Background

Cannabinoids may have an important therapeutic potential for the treatment of dependence on crack cocaine. Cannabidiol (CBD), in particular, has anxiolytic, antipsychotic and anticonvulsant properties and plays a role in regulating motivation circuitry and controlling sleep disorders. Several studies were performed evaluating CBD in experimental models for cocaine. This systematic review aims evaluate the potential use of CBD in the treatment of cocaine use disorder.

Method

Five databases (Scielo; Medline/PubMed; PsycINFO; Cochrane Library; Virtual Health Library-VHL) were searched up to January 2020. Full-text reports published in English were included if they were experimental studies that administered CBD to human and/or adult animals in use or with a history of crack/cocaine administration. The risk of bias of each study selected was appraised by two independent reviewers following the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) protocol.

Major findings

Fifty-one studies were analyzed, and 14 were selected. No studies conducted with humans were found; only one clinical trial was ongoing. The results were grouped into the following categories: cocaine self-administration, brain-stimulation reward, conditioned place preference, neuronal proliferation, anxiety, hepatic protection, anticonvulsant effect and locomotor sensitization response Only four studies had a low risk of bias. CBD promotes reduction on cocaine self-administration. Also, it interferes in cocaine induce brain reward stimulation and dopamine release. CBD promotes alteration in contextual memory associated with cocaine and in the neuroadaptations, hepatotoxicity and seizures induced by cocaine.

Conclusion

The evidence indicates that CBD is a promising adjunct therapy for the treatment of cocaine dependence due to its effect on: cocaine reward effects, cocaine consumption, behavioral responses, anxiety, neuronal proliferation, hepatic protection and safety. Moreover, clinical trials are strongly required to determine whether the findings in animal models occur in humans diagnosed for cocaine or crack cocaine use disorder.

中文翻译：

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评估大麻素在可卡因使用障碍治疗中的潜在用途：系统综述。

背景

大麻素对于依赖可卡因的治疗可能具有重要的治疗潜力。卡纳比多醇（CBD）特别具有抗焦虑，抗精神病和抗惊厥的特性，并在调节动力回路和控制睡眠障碍中发挥作用。对可卡因实验模型中的CBD进行了多项研究。该系统评价旨在评估CBD在可卡因使用障碍治疗中的潜在用途。

方法

检索到2020年1月的五个数据库（Scielo； Medline / PubMed； PsycINFO； Cochrane图书馆； Virtual Health Library-VHL）。如果它们是对CBD进行人类和/或成人管理的实验研究，则以英文发表的全文报告也包括在内。使用中或有开裂/可卡因历史的动物。两名独立的评价者按照实验室动物实验系统评价中心（SYRCLE）方案评估了所选研究的偏倚风险。

主要发现

分析了五十一个研究，并选择了十四个。未发现对人类进行的研究；只有一项临床试验正在进行中。结果分为以下几类：可卡因自我管理，脑刺激奖励，条件位置偏爱，神经元增殖，焦虑，肝保护，抗惊厥作用和运动敏化反应。只有四项研究偏倚风险低。《生物多样性公约》促进减少可卡因自我管理。而且，它会干扰可卡因诱导大脑的奖励刺激和多巴胺释放。CBD促进与可卡因有关的背景记忆的改变，以及可卡因引起的神经适应，肝毒性和癫痫发作。

结论

证据表明，CBD由于可卡因的奖励作用，可卡因消耗，行为反应，焦虑症，神经元增殖，肝保护和安全性的影响，是治疗可卡因依赖的有前途的辅助疗法。而且，强烈需要临床试验来确定动物模型中的发现是否发生在诊断为可卡因或可卡因使用障碍的人中。