Le Kelvin, Au Joanne, Hua Jean, Le Khang Duy Ricky
Melbourne Medical School, The University of Melbourne, Melbourne, AUS.
Department of Anaesthesia & Pain Management, The Royal Melbourne Hospital, Melbourne, AUS.
Cureus. 2023 Dec 16;15(12):e50634. doi: 10.7759/cureus.50634. eCollection 2023 Dec.
Opioid use disorder (OUD) is a significant cause of morbidity and mortality worldwide and is linked to a complex interplay of biopsychosocial factors as well as the increasing overprescription and availability of opioid medications. Current OUD management relies on the controlled provision of opioid medications, such as methadone or buprenorphine, known as opioid replacement therapy. There is variable evidence regarding the long-term efficacy of these medications in improving the management of OUD, thereby necessitating an exploration into innovative approaches to complement, or even take the place of, existing treatment paradigms. Cannabidiol (CBD), a non-psychoactive compound derived from the cannabis plant, has garnered attention for its diverse pharmacological properties, including anti-inflammatory, analgesic, and anxiolytic effects. Preliminary studies suggest that CBD may target opioid withdrawal pathways that make CBD a potential therapeutic option for OUD. This narrative review synthesises current literature surrounding OUD and offers a nuanced review of the current and future role of CBD in managing this condition. In doing so, we highlight the potential avenues to explore with respect to CBD research for the guidance and development of further research opportunities, framework and policy development, and clinical considerations before medicinal CBD can be integrated into evidence-based clinical guidelines.
阿片类物质使用障碍(OUD)是全球发病和死亡的重要原因,与生物心理社会因素的复杂相互作用以及阿片类药物的过度处方和可得性增加有关。目前对OUD的管理依赖于对阿片类药物(如美沙酮或丁丙诺啡)的控制性供应,即所谓的阿片类药物替代疗法。关于这些药物在改善OUD管理方面的长期疗效,证据不一,因此有必要探索创新方法来补充甚至取代现有的治疗模式。大麻二酚(CBD)是一种从大麻植物中提取的无精神活性化合物,因其多样的药理特性(包括抗炎、镇痛和抗焦虑作用)而受到关注。初步研究表明,CBD可能作用于阿片类物质戒断途径,这使CBD成为OUD的一种潜在治疗选择。这篇叙述性综述综合了围绕OUD的现有文献,并对CBD在管理这种疾病中的当前和未来作用进行了细致入微的综述。在此过程中,我们强调了在将药用CBD纳入循证临床指南之前,在CBD研究方面需要探索的潜在途径,以指导和开发进一步的研究机会、框架和政策制定以及临床考量。