Commentary
Addressing the stimulant treatment gap: A call to investigate the therapeutic benefits potential of cannabinoids for crack-cocaine use

https://doi.org/10.1016/j.drugpo.2015.09.005Get rights and content

Highlights

  • Crack-cocaine use and related health and social harms are prevalent in the Americas.

  • Few effective treatment options exist for crack-cocaine use disorders.

  • Cannabinoids feature potential therapeutic benefits for crack-cocaine use related problems.

  • Cannabidiol (CBD) specifically may offer valuable therapeutic potential.

  • Research investigating cannabinoids’ therapeutic potential for problematic crack-cocaine use is needed.

Abstract

Crack-cocaine use is prevalent in numerous countries, yet concentrated primarily – largely within urban contexts – in the Northern and Southern regions of the Americas. It is associated with a variety of behavioral, physical and mental health and social problems which gravely affect users and their environments. Few evidence-based treatments for crack-cocaine use exist and are available to users in the reality of street drug use. Numerous pharmacological treatments have been investigated but with largely disappointing results. An important therapeutic potential for crack-cocaine use may rest in cannabinoids, which have recently seen a general resurgence for varied possible therapeutic usages for different neurological diseases. Distinct potential therapeutic benefits for crack-cocaine use and common related adverse symptoms may come specifically from cannabidiol (CBD) – one of the numerous cannabinoid components found in cannabis – with its demonstrated anxiolytic, anti-psychotic, anti-convulsant effects and potential benefits for sleep and appetite problems. The possible therapeutic prospects of cannabinoids are corroborated by observational studies from different contexts documenting crack-cocaine users’ ‘self-medication’ efforts towards coping with crack-cocaine-related problems, including withdrawal and craving, impulsivity and paranoia. Cannabinoid therapeutics offer further benefits of being available in multiple formulations, are low in adverse risk potential, and may easily be offered in community-based settings which may add to their feasibility as interventions for – predominantly marginalized – crack-cocaine user populations. Supported by the dearth of current therapeutic options for crack-cocaine use, we are advocating for the implementation of a rigorous research program investigating the potential therapeutic benefits of cannabinoids for crack-cocaine use. Given the high prevalence of this grave substance use problem in the Americas, opportunities for such research should urgently be created and facilitated there.

Section snippets

Conflict of interest

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. We confirm that the manuscript has been read and approved by all named authors. We confirm that we have given due consideration to the protection of intellectual property associated with this work.

Acknowledgements

Dr. Fischer acknowledges research support from CIHR for the Ontario CRISM Node Team (grant# SMN-139150) and a CIHR/PHAC Applied Public Health Research Chair award. Dr. Wood acknowledges funding support from a Canada Research Chair (CRC) in Inner City Medicine.

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    Address: Social and Epidemiological Research, Centre for Addiction and Mental Health (CAMH), 33 Russell St., Toronto, ON M5S 2S1, Canada.

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