Can cannabis or THC help ease opioid withdrawal symptoms? | Research

The takeaway

Some evidence suggests cannabis and THC may reduce opioid withdrawal symptoms, but the therapeutic window appears narrow and results are inconsistent.

People interested in opioid withdrawal treatment alternatives and harm reduction approaches.

4 of 9 observational studies linked cannabis to reduced opioid withdrawal

What the researchers found

Of 11 studies with 5,330 participants, four observational studies found cannabis use was associated with reduced opioid withdrawal, one found worsening symptoms, and four found no association. Two RCTs showed dronabinol (synthetic THC) reduced withdrawal but also increased abuse liability and dysphoria.

Why it matters

Six U.S. states have authorized cannabinoids as opioid substitutes, but the evidence base for this approach remains weak and contradictory.

The numbers in context

11 studies, 5,330 total participants (64% male). Four of nine observational studies found withdrawal alleviation; two RCTs showed THC helped but with dose-dependent side effects.

How the study worked

Systematic review searching multiple databases through July 2022 for studies examining the association between opioid withdrawal and cannabis use or THC administration.

What this study cannot tell us

High heterogeneity in how opioid withdrawal was measured and in baseline opioid type and dose across studies.

How to read the evidence

Systematic review, but high heterogeneity and inconsistent findings across studies limit confidence.

When this study was published

Published in 2022 with studies searched through July 2022.

The bigger picture

The mixed results highlight the complexity of using cannabinoids for opioid withdrawal, where patient characteristics and pharmacological factors create unpredictable interactions.

Questions still open

What is the optimal dosing window for THC in opioid withdrawal? Can CBD or other cannabinoids provide withdrawal relief without the abuse liability seen with THC?

Common questions

Did cannabis consistently reduce opioid withdrawal symptoms?

No. Results were mixed: four observational studies found an association with reduced withdrawal, one found worsening, and four found no effect.

What happened in the clinical trials with synthetic THC?

Two RCTs found dronabinol (synthetic THC) reduced opioid withdrawal symptoms, but also produced dose-dependent increases in abuse liability, dysphoria, and rapid heart rate.

Read the original research

Alleviation of opioid withdrawal by cannabis and delta-9-tetrahydrocannabinol: A systematic review of observational and experimental human studies.

Drug and alcohol dependence, 241, 109702

View on PubMed ↗Publisher’s paper ↗

Citation

De Aquino, Joao P; Bahji, Anees; Gómez, Oscar; Sofuoglu, Mehmet. (2022). Alleviation of opioid withdrawal by cannabis and delta-9-tetrahydrocannabinol: A systematic review of observational and experimental human studies.. Drug and alcohol dependence, 241, 109702. https://doi.org/10.1016/j.drugalcdep.2022.109702