Mongeau-Pérusse Violaine, Rizkallah Elie, Morissette Florence, Brissette Suzanne, Bruneau Julie, Dubreucq Simon, Gazil Guillaume, Trépanier Annie, Jutras-Aswad Didier
From the Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis Street, Montréal, QC H2X 0A9, Canada (VM-P, ER, FM, SB, JB, SD, AT, DJ-A); Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, 2900 Édouard-Montpetit Boulevard, Montréal, QC H3T 1J, Canada 4 (VM-P, ER, FM, SD, AT, DJ-A); Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, 2900 Édouard-Montpetit Boulevard, Montréal, QC H3T 1J4, Canada, (SB, JB); Unité de recherche clinique appliquée (URCA), Research Center, CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada, (GG); Institut universitaire sur les dépendances, 950 Louvain East Street, Montréal, QC H2M 2E8, Canada (DJ-A).
J Addict Med. 2022;16(5):521-526. doi: 10.1097/ADM.0000000000000959. Epub 2022 Feb 8.
Individuals with a cocaine use disorder (CUD) are more likely to present anxiety, which in turn negatively impacts substance use outcomes. Some evidence suggests that cannabidiol (CBD) presents anxiolytic properties and could be a treatment for substance use disorders. This study explores CBD's effect on stress biomarker (cortisol) and anxiety symptoms in people with CUD.
Exploratory analyses were conducted using data from a randomized, double-blind, placebo-controlled trial evaluating CBD's efficacy to treat CUD. We randomized 78 individuals with CUD into receiving a daily oral dose up to 800 mg CBD (n = 40) or placebo (n = 38). The trial was divided into 2 phases: an inpatient detoxification lasting 10 days and an outpatient follow-up lasting 12 weeks. Anxiety symptoms and stress response were assessed using a visual analog scale, the Beck Anxiety Inventory, and cortisol levels at multiple time points throughout the study. We also measured anxiety after a stressful and a cocaine-cue scenarios. We used generalized estimating equations models and multiple linear regression to assess CBD's effects on anxiety and cortisol levels.
Both treatment groups had similar mean anxiety scores according to the Beck Anxiety Inventory ( P = 0.27) and the visual analog scale ( P = 0.18). CBD did not decrease anxiety after a stressful ( P = 0.14) and a cocaine ( P = 0.885) scenarios compared with placebo. No statistically significant group difference was found in cortisol levels ( P = 0.76).
We found no evidence for 800 mg of CBD to be more efficacious than placebo for modulating anxiety symptoms and cortisol levels in individuals with CUD.
患有可卡因使用障碍（CUD）的个体更易出现焦虑，而焦虑又会对物质使用结果产生负面影响。一些证据表明，大麻二酚（CBD）具有抗焦虑特性，可能是治疗物质使用障碍的一种方法。本研究探讨CBD对CUD患者应激生物标志物（皮质醇）和焦虑症状的影响。
使用一项评估CBD治疗CUD疗效的随机、双盲、安慰剂对照试验的数据进行探索性分析。我们将78名CUD患者随机分为两组，一组每日口服高达800 mg的CBD（n = 40），另一组服用安慰剂（n = 38）。试验分为两个阶段：为期10天的住院戒毒期和为期12周的门诊随访期。在整个研究过程中的多个时间点，使用视觉模拟量表、贝克焦虑量表评估焦虑症状和应激反应，并测量皮质醇水平。我们还在应激和可卡因提示场景后测量焦虑情况。我们使用广义估计方程模型和多元线性回归来评估CBD对焦虑和皮质醇水平的影响。
根据贝克焦虑量表（P = 0.27）和视觉模拟量表（P = 0.18），两个治疗组的平均焦虑得分相似。与安慰剂相比，在应激（P = 0.14）和可卡因（P = 0.885）场景后，CBD并未降低焦虑。在皮质醇水平上未发现具有统计学意义的组间差异（P = 0.76）。
我们没有发现证据表明，对于调节CUD患者的焦虑症状和皮质醇水平，800 mg的CBD比安慰剂更有效。
