The Opioid Epidemic & CBD: One Doctor’s Perspective

December 31, 2017

During last week’s Ask a Doctor session, we came across an interesting question regarding the connection between CBD and the Opioid Epidemic…

Question: I use THC because I have pain & anxiety and my doctor refuses to prescribe oxycodone because of the “opioid epidemic” – so I use THC instead.
The plant-derived CBD seems much “cleaner”, safer, and effective, and I’m going to switch to CBD. My question though, is what is causing the “opioid epidemic?”

Dr Zachar: Most people start taking opioids because they have physical pain. The physical pain usually improves, and may even resolve. But there are two problems.

Firstly, the more opioid you take, the more opioid you need to take to get the same relief, because there is a downgrading of the sensitivity of the cell surface receptor.
The person become dependent, and often addicted to the opioid.

Secondly, Pain is physical. Pain is also mental. Both types of pain can be horrific. The physical pain can be seen. The emotional pain cannot.

Opioids feed both types of pain. But result in dependence, addictive, and worse.
Why? Because, opioids bind to the CB1 receptor (the same receptor that THC binds to) and causes the locus ceruleus to release dopamine. The more the CB1 receptor is activated, the less responsive the CB1 receptor becomes to the opioid.
Consequently, more & more opioid is needed to “wake up” the CB1 receptor to “tell” the locus ceruleus to release dopamine.

“Here lies the rub,” to borrow a quote from Shakespeare…

The patient starts taking opioids because of physical pain. The patient realizes that the dopamine release makes him feel better. The “feel better” is misinterpreted as feeling better from the physical pain, but, the feeling better is often actually due to relieving the emotional pain. Pain is pain.

It is very hard for one to understand consciously if one is feeling physical pain or emotional pain. Both types of pain are real.
Interestingly, all studies about pain show that the pain that leads to suicide is not physical pain. It is emotional pain.

Herein lies the “slippery slope” that leads to so many to become addicted to opioids. This is why there is an opioid epidemic.

[Image credit- Pixabay]

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