Kritičen pogled na uporabo kanabidiola za zdravljenje odvisnosti

Jokan, Janja (author), Štrukelj, Borut (mentor)

Ozadje: Različne odvisnosti imajo uničujoče posledice za posameznike in družbo, saj vplivajo na delo, odnose in zdravje ljudi. Kljub temu, da obstaja že kar nekaj zdravil, še vedno v veliko primerih pride do ponovnega poseganja po drogi, zato zdravljenje odvisnosti predstavlja velik klinični izziv. Na osnovi modernejših študij v zadnjem času veliko pozornosti zbuja CBD, predvsem zaradi protivnetnih in nevroprotektivnih učinkov ter zmanjšanja odtegnitvenih simptomov pri odvisnikih. Hkrati pa ne povzroča psihoaktivnosti in drugih neželenih učinkov. Namen: Pregled literature in izdelava sistematičnega, kritičnega pregleda do sedaj objavljenih raziskav, ki so vrednotile vpliv CBD-ja na odvisnost (od nikotina, konoplje, alkohola in opioidov). Metode: Najprej smo določili iskalni profil, s pomočjo katerega smo v neodvisni zbirki člankov PubMed našli 291 člankov. Po pregledu naslovov, povzetkov in vsebine smo neustrezne članke odstranili iz pregleda. Dodali pa smo še enega, ki smo ga našli pri pregledu literature v ostalih člankih. Skupno je tako po podrobnem pregledu ostalo 27 člankov, ki so ustrezali vsem vključitvenim in izključitvenim kriterijem. Izsledke smo nato na kratko predstavili ter interpretirali dobljene rezultate. Rezultati: Terapija s CBD-jem, glede na vključene študije, predstavlja obetavne rezultate zdravljenja odvisnosti pri rednih uporabnikih droge. Pri občasnih uporabnikih pa bi bilo, glede na rezultate študij, bolje ubrati druge pristope zdravljenja. V različnih študijah so dokazali, da CBD posredno in neposredno vpliva na odvisnost in je učinkovita podpora na več različnih nivojih za zdravljenje odvisnosti. Zdravljenje odvisnosti s CBD-jem je smiselno tako v akutnih fazah, kot tudi dolgoročno. Pozitivne učinke dosežemo že z zmanjšanjem nevrodegeneracije, vnetnih procesov, vplivom na izboljšanje spomina, srčnega ritma in normaliziranjem genske ekspresije ter ravni receptorjev v telesu. Poleg tega pa CBD vpliva tudi na zmanjšanje hrepenenja po drogi, odtegnitvenih simptomov, tesnobe, depresije, stresa in razdražljivosti. Za samo učinkovitost CBD-ja so pomembni odmerki ter spol odvisnikov pa tudi želja posameznika, da opravi z odvisnostjo in ostali pristopi, s katerimi se lotimo zdravljenja. Pri tem mislimo predvsem kombinacijo zdravljenja s kognitivno-vedenjsko terapijo in motivacijskimi intervjuji.

• Language: Slovenian
• Keywords: odvisnost, odtegnitveni simptomi, CBD, THC, Sativex, Nabiximol
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2020
• PID: 20.500.12556/RUL-124083
• Publication date in RUL: 25.12.2020

Secondary language

• Language: English
• Title: Critical view on cannabidiol use for addiction treatment

Abstract

Background: Different addictions can have devastating consequences for individuals and society because they affect people’s work, relationships, and health. Even though there are already quite a few drugs for addiction treatment, in many cases there is still present drug relapse, so the treatment of addiction is a major clinical challenge. Based on many recent studies, CBD has attracted a lot of attention, mainly due to its anti-inflammatory and neuroprotective effects and the reduction of withdrawal symptoms in addicts. At the same time, it does not cause psycho-activity and other side effects. Aim: To review literature and create a systematic, critical review of studies, that has been published until now and has evaluated the impact of CBD on addiction (of nicotine, cannabis, alcohol, and opioids). Methods: At the beginning, we defined a search profile. With this search profile we found 291 articles in the independent article database, PubMed. After reviewing the titles, abstracts, and table of contents, we removed irrelevant articles from the review. We added another one, found when reviewing the literature in other articles. A total of 27 articles that met all inclusion and exclusion criteria remained after a detailed overview. The results were then briefly presented, and results interpreted. Results: According to the included studies, CBD therapy presents promising results in addiction treatment in regular drug users. On the other hand, it would be better for occasional users to take other treatment approaches. Various studies have shown that CBD directly and indirectly affects addiction and is an effective support at several different levels for addiction treatment. Addiction treatment with CBD makes sense in the acute stages and long term. Positive effects are achieved by reducing neurodegeneration, inflammatory processes, improving memory, heart rate and normalizing gene expression and receptor levels in the body. In addition, CBD also has the effect of reducing drug cravings, withdrawal symptoms, anxiety, depression, stress, and irritability. The doses and gender of addicts are important for the effectiveness of CBD, as well as the individual's desire to deal with addiction and other approaches to treatment. The best approach would be a combination of treatment with cognitive-behavioral therapy and motivational interviews.

• Keywords: addiction, withdrawal symptoms, CBD, THC, Sativex, Nabiximol