Can CBD interact with cocaine? Can it help overcome drug addiction?
- A 2019 study revealed that CBD was able to reverse the toxicity and seizures caused by cocaine, as well as the motivation to take cocaine and methamphetamine (meth)(1).
- It also showed that CBD could be a promising treatment for substance use disorders(2).
- Observational studies also imply that CBD “may reduce problems related to crack-cocaine addiction, such as withdrawal symptoms, craving, impulsivity and paranoia (Fischer et al., 2015).”(3)
- Another research conducted by Friedbert Weiss, PhD of Scripps Research Institute focused on the development of behavioural methods that can accurately model certain aspects of human drug-seeking behaviour in animals. During the behavior tests, which included stressful and anxiety-provoking situations, the rats did not display any sign of drug-seeking behavior. Five months later, the involved animals still proved to be free from relapse caused by stress or drug cues(4).
- Clinical trials and studies are still needed to fully gauge CBD’s potential to treat substance abuse and disorders.
Does CBD Interact with Cocaine?
What is Cocaine
Cocaine is a strongly-addictive stimulant drug that can have a detrimental effect on the mental health of the user. It is brewed from the leaves of the coca plant which originally came from South America. Although it can serve as local anesthesia for surgeries, cocaine is known as an illegal recreational drug.
Cocaine is known to give short-term pleasurable effects which is one of the main reasons why cocaine abuse has become a global phenomenon.
What is CBD
Cannabinoids, like CBD and tetrahydrocannabinol (THC), are chemicals found in cannabis plants. The most popular kinds of cannabis plants are marijuana and hemp plants.
Cannabidiol or CBD is the second active ingredient of cannabis. CBD can be pressed out from either marijuana or hemp. Hemp plants, or industrial hemp, contain a high amount of CBD, and a lesser percentage of THC, the primary psychoactive compound that brings about euphoria. Hemp naturally has 0.3% THC.
Medical marijuana, or medical cannabis, is the marijuana plant used to treat health issues.
Can CBD Be Taken with Cocaine?
Individually, cocaine and marijuana can already be damaging to the user. Thus, taking cannabinoids along with cocaine can have detrimental effects. The risks of using them together are amplified, which may even lead to a cocaine overdose(5).
Stimulants like cocaine, amphetamines, methamphetamine (meth), methylphenidate (MPH), and amphetamine-dextroamphetamine are often used and misused to boost physical strength, improve performance at work or school, control one’s appetite or lose weight.
A 2014 study by The U.S. National Library of Medicine National Institutes of Health which presents that the combination of low to moderate dosages of MPH and THC resulted to a significantly higher heart rate which caused an increase in cardiovascular strain(6).
In the same manner as with THC, using CBD along with any kind of stimulant must be only upon the prescription of a medical professional.
Can CBD Treat Cocaine Craving and Reduce Addiction Relapse?
A 2019 study reveals that CBD could be a promising treatment for substance use disorders(7). CBD was able to reverse the toxicity and seizures caused by cocaine, as well as the motivation to take cocaine and methamphetamine. Observational studies also imply that CBD “may reduce problems related to crack-cocaine addiction, such as withdrawal symptoms, craving, impulsivity and paranoia (Fischer et al., 2015).”(8)
A team from Scripps Research Institute also facilitated a research to verify if it can decrease cocaine craving and treat cocaine addiction. The recent studies conducted by the Scripps Research Institute in Neuropsychopharmacology explained that CBD activates the brain’s serotonin receptors(9).
The leader of the investigative team, Friedbert Weiss, and his research associate, Gustavo Gonzalez-Cuevas, focused on the development of behavioral methods that can accurately model certain aspects of human drug-seeking behavior in animals.
Since drug cravings and relapse in humans occur take place when they are exposed to drug-related environmental stimuli and stressful setting, Weiss’s team experimented on rats that had become dependent on cocaine and alcohol, which led to substance addiction.
The researchers then applied a gel which contained CBD to the skin of the rats being studied. The team repeated the process once daily for an entire week.
During the behavior tests, which included stressful and anxiety-provoking situations, the rats did not display any sign of drug-seeking behavior. Five months later, the involved animals still proved to be free from relapse caused by stress or drug cues.
Friedbert Weiss pointed out, “The results provide proof of principle supporting the potential of CBD in relapse prevention along two dimensions: beneficial actions across several vulnerability states, and long-lasting effects with only brief treatment.”
He added, “Drug addicts enter relapse vulnerability states for multiple reasons. Therefore, effects such as these observed with CBD that concurrently ameliorate several of these are likely to be more effective in preventing relapse than treatments targeting only a single state.”
While the results of these studies are on the affirmative, clinical trials and studies are still needed to fully gauge CBD’s potential to treat substance abuse and disorders.
Effects of Cocaine Addiction
Generally, cocaine consumption affects all systems in the body, but its primary target is the central nervous system (CNS).
Cocaine blocks the reuptake of neurotransmitters in the neuronal synapses, and this mechanism affects the CNS(10).
Some of the short-term side effects of substance abuse include:
- Extreme happiness
- Sensitivity to touch, sound, and sight
- Loss of appetite
- Irritability or anger
- Fast or irregular heartbeat
- Tremors and muscle twitches
However, heavy and frequent usage of cocaine can lead to more severe health issues, such as:
- Seizures and convulsions
- Heart disease, heart attack, or stroke
- Mood swings
- Lung damage
- Memory loss
- Sleep problems
Using cocaine can be destructive to anyone, but the injurious effect can be greater for pregnant women.
American Addiction Centers stated that pregnant women who abuse cocaine consumption may suffer from anemia, skin infections, and malnutrition. It may also cause anxiety, severe postpartum depression, and suicidal thoughts(11).
It can also affect the unborn baby. Taking cocaine during the early stage of the pregnancy may yield to miscarriage, and can also cause placental abruption, decrease blood flow in the uterus, and preterm labor(12).
What Causes Cocaine Addiction?
The National Survey on Drug Use and Health (NSDUH) revealed in a 2014 survey that there were close to 1.5 million cocaine users in the United States aged 12 or older (6 out of 10 of the population)(13).
In a latter report, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) said nearly 1.9 million people aged 12 or older used cocaine in 2016, and almost half a million people engaged in using crack cocaine (crystal form of cocaine)(14).
A 2006 review published by the U.S. National Library of Medicine National Institutes of Health emphasized results that the endocannabinoid system (ECS) has a crucial role in the neurobiological mechanism underlying drug addiction. It engages in the rewarding effects of nicotine, cannabinoids, opioids, and alcohol(15).
Once cocaine is inhaled, snorted, or injected, the drug increases the amount of dopamine in the body. It serves as the chemical messenger into the parts of the brain which control pleasure. As a result, the body experiences heightened alertness and increase in energy, or what is generally known as “high.”
In an attempt to continuously experience the same high, people tend to use cocaine more frequently and in an increased dosage until it becomes a habit. Eventually, trying to stop using drugs can become painful and can cause intense cravings and withdrawal symptoms.
According to The National Institute of Drug Abuse (NIDA), withdrawal happens when a drug-dependent person suddenly stops using substances after a long time. Withdrawal symptoms include insomnia, muscle and bone pain, cold flashes, and vomiting. It may also come with depression or dysphoria (opposite of euphoria) which can last for weeks(16).
Treatments for Cocaine Addiction
Behavioural therapy may be used to help treat cocaine addiction.
Behavioural therapy includes:
- cognitive-behavioural therapy, or psychotherapy with a mental health counsellor
- Incentive-based initiatives for recovering addicts who remain substance-free
- 12-step programs for addiction recovery
According to the National Institute of Drug Abuse (NIDA), there are currently no government-approved medicines available to treat cocaine addiction(17).
Despite the benefits of CBD, Peter Grinspoon, MD, a professor of medicine at Harvard Medical School, advises the public through a Harvard health article to be wary of the health risks that it may pose. Some of the side effects of CBD include nausea, fatigue, and irritability(18). It may also increase the level of blood thinners like coumadin.
Notably, CBD is primarily sold as a dietary supplement and not a medicinal alternative. The Food and Drug Administration (FDA) does not regulate nutritional supplements. FDA also discourages the “use of CBD, THC, and marijuana in any form during pregnancy and while breastfeeding.”(19)
It is always highly encouraged to consult a licensed medical professional for general health care advice or to alleviate symptoms of specific ailments.
Lopez, C. C., Pardo, M. P. G., & Aguilar, M. A. (2019). Cannabidiol Treatment Might Promote Resilience to Cocaine and Methamphetamine Use Disorders: A Review of Possible Mechanisms. Molecules, 24(14). doi: https://doi.org/10.3390/molecules24142583
Gonzalez-Cuevas, G. et al. Unique treatment potential of cannabidiol for the prevention of relapse to drug use: Preclinical proof of principle, Neuropsychopharmacology DOI: 10.1038/S41386-018-0050-8
National Institute on Drug Abuse. Source: https://www.drugabuse.gov/publications/drugfacts/marijuana
U.S. National Library of Medicine National Institutes of Health. Published online 2014 Aug 7. doi: 10.1016/j.jsat.2014.07.014. An exploratory study of the combined effects of orally administered methylphenidate and delta-9-tetrahydrocannabinol (THC) on cardiovascular function, subjective effects, and performance in healthy adults. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250392/
Cannabidiol Treatment Might Promote Resilience to Cocaine and Methamphetamine Use Disorders: A Review of Possible Claudia Calpe-Lopez, et al., 2019) Retrieved from https://www.researchgate.net/publication/334517310_Cannabidiol_Treatment_Might_Promote_Resilience_to_Cocaine_and_Methamphetamine_Use_Disorders_A_Review_of_Possible_Mechanisms
Lopez and Pardo, op. cit.
Gonzalez-Cuevas, G., op.cit.
Gonzalez-Cuevas, G., op.cit.
U.S. National Library of Medicine National Institutes of Health. Int J Clin Pharmacol Ther Toxicol. 1993 Dec;31(12):575-81. Cocaine and the Nervous System. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/8314357
American Addiction Centers. Dangers of Cocaine in Pregnancy. Retrieved from https://americanaddictioncenters.org/cocaine-treatment/dangers-pregnancy
American Addiction Centers. Dangers of Cocaine in Pregnancy. Retrieved from https://americanaddictioncenters.org/cocaine-treatment/dangers-pregnancy
National Institute on Drug Abuse. What Is the Scope of Cocaine Use in the United States? Source: https://www.drugabuse.gov/publications/research-reports/cocaine/what-scope-cocaine-use-in-united-states
Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
Pharmacol Biochem Behav. 2005 Jun;81(2):396-406. The role of endocannabinoid transmission in cocaine addiction. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15925401
National Institute on Drug Abuse https://www.drugabuse.gov/about-nida/frequently-asked-questions)
National Institute on Drug Abuse (May 2016). How Is Cocaine Addiction Treated? Source: https://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers
Harvard Health Publishing, Harvard Medical School. (2019, August 27). Peter Grinspoon, MD. Source: https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
U.S. Food and Drug Administration Source: https://www.fda.gov/consumers/consumer-updates/what-you-should-know-about-using-cannabis-including-cbd-when-pregnant-or-breastfeeding
Neonatal Hair Test for Cocaine: Toronto Experience
In large US cities, an estimated 10% to 45% of women cared for at teaching hospitals use cocaine during pregnancy. Between June 1990 and December 1991, we conducted a prevalence study of cocaine use during pregnancy in one inner-city and two suburban metropolitan Toronto hospital nurseries and found 37 of 600 (6.25%) infants tested positive for cocaine.
Since the neonatal hair test for cocaine was established in 1989 and its use as a research tool for ascertaining the prevalence of use in the Toronto area was confirmed, physicians, hospital nurseries, and social welfare agencies (e.g., Children’s Aid) have increasingly requested analysis of neonatal hair to corroborate or refute clinical suspicion of cocaine use during pregnancy when urine test results were negative.
This report should help establish the sensitivity of clinical suspicion of in utero exposure to cocaine as validated by hair testing.
The hypothesis underlying this research was that use of the hair test in cases of clinical suspicion but negative urine test results would yield a substantially higher prevalence rate than expected in the general population.
Samples for Neonatal Hair Test for Cocaine
Between October 1991 and April 1995, we analyzed hair samples from 192 neonates and four mother-infant pairs. Among the neonatal hair samples provided for analysis, 10 did not contain sufficient hair to analyze for cocaine metabolites, but 55 (30%) of the remaining 182 samples tested positive for the cocaine metabolite benzoylecgonine. Most samples (72%) were sent from hospital nurseries and clinics. The rest were sent from social welfare agencies and privately practicing physicians.
Neonatal Hair Test for Cocaine: The Results
Whether all newborns should be screened for exposure to cocaine is continually under debate. The complex relationships between maternal and fetal rights and the extremely heterogenous views on drug testing in western societies make it unlikely that routine screening will ever take place.
Our results suggest strongly that it might be sufficient to test suspected cases based on nonspecific signs of cocaine exposure and not take on the enormous cost and ethical-legal liabilities inherent in universal testing.
Confirmation of in utero exposure to cocaine might allow for earlier intervention to ensure proper care for both baby and mother.
Both mother and infant should be closely followed with postnatal care, supportive counseling, contraceptive counseling, public health nurse visits, and training in parenting skills. Evidence shows that interventions such as home visits benefit children’s early development.
Publications on Recreational/Social Drugs: Cocaine
Morris P, Binienda Z, Gillam MP, Klein J, McMartin K, Koren G, Duhart HM, Slikker W Jr, Paule MG: The effect of chronic cocaine exposure throughout pregnancy on maternal and infant outcomes in the rhesus monkey. Neurotoxicology & Teratology. 19(1):47-57, 1997 Jan-Feb.
Koren G, Graham K, Shear H, Einarson T: Bias against the null hypothesis; The reproductive hazards of cocaine. Lancet 2: 1440-1442, 1989.
Nulman I, Rovet J, Altman D, Bradley C, Einarson T, Koren G: Neurodevelopment of adopted children exposed in utero to cocaine. Can Med Assoc J 151: 1591-1597, 1994.
Eliopoulos C, Klein J, Koren G: Neonatal markers for intrauterine exposure to cocaine and nicotine. Can J Obstet Gynecol 6: 615-620, 1994.
Forman R, Graham K, Klein J, Greenwald M, Koren G: Accumulation of cocaine in fetal hair; The dose response curve. Life Sci 50: 1333-1341, 1992.
Forman R, Klein J, Meta D, Barks J, Greenwald M, Koren G: Maternal and neonatal characteristics following exposure to cocaine in Toronto. Reprod Toxicol 7: 619-622, 1993.
Forman R, Klein J, Meta D, Barks J, Greenwald M, Koren G: Prevalence of fetal exposure to cocaine in Toronto 1990-1991. Clin Invest Med 17: 206-211, 1994.
Graham K et al: Pregnancy outcome and infant development following gestational cocaine use by social cocaine user. Koren G (ed): Maternal-Fetal toxicology, 2nd edition, Marcel Dekker, NY 371-386, 1994.
Graham K, Demitrakoudis D, Pellegrini E, Koren G: Pregnancy outcome following first trimester exposure to cocaine in non addict social users in Toronto. Vet Hum Toxicol 31: 143-148, 1988.
Graham K, Klein J, Forman R, Flynnk, Sakuma T, Davidson W, Koren G: Potential misclassification of a case of SIDS: Maternal and neonatal hair analysis for cocaine and heroin. Maternal Fetal Med 2: 91-93, 1993.
Graham K, Koren g, Klein J, Schneiderman J: Determination of gestational cocaine exposure by hair analysis. JAMA 262: 3328-3330, 1989.
Graham K, Koren G: Characteristics of pregnant women exposed to cocaine in Toronto between 1985 and 1990. Can Med Assoc J 144: 563-568, 1991.
Graham K, Koren G: Maternal cocaine use and risk of sudden infant death J Pediatr 115: 333, 1989.
Johnson D, Schwartz H, Forman R, Klein J, Jacobson, S, Greenwald M, Koren G: Assessment of in utero exposure to cocaine; Radioimmunoassay testing for benzoylecgonine in meconium, neonatal hair and maternal hair. Can J Clin Pharmacol 1: 83-86, 1994.
Addis A, Moretti M, Syed FA, Einarson TR, Koren G. Fetal effects of cocaine: an updated meta-analysis. Reprod Toxicol 15 (4): 341-69, 2001.
Nulman I, Rovet J, Greenbaum R, Loebstein M, Wolpin J, Pace-Asciak P, Koren G. Neurodevelopment of adopted children exposed in utero to cocaine: the Toronto Adoption Study. Clin Invest Med 2001 Jun;24(3):129-37
Klein J, Eliopoulos C, Ursitti F, Koren G: Issues in measuring cocaine and nicotine in neonatal hair. NIDA monograph (In Press)
Klein J, Forman R, Eliopoulos C, Koren G: A method of simultaneous measurement of cocaine and nicotine in neonatal hair. Ther Drug Monit 16: 67-70, 1994.
Klein J, Greenwald M, Becker L, Koren G: Fetal distribution of cocaine: Case analysis. Ped Pathol, 12: 463-468, 1992.
Koren G et al: Biological markers of intrauterine exposure to cocaine and cigarette smoking. Koren G (ed): Maternal-Fetal Toxicology, 2nd edition, Marcel Dekker, NY 387-398, 1994.
Koren G, Klein J, Forman R, Graham K, My-Khan P: Biological markers of intrauterine exposure to cocaine and cigarette smoking. Dev Pharmacol Ther 18: 228-236, 1992.
Koren G, Klein J, Forman R, Graham K: Hair Analysis of cocaine: Differentiation between systemic exposure and external contamination. J Clin Pharmacol 32: 671-675, 1992.
Koren G, Klein J, Graham K, Forman R: Hair test to verify gestational cocaine exposure. In: Recent Developments in TDM and Clin Toxicology Marcel Dekker, NY 569-574, 1992.
Koren G: Cocaine use by pregnant women in Toronto; An alarming note. IM Paint 11: 20-21, 1995 (Winter).
Koren G: Cocaine and the human fetus: The concept of teratophilia. Neurotoxicol & Teratol, 15: 301-304, 1993. No abstract available.
Levy M, Koren G: Obstetric and neonatal effects of drugs of abuse. Emerg Med N Amer 8: 633-652, 1990.
Lutiger B et al: Relationship between gestational cocaine use and pregnancy outcome. Koren G (ed): Maternal-Fetal Toxicology, 2nd edition, Marcel Dekker, NY 353-370, 1994.
Lutiger B, Graham K, Einarson T, Koren G: Relationship between gestational cocaine use and pregnancy outcome: A meta-analysis. Teratology 44: 405-414, 1991.
Koren G, Gladstone D, Robeson C, Robieux I: The perception of teratogenic risk of cocaine. Teratology 46: 567-571, 1992.
Potter S, Klein J, Valiante G, Stack DM, Papageorgiou A, Stott W, Lewis D, Koren G, Zelazo PR: Maternal cocaine use without evidence of fetal exposure. J Pediatr 125: 652-654, 1994.
Ursitti F, Klein J, Koren G: Clinical utilization of the neonatal hair test for cocaine: a four-year experience in Toronto. Biology of the Neonate 1997;72(6):345-351