This case study illustrates the use of cannabidiol (CBD) oil to decrease the addictive use of marijuana and provide anxiolytic and sleep benefits. Addiction to marijuana is a chronic, relapsing disorder, which is becoming a prevalent condition in the United States. The most abundant compound in the marijuana, which is called tetrahydrocannabinol (THC), has been widely studied and known for its psychoactive properties. The second most abundant component—CBD—has been suggested to have the medicinal effects of decreasing anxiety, improving sleep, and other neuro-protective effects. The mechanism of action for CBD has been suggested to be antagonistic to the psychoactive properties of THC in many locations within the central nervous system. Such action raises the issue of whether it might be beneficial to use CBD in isolation to facilitate withdrawal of marijuana use. The specific use of CBD Vape Oil for marijuana reduction has not been widely studied.
The patient was a 27-y-old male who presented with a long-standing diagnosis of bipolar disorder and a daily addiction to marijuana use. In the described intervention, the only change made to the patient’s treatment was the addition of CBD oil with the dosage gradually decreasing from 24 to 18 mg. With use of the CBD oil, the patient reported being less anxious, as well as settling into a regular pattern of sleep. He also indicated that he had not used any marijuana since starting the CBD oil. With the decrease in the dosage to 18 mg, the patient was able to maintain his nonuse of marijuana.
Cannabidiol (CBD) oil is a naturally occurring constituent of industrial hemp and marijuana collectively called cannabis. CBD oil is one of at least 85 cannabinoid compounds found in cannabis and is popular for its medicinal benefits. After tetrahydrocannabinol (THC), which is the most abundant compound in cannabis, CBD is the second most abundant. Other names for CBD oil include CBD-rich hemp oil, hemp-derived CBD oil, or CBD-rich cannabis oil. CBD is generally considered to be safe and has been used medicinally for decades. The suggested medicinal effects of CBD include decreasing anxiety, improving sleep, and providing other neuroprotective effects.
THC is a cannabinoid and is the component that induces the euphoric psychoactive effect. Various cannabis plants can have different amounts of CBD and THC depending on the strain, and, thus, can provide different recreational or medicinal effects. The cannabinoid profile of industrial hemp or medical marijuana is ideal for people looking for the medical benefits of CBD without the high of the THC. The mechanism of action for CDB has been suggested to be antagonistic to the psychoactive properties of THC in many locations within the central nervous system, thus helping to attenuate the psychoactive behaviors of THC.1,2
The mechanism of action of CBD is multifold.3,4,5 Two cannabinoid receptors are known to exist in the human body: CB1 and CB2 receptors. The CB1 receptors are located mainly in the brain and modulate neurotransmitter release in a manner that (1) prevents excessive neuronal activity, thus calming and decreasing anxiety; (2) reduces pain; (3) decreases inflammation; (4) regulates movement and posture control; and (5) controls sensory perception, memory, and cognitive function.4
Anandamide, an endogenous ligand that occurs naturally within our bodies, binds to the CB1 receptors through the G-protein coupling system. CBD has an indirect effect on the CB1 receptors by stopping the enzymatic breakdown of anandamide, allowing it to stay in the system longer and to provide its medical benefits.6 CBD has a mild effect on the CB2 receptors, which are located in the periphery of the lymphoid tissue. The CBD helps to mediate the release of cytokines from the immune cells in a manner that helps to reduce inflammation and pain.4
Other mechanisms of action of CBD include stimulation of vanilloid pain receptors, such as the transient receptor potential cation channel subfamily V member 1 (TRPV-1) receptor, which are known to mediate pain perception, inflammation, and body temperature.7 CBD may also exert its antianxiety effects by activating adenosine receptors that play a significant role in cardiovascular function, causing a broad anti-inflammatory effect throughout the body.7 At high concentrations, CBD directly activates the 5-HT1A serotonin receptor, thereby conferring an antidepressant effect.8CBD has been found to be an antagonist at a potentially new third cannabinoid receptor (ie, G protein-coupled receptor 55, or GPR55), which resides in the caudate nucleus and putamen and can contribute to osteoporosis when stimulated.9
Since the 1940s, a considerable number of published articles have addressed the chemistry, biochemistry, pharmacology, and clinical effects of CBD.10 The last decade has shown a notable increase in the scientific literature on CBD, owing to its identification as being beneficial in reducing nausea and vomiting, combating psychotic disorders, decreasing inflammation, lessening anxiety, reducing depression, improving sleep, and increasing a sense of well-being.11,12,13,14 Findings presented at the 2015 International Cannabinoid Research Society at their 25th Annual Symposium in Nova Scotia, Canada, reported that use of CBD was beneficial for treatment of liver fibrosis and inflammation, metabolic syndrome, overweight and obesity, anorexia/cachexia syndrome, and osteoarthritic and other musculoskeletal conditions.15
Although studies have demonstrated the calming, anti-inflammatory, and relaxing effects of CBD, clinical data demonstrating the use of CBD to obtain help in marijuana withdrawal is minimal. One prior case study by Crippa et al16 documented the positive effects of using CBD for the treatment of marijuana withdrawal. The current case study offers further evidence that CBD is effective as a safe method of transitioning off marijuana without unwanted side effects.