Daily Dose Q&A

2025-05-08
What is the rationale for using CBD as a pharmacotherapy for substance use disorder (SUD)?
"The use of CBD as a pharmacotherapy for SUD is supported by evidence indicating its action on multiple molecular targets and neural circuits involved in addiction -5HT1A, MOR [Mu opioid receptor] and DOR [Delta opioid receptor], TRPV1, CB1,CB2 and others." MORs mediate the effects of endogenous opioids (beta-endorphins) as well as exogenous opioids (morphine). MOR play a key role in producing analgesia, euphoria, and in the development of tolerance and dependence—all of which are critical factors in addiction processes. DORs are involved in modulating mood, emotional responses, and have been implicated in reducing anxiety and producing antidepressant effects. Also, DORs contribute to the overall modulation of reward and reinforcement pathways.
Kieffer, B. L. & Gaveriaux‐Ruff, C. (2002). Exploring the opioid system by gene knockout. Progress in Neurobiology, 66(5), 285–306. and Manzoni OJ, Manduca A, Trezza V. Therapeutic potential of cannabidiol polypharmacology in neuropsychiatric disorders. Trends in Pharmacological Sciences. Vol 46, Issue 2 Feb 2025.
2025-05-07
If THC and CBD have the same chemical formula, why do their pharmacological properties differ?
"While both compounds share the same molecular formula (C21H30O2), they differ in chemical structure: Δ9-THC contains a cyclic ring, whereas CBD has a hydroxyl group. This small structural difference results in markedly distinct pharmacological properties. Notably, CBD lacks the intoxicating effects of Δ9-THC and demonstrates minimal abuse potential"
Manzoni OJ, Manduca A, Trezza V. Therapeutic potential of cannabidiol polypharmacology in neuropsychiatric disorders. Trends in Pharmacological Sciences. Vol 46, Issue 2 Feb 2025.
2025-05-06
What are the mechanisms in which THC and CBD impact pain sensation?
According to a British Medical Journal (BMJ) article, "THC inhibits glutamate and 5-hydroxytryptamine release and increases dopamine secretion. CBD enhances adenosine receptor signaling, and decreases reactive oxygen species, tumour necrosis factor, and T cell proliferation, without the psychoactive effects of THC. The multifaceted analgesic and anti-inflammatory properties of cannabinoids may positively influence the perception of pain across different conditions."
BMJ - Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline. BMJ 2021;374:n2040.
2025-05-05
Does abrupt discontinuation of CBD use lead to a withdrawal syndrome?
No. In a 2020 study evaluating abuse liability of CBD, it was found that “abrupt withdrawal of CBD after 4 weeks of use (750 mg twice daily taken orally) did not result in any symptoms of physical withdrawal.”
Kirkland AE, Fadus MC et al.. A scoping review of the use of cannabidiol in psychiatric disorders. Psych Resear. 308 (2022)
2025-05-02
For what health conditions are patients using CBD therapeutics?
A case series that assessed treatment applications reported by CBD users in public testimonials on the Reddit forum r/CBD was conducted. A random sample of posts was drawn (n = 3000) and filtered to include posts in which self-identified CBD users testified why they take CBD (n = 376). Psychiatric conditions (e.g., autism or depression) were the most frequently cited subcategory, mentioned in 63.9% of testimonials, followed by orthopedic (26.4%), sleep (14.6%), and neurological (6.9%) conditions. Testimonials also claimed that CBD treated gastroenterological conditions (3.9%), as well as addiction, cardiological, dermatological, ophthalmological, oral health, and sexual health conditions (<2.0% each).
Leas EC, Hendrickson EM, Nobles AL, et al. Self-reported Cannabidiol (CBD) Use for Conditions With Proven Therapies. JAMA Network Open. 2020 Oct;3(10):e2020977. DOI: 10.1001/jamanetworkopen.2020.20977. PMID: 33057645; PMCID: PMC7563067.