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Does CBD Help or Harm Sobriety?

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The process of recovery is different for every person. For some, it includes the use of CBD. However, this is a controversial topic. Many believe that the use of any psychoactive substance, including prescribed medication, interferes with sobriety. And if you’re deciding whether or not CBD will play a role in your recovery journey, it’s important to remember that recovery isn’t about following universal rules. It’s a way to build a life that feels healthy for you.

CBD, or cannabidiol, is one of hundreds of active ingredients in cannabis. It’s readily—and legally—available in many areas. As more and more U.S. states legalize marijuana use, for medical and/or recreational purposes ((State medical marijuana laws. (n.d.). Retrieved October 14, 2021, from https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx)), CBD will likely become even more accessible.

Some areas have also decriminalized marijuana ((Cannabis overview. (n.d.). Retrieved October 14, 2021, from https://www.ncsl.org/research/civil-and-criminal-justice/marijuana-overview.aspx)), with or without officially making it legal. According to the National Conference of State Legislatures, “This generally means certain small, personal-consumption amounts are a civil or local infraction, not a state crime (or are a lowest misdemeanor with no possibility of jail time).” This speaks to a cultural shift in perspective.

Cannabis is becoming more socially acceptable and more accessible over time ((Recent medical marijuana research. (n.d.). NORML. Retrieved October 14, 2021, from https://norml.org/marijuana/library/recent-medical-marijuana-research/)). As this trend continues, more researchers are studying its potential medical applications. Some of this research centers around the use of cannabis to treat mental health ((Can marijuana ease mental health conditions? (n.d.). Https://Www.Apa.Org. Retrieved October 14, 2021, from https://www.apa.org/monitor/2018/12/marijuana)). Some evidence suggests that CBD, in particular, may be beneficial for people in recovery from substance use.

What is CBD?

CBD is a cannabinoid ((Cannabinoids—Alcohol and drug foundation. (n.d.). Retrieved October 14, 2021, from https://adf.org.au/drug-facts/cannabinoids/)). That is, it’s a chemical substance that interacts with the human body’s cannabinoid receptors. Cannabis plants are believed to produce between 80-100 different cannabinoids. You may be more familiar with THC, which is the most prevalent cannabinoid we know of, and which produces a “high.” CBD is “the second most prevalent active ingredient in cannabis ((MD, P. G. (2018a, August 24). Cannabidiol (Cbd)-what we know and what we don’t. Harvard Health. https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
)).”

The Chemistry of CBD

There is much research to be done on all cannabinoids, including THC and CBD. However, these two chemicals are the best-known, and most-researched, cannabinoids to date.

Many experts describe a simple difference between these two compounds: THC is psychoactive, and CBD is not ((What is CBD? The “miracle” cannabis compound that doesn’t get you high. (2018, May 28). The Guardian. https://www.theguardian.com/society/2018/may/28/what-is-cbd-cannabidiol-cannabis-medical-uses)). However, this may be an oversimplification. According to one source, “A chemical is considered psychoactive when it acts primarily on the central nervous system and alters brain function, resulting in temporary changes in perception, mood, consciousness or behavior.” Despite this distinction, it remains true that CBD, unlike THC, is not intoxicating.

There is a clear reason for this: CBD and THC have different neurochemical effects ((Does cbd get you high? Understand the difference between cbd and thc. (2019, August 23). Healthline. https://www.healthline.com/health/does-cbd-get-you-high)). Both CBD and THC act on the brain’s cannabinoid type 1 (CB1) receptors. “THC activates these receptors. This causes a euphoria or the high associated with marijuana. CBD, on the other hand, is a CB1 antagonist. It blocks any intoxicating impact caused by the CB1 receptors. Taking CBD with THC may inhibit the effects of THC. In other words, CBD may block the high effects.” Even without the feeling of intoxication, CBD has a noticeable impact on brain chemistry, and may be able to treat both physical and emotional symptoms.

The Experience of CBD

Research suggests that CBD may be helpful in treating anxiety, insomnia, chronic pain, inflammatory conditions and symptoms associated with substance use disorders ((MD, P. G. (2018a, August 24). Cannabidiol (Cbd)-what we know and what we don’t. Harvard Health. https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476)). Some people use it to help with acute symptoms, such as panic attacks and pain flare-ups. Others take it daily, in order to manage chronic conditions.

CBD is available in a number of forms. Tinctures can be added to food or taken sublingually, delivering the cannabinoid directly to the bloodstream. Vape oils and high-CBD plant strains can be inhaled, taking effect more quickly but lasting for a shorter time. Lotions and salves are used topically, for a greater impact on localized physical pain.

The effects of CBD can last for a matter of hours ((How long does cbd stay in your system? (2019, December 12). Healthline. https://www.healthline.com/health/how-long-does-cbd-stay-in-your-system)), depending on the dosage and your metabolism. In some cases, it can cause mild side effects like nausea, dizziness, and fatigue.

Medical Applications of CBD

Because it’s a relatively new subject of study, experts still have much to learn about the benefits and risks of CBD. To date, it’s believed to have a variety of medical applications.

Reportedly, more than 60% of CBD users find that it alleviates anxiety ((MacKeen, D. (2019, October 16). What are the benefits of cbd? The New York Times. https://www.nytimes.com/2019/10/16/style/self-care/cbd-oil-benefits.html)). In 2018, a purified version of the chemical was approved as a treatment for rare pediatric seizure disorders. It also regulates the perception of pain ((Vučković, S., Srebro, D., Vujović, K. S., Vučetić, Č., & Prostran, M. (2018). Cannabinoids and pain: New insights from old molecules. Frontiers in Pharmacology, 9, 1259. https://doi.org/10.3389/fphar.2018.01259)). Because of this, it may be helpful in treating conditions like fibromyalgia, chronic back pain, and rheumatoid arthritis.

There is some controversy about cannabis as a treatment for mental health conditions. However, preliminary research suggests that CBD may have antidepressant and antipsychotic qualities. And experts agree that CBD is a promising area of study in the treatment of people with addiction ((Kessler, F. H., von Diemen, L., Ornell, F., & Sordi, A. O. (2021). Cannabidiol and mental health: Possibilities, uncertainties, and controversies for addiction treatment. Brazilian Journal of Psychiatry. https://doi.org/10.1590/1516-4446-2021-1838)).

CBD and Substance Use Disorders

A steadily growing body of research suggests that CBD may alleviate many of the symptoms associated with substance use disorders. According to one study, “the fact that patients with substance use disorders often present with various psychiatric and medical symptoms that are reduced by CBD ((Hurd, Y. L., Yoon, M., Manini, A. F., Hernandez, S., Olmedo, R., Ostman, M., & Jutras-Aswad, D. (2015). Early phase in the development of cannabidiol as a treatment for addiction: Opioid relapse takes initial center stage. Neurotherapeutics, 12(4), 807–815. https://doi.org/10.1007/s13311-015-0373-7))—symptoms such as anxiety, mood symptoms, insomnia, and pain” suggests that this cannabinoid may help people in various stages of detox and recovery.

CBD is an especially promising option for people healing from opiate use. This is because certain cannabinoid receptors are co-localized with opioid receptors in the brain. As a result, CBD can have a direct impact on these receptors, which may help during withdrawal and detox.

Also, many people who overuse opiates do so because they experience physical pain. Because pain relief is one effect of CBD, the cannabinoid may decrease the underlying symptoms that lead to substance use.

Studies show that CBD may also have a positive effect on people recovering from the use of cocaine and methamphetamines ((Calpe-López, C., García-Pardo, M. P., & Aguilar, M. A. (2019). Cannabidiol treatment might promote resilience to cocaine and methamphetamine use disorders: A review of possible mechanisms. Molecules, 24(14), 2583. https://doi.org/10.3390/molecules24142583)). Specifically, it has been shown to reverse “toxicity and seizures induced by cocaine, behavioural sensitization induced by amphetamines, [and the] motivation to self-administer cocaine.”

Beyond its application for recovery from these specific substances, CBD may help to alleviate cravings and other withdrawal symptoms. According to one study, CBD can even help people quit smoking ((Morgan, C. J. A., Das, R. K., Joye, A., Curran, H. V., & Kamboj, S. K. (2013). Cannabidiol reduces cigarette consumption in tobacco smokers: Preliminary findings. Addictive Behaviors, 38(9), 2433–2436. https://doi.org/10.1016/j.addbeh.2013.03.011)).

While there are other medical treatments to aid in this process, CBD may be an even safer option, because it has a low risk of chemical dependency. “According to a report from the World Health Organization, ‘In humans, CBD exhibits no effects indicative of any abuse or dependence potential ((MD, P. G. (2018a, August 24). Cannabidiol (Cbd)-what we know and what we don’t. Harvard Health. https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476))…To date, there is no evidence of public health related problems associated with the use of pure CBD.’”

Am I Still Sober if I Use CBD?

Although CBD is not believed to be habit-forming, it is still a substance. And it’s important for people in recovery to be mindful of how they use all medications. Because of this, it may or may not be appropriate for a person in recovery to use CBD.

One important part of recovery is learning to define what health means specifically for you. And your definitions of health and sobriety may change over time. As you approach these issues, it’s extremely important to stay true to yourself, and be honest with your mental healthcare team. You might also connect with a community that defines sobriety in a particular way, which may impact how you view your own recovery process.

Total Abstinence

For some people, sobriety means total abstinence from all psychoactive substances ((Laudet, Alexandre B. “What Does Recovery Mean to You? Lessons from the Recovery Experience for Research and Practice.” Journal of Substance Abuse Treatment, vol. 33, no. 3, Oct. 2007, pp. 243–56. PubMed Central, https://doi.org/10.1016/j.jsat.2007.04.014. )), including prescribed psychiatric medication. This strict boundary may even impact the way you approach your physical health. For example, some people in recovery from opiate use refuse narcotic medications at all costs, even when they have surgery.

There is nothing inherently right or wrong about this perspective. It has become common enough that most doctors are able to accommodate their patients’ needs without the use of these medications. It’s not an easy path, but for many people, it’s the right one.

Harm Reduction

Not everyone commits to total abstinence. And not everyone should. Some serious mental health conditions make prescription medications an absolute necessity. For example, people with bipolar disorder may experience debilitating depression if they abstain from mood stabilizers. At the end of the day, sobriety is meant to be a path toward health, not away from it.

Even Alcoholics Anonymous takes a nuanced approach to the idea of abstinence ((The A.A. Member—Medications & Other Drugs. (n.d.). Alcoholics Anonymous. https://www.aa.org/assets/en_US/p-11_aamembersMedDrug.pdf)). They recommend that members who require medication continue to take it, but only if they can stay accountable to themselves, their communities, and their medical teams. It’s possible to use substances safely, if you’re doing so under appropriate supervision.

As cannabis use becomes more and more culturally acceptable, we are likely to learn more about the medical applications of CBD, especially as relates to recovery from substance use disorders. Because of this, it may become more widely used by people who still consider themselves to be sober.

The Risks of CBD

Despite promising research, there are still some risks associated with CBD use. Although it’s not believed to be habit-forming, it is still a cannabinoid. And many CBD products include trace amounts of THC, which can sometimes be addictive. Studies suggest that 9% of people who smoke cannabis develop a dependence on it ((Abuse, N. I. on D. (–). Is marijuana addictive? National Institute on Drug Abuse. https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive)). For those without substance use disorders, that may be an acceptable risk. For some people in recovery, it may be too dangerous.

If you plan to use CBD in response to a substance use disorder, proceed carefully. Make sure to talk to your treatment providers about its potential risks and benefits, and find out if it can interact with any of your other medications.

Whether or not CBD is right for you, it’s important to be fully honest with yourself, your support network, and your healthcare providers about your experience. For example, if you decide to use cannabis in response to acute panic attacks, and then find yourself using it daily, this may be a warning sign. As with any other substance, it’s best to be mindful of the emotions you associate with its use. Like many other substances, it’s possible to use CBD appropriately. It’s also possible to misuse it, or to overuse it.

Finding Balance, With or Without CBD

As cannabis use becomes less stigmatized, people are starting to question whether or not it interferes with sobriety. There’s not a clear answer to this. However, the same is true for most substances. If you’re recovering from cocaine use, can you still safely drink? If you’re recovering from opiate use, should you take Prozac? These questions are complicated, and the answers may vary from person to person. During rehab and recovery, you’ll likely start to define where the line is for you.

As you think about your personal history with substance use, you’ll start to distinguish between healthy and problematic behaviors. Are there ways you’ve used substances in the past that felt sustainable? In the process of recovery, are you still capable of approaching medication in that way? If you can incorporate CBD into a genuinely healthy lifestyle, it has many benefits. However, if you’re concerned about using it unsustainably, it may not be worth the risk.

With or without the aid of CBD, there are many ways to begin recovery. Learn more about private rehab programs here.

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