The Efficacy of Cannabidiol in Substance Use Disorder Management

Substance use disorders (SUDs) represent a significant public health concern, impacting millions globally and contributing to a vast array of health complications and mortality. Traditional treatment options often fall short, leading to increased interest in alternative therapies, including cannabinoids like cannabidiol (CBD). CBD, a non-psychoactive compound found in cannabis, has been investigated for its potential therapeutic effects in managing various SUDs, particularly due to its pharmacological properties that interact with the endocannabinoid system (ECS).

Recent studies have shown that CBD may help in reducing cravings and withdrawal symptoms associated with substance use, particularly in alcohol and opioid use disorders. For instance, evidence suggests that CBD can attenuate the anxiety and stress responses triggered by drug-related cues, thereby reducing the likelihood of relapse (Redonnet et al., 2025). Additionally, CBD has demonstrated anti-inflammatory and neuroprotective effects, which may further support its use in the treatment of SUDs (Redonnet et al., 2025).

Comparison of Cannabidiol Alone versus Combination with THC

The therapeutic effects of CBD are often compared with those of Δ-9-tetrahydrocannabinol (THC), the primary psychoactive component of cannabis. While both compounds have shown promise in treating SUDs, their effects can differ significantly based on their mechanisms of action and the resulting pharmacological profiles.

Studies indicate that CBD may be particularly effective when used in combination with THC, as the two compounds can work synergistically to enhance therapeutic outcomes. For instance, nabiximols, a medication that combines CBD and THC, has been shown to effectively reduce withdrawal and craving symptoms in individuals with cannabis dependence (Redonnet et al., 2025). In contrast, CBD alone has not consistently demonstrated efficacy across various SUDs, particularly in terms of reducing long-term substance use or achieving complete abstinence (Redonnet et al., 2025).

Treatment Type	Efficacy in Reducing Cravings	Efficacy in Long-term Abstinence
Cannabidiol Alone	Mixed evidence	Limited efficacy
Cannabidiol + THC	Positive effects	Enhanced outcomes

Mechanisms of Action: How Cannabidiol Affects Addiction Pathways

Understanding the mechanisms by which CBD influences addiction pathways is crucial for its application in treating SUDs. The ECS plays a pivotal role in regulating mood, reward, and memory, which are fundamental aspects of addiction behavior. CBD’s interaction with the ECS, particularly its modulation of cannabinoid receptors, leads to a variety of neurophysiological effects that may mitigate the reinforcing properties of addictive substances.

Research suggests that CBD can enhance the activity of serotonin receptors, which are involved in mood regulation and can help alleviate anxiety, a common trigger for substance use and relapse (Redonnet et al., 2025). Furthermore, CBD may influence the release of dopamine in response to drug-related cues, effectively dampening the cravings associated with substance use.

Additionally, the anti-inflammatory properties of CBD may also play a role in reducing the neuroinflammation often observed in individuals with SUDs. By modulating inflammatory pathways, CBD could potentially create a neuroprotective environment that helps restore balance in the brain’s reward circuitry, thereby reducing the likelihood of relapse (Redonnet et al., 2025).

Review of Recent Systematic Findings on Cannabidiol and SUD

Recent systematic reviews have provided a comprehensive overview of the efficacy of CBD in treating SUDs. These reviews highlight the inconsistencies in findings, with some studies reporting positive outcomes, particularly for alcohol and opioid use disorders, while others fail to demonstrate significant effects (Redonnet et al., 2025).

For example, in a meta-analysis of randomized controlled trials (RCTs), it was found that CBD significantly reduced cravings and withdrawal symptoms in patients with alcohol use disorder. However, the evidence for its effect on complete abstinence remains inconclusive (Redonnet et al., 2025). Similarly, while CBD has shown promise in reducing opioid cravings, the variability in study designs and populations complicates the interpretation of results.

The following table summarizes key findings from recent systematic reviews regarding the efficacy of CBD in managing SUDs:

Substance Use Disorder	Efficacy of CBD	Notes
Alcohol Use Disorder	Moderate efficacy	Reduces cravings and withdrawal symptoms
Opioid Use Disorder	Promising effects	Reduces cravings but limited long-term abstinence data
Cannabis Use Disorder	Mixed evidence	Positive effects when combined with THC

Implications for Future Research on Cannabidiol in Addiction Treatment

The existing body of research on CBD’s role in treating SUDs suggests several essential directions for future studies. First, more robust RCTs are needed to clarify the efficacy of CBD alone and in combination with THC across various substance use disorders. These studies should aim to standardize dosing regimens, assess long-term outcomes, and include diverse populations to enhance the generalizability of findings.

Moreover, exploring the biochemical and neurophysiological mechanisms of CBD will provide valuable insights into its therapeutic potential. Understanding how CBD interacts with the ECS and other neurotransmitter systems will aid in developing targeted interventions.

Finally, investigating the safety and tolerability of CBD, particularly in populations with existing health conditions or those taking other medications, is crucial. Adverse events and interactions should be thoroughly documented to ensure that CBD can be safely integrated into comprehensive treatment plans for individuals with SUDs.

FAQ

Is CBD effective for treating substance use disorders?

CBD has shown potential in reducing cravings and withdrawal symptoms associated with certain substance use disorders, particularly alcohol and opioids. However, evidence regarding its efficacy for achieving long-term abstinence is mixed.

Can CBD be used alone for SUD treatment?

While CBD can provide benefits, combining it with THC may enhance therapeutic effects, particularly for conditions like cannabis use disorder. CBD alone has not consistently demonstrated significant results in all SUDs.

What are the mechanisms by which CBD works?

CBD interacts with the endocannabinoid system, affecting mood, memory, and reward pathways. It also has anti-inflammatory properties that may help mitigate neuroinflammation associated with addiction.

What does future research on CBD for SUDs look like?

Future research should focus on well-designed randomized controlled trials to establish clear efficacy and safety profiles of CBD alone and in combination with THC, as well as mechanisms of action in various SUD populations.

Are there any side effects of using CBD for SUDs?

While CBD is generally well-tolerated, patients should consult healthcare providers about potential interactions with other medications and monitor for any adverse effects.

References

Redonnet, B., Eren, F., Avenin, G., Melchior, M., & Mary‐Krause, M. (2025). Efficacy of cannabidiol alone or in combination with Δ‐9‐tetrahydrocannabinol for the management of substance use disorders: An umbrella review of the evidence. Addiction
Jogendran, M., Huynh, L., & Flemming, J. A. (2025). Alcohol Use Disorder Pharmacotherapy in Patients With Alcohol-Related Liver Disease: A Scoping Review. Canadian Journal of Gastroenterology & Hepatology
Examining the genetic relationship between Alzheimer’s disease, schizophrenia and their shared risk factors using genomic structural equation modelling. (2025). https://pubmed.ncbi.nlm.nih.gov/11981896/