in general may not be sufficient treatment on their own for those who are chronically anxious, notes integrative physician Robert Rountree, MD. “For that reason, I recommend phytocannabinoids mostly as an enhancement to the primary treatment regimen,” he says.
Tiffany Lester, MD, suggests that people on medication for pain, anxiety, or sleep consult with their doctors before adding CBD to a treatment plan, in order to avoid potential interactions.
A number of studies have linked the endocannabinoid system (ECS) and the gastrointestinal system, which is full of CB2 receptors — the kind indirectly stimulated by CBD. While no tests can currently determine the health (or “tone”) of a person’s ECS, there are certain symptoms that point to an imbalance.
“Among the main indicators that the ECS system is out of whack are fibromyalgia, chronic migraine, and irritable bowel syndrome,” explains Rountree. “The way to test if illness is due to an imbalance in the ECS is to have someone try phytocannabinoids and see how they respond.”
Cannabinoids have been found to reduce inflammation in the bowel; one 2016 study showed that CBD might suppress colitis in mice by inhibiting T-cell activation and inflammatory response in the colon. It has also been shown to alleviate hypermotility in the guts of mice. Some studies suggest that CBD works best in treating irritable bowel disease when used in conjunction with tetrahydrocannabidiol (THC). More research is needed, but cannabinoids represent a promising avenue of study for treating Crohn’s disease, colitis, and other digestive disorders.
Research has shown that CBD (particularly in combination with THC) can be a useful supplement to traditional cancer treatments. It effectively treats side effects of chemotherapy, including nausea, vomiting, lack of appetite, pain, and insomnia.
Though we’re a long way from replacing traditional cancer treatments with cannabinoid-based treatments, studies support CBD’s use as a complementary addition to conventional treatments, which could spark additional research into its potential as a cancer-fighting agent.
Jason Ballweber, 39, suffered from back pain for most of his life due to a herniated disc and arthritis in his vertebrae. For years, he took the maximum daily dose (and sometimes more) of over-the-counter pain relievers. He recently began using CBD as a topical cream, which helped so much that he found himself going days without needing to pop an NSAID. Now he takes 10 mg of CBD daily in gummy form, supplementing with the cream on bad pain days. “I rarely take Advil or Aleve now,” he reports. “My pain is much more manageable.”
CBD relieves pain through several mechanisms. “CBD is a powerful anti-inflammatory compound,” says Ivker, “and most chronic pain conditions involve some degree of inflammation.” It also reduces anxiety, and because stress has been shown to increase the subjective experience of pain, CBD’s antianxiety properties can also help it function as an analgesic, he adds. “CBD has a multipronged effect on inflammation, pain, anxiety, and sleep, and for relaxing tight muscles to increase blood flow.”
Studies suggest that CBD may also help alleviate opioid-withdrawal symptoms and decrease the risk of relapse. “People say that cannabis is a gateway drug,” says Rountree, “but it’s actually more of an exit drug. There’s huge potential for it to help people exit from opioid addiction, while taking the edge off their pain.”
For those who aren’t seeking to treat any particular health complaint or condition, CBD is still a worthwhile wellness supplement, says Michael Moskowitz, MD — if only for its anti-inflammatory properties.
“It’s analgesic, anti-inflammatory, anticancer, neuroprotective, antiemetic, antianxiety, antibacterial, antipsychotic; it slows the spread of disease and helps with bone loss and formation,” he explains. “Unless you experience untoward effects from using it, let it work in the background and assume it’s probably doing something positive.”
— Mo Perry – ExperienceLife.com
I just want to know if I can smoke cbd hemp while taking Suboxone I take suboxone three times a day 8 mg and I want to know if I can smoke to hemp CBD with 0.3% THC
I can’t offer you medical advice, so be sure check with your physician to be sure it’s safe for you. Everyone reacts differently to medications whether prescription of natural remedy. CBD can interact with other medications you might be taking as well. My personal experience: I take CBD oil twice daily along with 4-8mg of Suboxone and feel fantastic. CBD oil helps me with sleep, achy joints, and gives me a clear head from what I can tell. Best of success in recovery my friend!
4-8 mg is a lot per day. I barely take 1mg throughout the day along with bing rips
Sorry, but what are bing rips?
Thank you for info, I’m a cbd Consultant healing everyday people like yourself one drop at a time..Thanks for a reply, I’d been searching for that info, to help a client out with skin cancer but has been and still is on suboxone for over 10 years, now I’m comfortable advising her of dose..
Nice!! I love what you’re doing to help people 🙂
I’ve been using Suboxone for allmost 15 years, my life is 180° different from the time before when I used Heroin.
Now I have job,family and motivation.
Can CBD help me quit Suboxone? My biggest desire now is to quit Suboxone without the 14 days cold turkey…
Long-time users typically need a very slow and gradual taper to minimize discomfort at the end. I would speak to your doctor about it, and perhaps share this incredible taper with him. This is the best taper I have ever seen and is being used by lots of people. At the very end, some people forget to take their doses because it’s so low. Take a look: Painless Suboxone Taper Congratulations on your recovery. Suboxone saved my life and allowed me to function normally while I started working on my biggest problem – Me. Best of success!
Hi. I happened upon this page while researching cbd oil’s effect on buprenorphine withdrawal. I am so glad to see this info and I can’t wait to look at the taper you linked to. I have been on buprenorphine for 10 years due to a opiate addiction – different dosages, but mostly 8mg tab x 4 daily sublingually. I started by taking Suboxone, but the naloxone gave me terrible headaches – so it’s only the Subutex for me. My question is this: Suboxone is referenced here, would that taper work on buprenorphine only? And at the high doses I have been taking it at for so long. I am a large woman – have run between 275 and 300 the entire time of tx, so the dosage isn’t as bad as it would be if I were the size of a waif. I am just desperate to be out from under the buprenorphine. I can’t move to Europe – something I had been considering, they don’t even prescribe it there – I can’t move to some states because there are laws against prescribing buprenorphine without the naloxone!! If I become unconscious and need emergency surgery, I am SOL where pain management is concerned post-op. And it can actually be dangerous! EVEN with PLANNED surgery – the doctors simply don’t know enough about it to know how to prepare Suboxone patients for surgery, and then how to administer pain relief and how much for how long – enabling a smooth transition back to the bupe without initiating precipitated withdrawals. As an addict, being proactive in this arena doesn’t get you very far. The fact is that a bupe or Suboxone patient needs to be taken off the meds at least SIX WEEKS prior to surgery and ONLY WHEN withdrawals begin, they need to introduce pain medication into the system. The problem with this is that because of the Subutex and the ultra long half-life and it’s affinity for binding, the addict needs HIGHER THAN NORMAL doses of narcotic pain relief. Without this, it is a cluster f#@k of breakthrough withdrawals from the bupes. Go ahead, let’s see an addict in recovery try to tell a surgeon, doctor, PCP, anesthesiologist, etc. that they need more narcotics than the average Joe. They will be laughed out of the office. And the physicians will proceed in what seems to them as the logical manner, with nightmare results because a smooth transition back ON to bupe also has its protocol to avoid serious problems. This is ugly to me. And as I’m almost 60 now, I just don’t want to take these chances. I want off so badly. Thank you for posting the painless taper – please advise about it’s effectiveness on bupe only. Thanks!
Hi Elizabeth. Thanks for reaching out. My personal experience with CBD is that it provides a calming effect that can assist with opioid withdrawals. It didn;t eliminate them,but it certain helped. It also provided me sleep benefits, much like melatonin, but stronger, at least with the CBD I used. The key here is to work with a provider who is open to alternative solutions who understands your desire to taper and is willing to help. The taper used at our clinic is one we created after seeing so many people fail and relapse. What we realized is that most people need to reduce buprenorphine levels VERY SLOWLY over a period of many months in order to achieve a safe, comfortable and effective taper. The primary goal is to get to 1mg daily, and then begin taking it every other day, then every third day, etc. Again – Always discuss any medical-related issues with a physician.
I’ve included a link to the taper we use at Nashville Recovery below and hope that you find it helpful. I wish you the very best of success. God bless you. Link to The Easiest (and very long) Suboxone Taper on the Planet: https://suboxnashville.com/wp-content/uploads/2020/07/The-Most-Painless-Suboxone-Taper-on-the-Planet-Nashville-Suboxone-Recovery-615-431-3701-1.pdf
I’m a Suboxone patient as well, for about 2 years now. CBD has made it possible to cut back on my Sub dose by 50% a day. I also incorporate THC into my daily medications, but if I take my CBD in the morning, later on when I ingest THC I do not feel any psychoactive effects. As long as I keep my CBD levels up a little bit I never get the head “high” from THC, which is great for pain relief as well as avoiding any anxiety. Just keep in mind everyone reacts differently to different amounts of CBD. For me I’ve also noticed a positive difference in how I feel overall as every day goes by that I use CBD. Using everyday has had better effects than just using once in awhile or when I think I may need it…CBD has definitely lessened the anxiety and any physical symptoms of cutting back on Suboxone for me.
I love the idea of CBD with Suboxone. It settles me down, so I can how it could help when lowering your dose. Great share Matthew – Thank you!
Would taking CBD products show up in the mandatory drug screening for suboxone users and if so would that get them kick out of the suboxone therapy?
According to the data sheet we received from a local company named TenneCBD, there is absolutely no THC in most CBD oils. THC is only found in CBD’s that state they have THC, but those aren’t legal in Tennessee. I would read the bottle closely to make sure. Look at this page and you’ll see “ZERO THC” listed prominently: https://labcanna.com/product/tennecbd-formula-black/ Be safe 🙂
Great feed on this topic! I was taking plant people calm and mind CBD oil every single morning from 2018 to early 2021 with incredible benefits, got expensive though. Then I had a cervical spine surgery and got hooked on opiates for 5 months whilst stopping cbd. I went to a suboxone doctor and got a prescription and have been on it for about 9 months. I was at 4mg and now I’m at 2mg once per day, so thankfully no high doses. 3 months ago I decided to mix in my CBD in the morning and actually felt kind of terrible after for some reason, I felt brain fog and anxious, so I stuck solely with the suboxone. Starting yesterday I switched to night and had not problem, so I took again tonight and all seems well. I’m assuming that one day I took it was an anomaly and hope to be off suboxone in two months based on your program. Any thoughts or comments would be much appreciated!