Adjunctive Cannabidiol in Inpatient Buprenorphine Treatment for Opioid Use Disorder: A Pilot Randomized Trial

Area of Science:

• Addiction Medicine
• Psychopharmacology
• Clinical Trials

Background:

• Medications for opioid use disorder (MOUD) are effective, but relapse remains a challenge.
• Cannabidiol (CBD) shows potential for reducing cravings and improving treatment outcomes.
• This study investigates CBD as an add-on therapy for MOUD.

Purpose of the Study:

• To evaluate the safety and tolerability of adjunctive cannabidiol (CBD) with buprenorphine in an inpatient setting.
• To assess the preliminary efficacy of CBD in reducing opioid craving, withdrawal, and affective symptoms.
• To explore potential pharmacokinetic interactions between CBD and buprenorphine.

Main Methods:

• A randomized, double-blind, placebo-controlled trial involving adults with opioid use disorder.
• Participants received oral CBD (600 mg/day) or placebo for 28 days alongside buprenorphine.
• Safety was monitored via adverse events and lab tests; efficacy assessed through craving, withdrawal, and mood symptom changes.

Main Results:

• Adjunctive CBD was safe and well-tolerated, with no serious adverse events. Gastrointestinal issues were the most common side effect in both groups.
• No significant pharmacokinetic interactions were observed between CBD and buprenorphine.
• Both CBD and placebo groups showed reductions in craving and negative affect; cue-induced craving trended towards greater improvement with CBD.

Conclusions:

• Adjunctive CBD is safe and well-tolerated when used with buprenorphine for MOUD treatment.
• This pilot study did not demonstrate a clear clinical advantage of CBD over placebo.
• Larger clinical trials are necessary to confirm the utility of CBD in MOUD treatment.