New Study investigates CBD for Cannabis Use Disorder

Time to be honest – while many Australians smoke cannabis occasionally or regularly, chronic and everyday smoking can cause a range of health and social problems that together are known as Cannabis Use Disorder.

Australia has a long history with the cannabis plant, going back at least to the First Fleet when head botanist Joseph Banks brought hemp seeds with him on the voyage for making sails and rope.

In the 1960s and 70s, the country saw a cannabis boom that went hand in hand with the rise of the hippy era. And now that medical cannabis is legal in Australia, cannabis is increasingly seen as a normal part of healthcare, with hundreds of thousands of Australians being prescribed medicinal cannabis since 2019.

Cannabis has even been decriminalised to some extent in South Australia, Queensland, Victoria, the Northern Territory and the Australia Capital Territory. Similarly, in NSW, the Cannabis Cautioning Scheme means many people only receive a warning when caught with less than 15 grams.

Today, cannabis is considered by many Australians to be a socially acceptable drug, as well as an effective medicine for a range of health conditions.

What is Cannabis Use Disorder? When do you know you have a problem with your cannabis use?

But what happens when cannabis use ‘goes wrong’? The negative impact of regular and long-term cannabis smoking has been written about in research, including research that focuses on Cannabis Use Disorder.

Cannabis Use Disorder (or CUD) is a medical condition that refers to when a person continues to use cannabis despite experiencing long-term (physical, psychological or social) harms, and finds it difficult to control or stop their use.

To get diagnosed with Cannabis Use Disorder, a person has to meet a number of criteria. These include:

• spending more money or time than planned on cannabis use,

• facing challenges with work or social situations due to their cannabis use,

• neglecting friends or family to smoke cannabis,

• experiencing ongoing physical or mental health problems,

• using more and more cannabis to get the same effects (tolerance), and

• experiencing withdrawal symptoms when trying to stop — about 50% of people who use cannabis daily will experience cannabis withdrawal when they stop, which include symptoms like cravings, feeling anxious, sleep problems, irritability and loss of appetite, sweating, nausea, gut cramps, and depression. Symptoms typically start within 1-2 days of stopping and usually last for several days, although some symptoms (mood or sleep problems) may continue for several weeks.

As well as being the symptoms doctors use to diagnose Cannabis Use Disorder, these are also common reasons why people decide to quit smoking weed. A lot of people who use cannabis attempt to quit or reduce their use at different points in their lives.

Some people find that cutting down isn’t a problem and don’t need medical treatment. With a little bit of motivation, some find that stopping weed with no medications or reductions – aka going “cold turkey” – worked for them. Others use various medications (e.g. to help with sleep or manage their mood) to help them get through the withdrawal stage.

However, as with dependence on other drugs, getting through withdrawal is only part of the issue, many people return to using cannabis regularly again after stopping. That is where longer-term treatment may be of use for those who wish to stop completely.

Cannabis Use: Treatment Options

A lot of people have quit smoking weed before – you’re not alone if you’re trying to reduce your use or cut it out completely. If you’re using more cannabis than you’d like to, or think that you might have Cannabis Use Disorder, you have a range of options for treatment. These include:

• Self-help and peer support groups: These sorts of groups, such as SMART Recovery, can be a great option for many people trying to quit using cannabis.

• Counselling: Some will find that counselling with a psychologist or counsellor helps them rethink or change their relationship with cannabis. Counselling is the most common treatment for Cannabis Use Disorder across Australia. Counselling generally is used to help motivate people to change their cannabis use, and can give them the skills to stop using and stay off of it.

• Medication: Whilst short-term use of medications for sleep and anxiety can help people get through withdrawal, researchers have not yet found any pharmaceutical medications that help people reduce their cannabis use long term.

In the last few years, there has been some promising research looking into using extracts from cannabis to assist people with quitting – particularly with cannabidiol (CBD) which is a natural component/extract of the cannabis plant.

Unlike THC, the cannabis component which leads to the classic “high”, CBD does not cause intoxication (i.e. it will not get you stoned). It also doesn’t lead to dependence, so people don’t get withdrawals when they stop using CBD.

CBD is known to have a range of effects such as reducing anxiety, seizures, psychosis and possibly cannabis cravings. It is considered a form of ‘medicinal cannabis’ and is being increasingly used in Australia to treat anxiety, sleep problems, epilepsy and some pain conditions.

The research around using CBD products to help people reduce their cannabis use looks promising.

In France, CBD-containing products (oral liquid, vapes, CBD flower), are available ‘over-the-counter’ through tobacconists and health food stores (unlike in Australia where CBD is only legally available with a prescription from a doctor). Researchers in one French study looked at the experience of people using over-the-counter CBD to help them reduce their cannabis use. They found that many people reported successfully using CBD to reduce the amount of cannabis they were smoking, and that CBD helped some people manage their cannabis withdrawal symptoms.

This study builds on other small yet positive clinical trials – and suggests CBD may be a useful medication to help people control their cannabis use.

What is the CBD-CUD study and why is it important?

The CBD-CUD study is a new study looking at treatment of cannabis use disorder. Led by the University of Sydney and rolling out across sites in Sydney, Newcastle and Melbourne, the study focuses on whether CBD (in combination with counselling) can help people with cannabis use disorder reduce their cannabis use.

Researchers from USYD, including Prof Nick Lintzeris and NUAA’s CEO Mary Ellen Harrod, are leading the study, using a ‘randomised placebo-controlled’ trial. In this type of trial, half the people entering the study are chosen randomly to get CBD, and the other half get a ‘placebo’ (a substance that looks and tastes the same but has no CBD or other drug).

Clients and treatment staff will not know which medication (CBD or placebo) a client gets until after the study has finished and data is analysed. Basically, the study is looking at whether CBD (alongside counselling) will be more effective than no drug (the placebo) in helping people to use less cannabis (or stop using cannabis completely).

From the study brief: “The treatment being investigated in this study differs from the standard treatment offered for treating cannabis use disorder (CUD) at this clinic because of its use of the drug, cannabidiol (CBD), a medication that has been recently found to have properties that may be useful in treating cannabis use disorder. Treatment of cannabis use disorder usually only involves counselling and does not include the use of medications. The study will look at whether CBD provides benefits for people in addition to counselling provided as part of the study.”

How to get involved in the CBD-CUD study?

Are you interested in being a participant in the trial? If you’re a regular cannabis user looking to cut down or stop completely, you may be eligible to take part. If you decide to join the study and are eligible, you will be given either a CBD-based medication or placebo to take every day, and will meet with clinical staff and researchers about once every 3 weeks over the 12-week treatment period, and again 12 weeks after treatment has stopped to see the longer term effects of the study. Counselling is provided as part of the study (face-to-face or by telehealth). All parts of the treatment (medication, counselling, doctor appointments) are free to study participants.

There are trial sites in Newcastle, Sydney (Eastern and Southern Suburbs), North Sydney, Western Sydney, and Melbourne, so if you’re in one of those areas you might be a suitable participant. The study is recruiting approximately 250 individuals across all the trial sites. The sub-set of the study also aims to look at the outcomes for Aboriginal people with Cannabis Use Disorder and encourages Aboriginal people to apply.

This trial is only for people who are already interested in reducing or stopping their cannabis use – if you have no issue with the amount of cannabis you are using, there’s no reason for you to be involved. Participants will be reimbursed for their expenses throughout the trial in the form of Eftpos gift cards, which you can use anywhere in person. Check out the poster below, and follow the QR code or this link for more information about the study.

Trying to reduce to a level that you are comfortable with, that doesn’t break the bank, and gives you room for other things in your life again is a great way to go.

If you’re not sure about how to go about reducing or quitting, or you’re after a little bit of extra help and support, you can find out about alcohol and other drug treatment services (e.g. counselling, withdrawal, self-help programs) by contacting PeerLine on 1800 644 413.

Call 0431 519 495 to find out whether the CBD-CUD study is be right for you.