An opioid-withholding human laboratory paradigm during opioid agonist treatment for opioid use disorder and chronic pain: Phase- and dose-dependent effects of cannabidiol.
Gabriel P A Costa, Mehmet Sofuoglu, Peggy Compton et al.
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In 30 seconds
This randomized controlled trial investigated the effects of cannabidiol (CBD) on pain modulation, craving, and cognition in 23 individuals with opioid use disorder (OUD) and chronic pain receiving opioid agonist treatment (OAT). Results indicated that CBD enhanced descending pain inhibition pre-OAT, with a significant linear dose-response observed at 800 mg and 1200 mg (p = 0.034). However, post-OAT, 1200 mg CBD worsened heat pain sensitivity compared to placebo (p = 0.017).
Key findings
- CBD enhanced descending pain inhibition pre-OAT with a significant linear dose-response (p = 0.034).
- At 1200 mg post-OAT, CBD significantly reduced heat pain threshold compared to placebo (p = 0.017).
- CBD showed no significant effects on opioid craving.
- Cognitive performance remained stable across all CBD doses.
Why it matters
Understanding the effects of CBD in patients with co-occurring OUD and chronic pain is crucial, as it may inform non-opioid adjunct therapies. The phase-dependent effects observed suggest that timing of CBD administration relative to OAT is important for optimizing pain management.