Posted on

cbd oil and oxycodone

Many drugs are broken down by enzymes in the liver, and CBD may compete for or interfere with these enzymes, leading to too much or not enough of the drug in the body, called altered concentration. The altered concentration, in turn, may lead to the medication not working, or an increased risk of side effects. Such drug interactions are usually hard to predict but can cause unpleasant and sometimes serious problems.

Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.

CBD can alter the effects of other drugs

The researchers further warned that while the list may be used as a starting point to identify potential drug interactions with marijuana or CBD oil, plant-derived cannabinoid products may deliver highly variable cannabinoid concentrations (unlike the FDA-regulated prescription cannabinoid medications previously mentioned), and may contain many other compounds that can increase the risk of unintended drug interactions.

Researchers from Penn State College of Medicine evaluated existing information on five prescription CBD and delta-9-tetrahydrocannabinol (THC) cannabinoid medications: antinausea medications used during cancer treatment (Marinol, Syndros, Cesamet); a medication used primarily for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the US, but available in other countries); and an antiseizure medication (Epidiolex). Overall, the researchers identified 139 medications that may be affected by cannabinoids. This list was further narrowed to 57 medications, for which altered concentration can be dangerous. The list contains a variety of drugs from heart medications to antibiotics, although not all the drugs on the list may be affected by CBD-only products (some are only affected by THC). Potentially serious drug interactions with CBD included

Absolutely. Inhaled CBD gets into the blood the fastest, reaching high concentration within 30 minutes and increasing the risk of acute side effects. Edibles require longer time to absorb and are less likely to produce a high concentration peak, although they may eventually reach high enough levels to cause an issue or interact with other medications. Topical formulations, such as creams and lotions, may not absorb and get into the blood in sufficient amount to interact with other medications, although there is very little information on how much of CBD gets into the blood eventually. All of this is further complicated by the fact that none of these products are regulated or checked for purity, concentration, or safety.

“Both cannabis and CBD are commonly used to treat these symptoms and can be very beneficial to patients while detoxing to make it easier for them to complete the detox,” anesthesiologist and pain medicine physician Anand Dugar, MD, tells WebMD Connect to Care. “In addition, New Mexico, New Jersey, New York and Pennsylvania specifically allow patients with an opiate disorder to become medical cannabis patients because of the benefit of medical cannabis in helping these patients wean off opiates.”

Researchers have discovered many benefits of cannabis and CBD oil. CBD and medical cannabis products have been used to help with pain, anxiety, and sleep problems, among other ailments. But can cannabis products help you successfully detox from OxyContin? While there are some promising studies, more research is needed in order to quantify the efficacy of cannabis as an opioid withdrawal aid. We asked medical experts to weigh in.

CBD Oil and OxyContin Detox

One of the current research gaps is the lack of randomized double-blinded placebo-controlled trials demonstrating that cannabis can effectively reduce the effects of opioid withdrawal. Randomized double-blinded placebo-controlled trials are a gold standard of epidemiologic studies.

Drug cravings are a major hurdle for people detoxing from OxyContin and other opioids, according to the U.S. Department of Health and Human Services. According to a 2019 study published in the American Journal of Psychiatry, CBD oil significantly reduced cravings and anxiety in patients detoxing from opioid drugs. Reduced cravings can not only make the detox experience more tolerable but can also decrease the chance of relapse.

“Although further research is needed, in select populations that include addictions to alcohol, opioids or other substances, medical cannabis may dampen the behaviors that contribute to relapse,” physician and Cannalogue CEO Mohan Cooray, MD, FRCPC, tells WebMD Connect to Care.

Many promote cannabis as a safe and effective drug for chronic pain management, and have gone as far to argue that cannabis can reduce the need for opioid pain medications. At the same time, it is well appreciated that the co–use of certain substances is generally associated with poorer outcomes than single substance use. In this study, authors found that individuals with chronic pain who combine opioids and cannabis are not functioning as well as those who are only using opioids. Although the exact nature of this relationship is unclear, the results may have implications for medical cannabis in the context of chronic pain management.

C ompared to participants using opioids alone to manage chronic pain, those combining opioids with cannabis endorsed greater anxiety and depression. Notably, participants combining opioids and cannabis were also more likely to be taking opioids not as prescribed and had greater scores on an opioid dependence severity scale , and were more likely to be using tobacco, alcohol, cocaine, and sedatives. This overall pattern of poorer functioning and risky substance use is illustrated in the figure below. At the same time, participants combining opioids and cannabis reported pain levels similar to those using opioids alone .


Figure 1. Graph showing differences between study participants using opioids alone (grey bars), and opioids in conjunction with cannabis (black bars) to manage chronic pain. Measures are reported as estimated marginal means (vertical axis); in other words, the mean response for each measure, adjusted for the other reported measures. The asterisk (*) indicates a highly significant difference at the p< 0.005 level, meaning the differences observed are highly unlikely to be due to chance. It is important to note that the range of possible scores on each measure is different. Participants combining opioids and cannabis reported more anxiety and depression, were more likely to be using opioids not as prescribed and endorse more symptoms associated with opioid dependence, and were more likely to be using tobacco, alcohol, cocaine, and sedatives. PHQ-4 Anx= Anxiety, PHQ-4 Dep= Depression, GCPS Intensity= Pain intensity, GCPS Disability= Pain disability, COMM Total= Current not as prescribed opioid use, SDS Total= Severity of opioid dependence (Source: Rogers et al., 2018).

Also, these individuals were possibly purchasing cannabis from the illicit market in which strains with higher THC contents predominate (the compound in cannabis that causes euphoria/high). This study cannot tease apart whether CBD (a compound in cannabis thought to have some therapeutic benefits but does not cause euphoria/high) in combination with opioids for chronic pain would be associated with different mental health and substance use outcomes.

This cross-sectional study surveyed 450 United States adults who endorsed taking opioids to manage chronic pain. Of these 450 people, 176 endorsed also using cannabis for pain management. Participants were asked about their opioid and cann a bis use, as well as any use of other substances , including nicotine. Participants were also assessed for opioid use problems , a s well as anxiety and depression. Questionnaires administered included 1) the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) , an 8-item questionnaire designed to asses risk of substance use involvement , 2) the p atient Health Questionnaire-4 (PHQ-4) , a 4-item self-report measure comprised of the PHQ-2 for depression and the GAD-2 for anxiety , 3) t he Current Opioid Misuse Measure (COMM) that is used to identify individuals who are exhibiting behaviors of problematic opioid use , 4) the Severity of Dependence Scale (SDS) , a measure severity of dependence to opioids , and 5) t he Graded Chronic Pain Scale (GCPS) , a measure that assesses pain intensity and pain disability . The authors statistically controlled for differences among study participants in age, sex, income, and education.