ECHO: Evaluating Cannabis to Help Reduce Opioid Use

In summary, retrospective studies suggest that many individuals have already turned to cannabis to alleviate pain and are substituting cannabis for opioids. Systematic reviews of RCTs have indicated that cannabis products demonstrate efficacy in the management of pain10–13. RCTs, participant registries, and the experience of 30 countries that have approved a cannabis plant derived product that is equal parts of THC to CBD (i.e., Sativex) indicate that this product is well tolerated with low potential for harm53,56,57. Subjective and objective data suggest that individuals who use cannabis for pain are able to decrease their use of opioids and potentially other medications16,58. Clearly, there exists an empirical basis for hypothesizing that cannabis might be effective in terms of reducing opioid use. However, in the U.S. there are currently no published guidelines on how to minimize harms and maximize benefits when using cannabis products, giving providers and participants little on which to base their decisions and discussion around cannabis use and opioid reduction.

AIM: Alcohol, Inflammation and Motivation

“Dismantling Mindfulness Based Relapse Prevention (MBRP): Identifying Critical Neuroimmune Mechanisms of Action”

Alcohol use disorders (AUDs) are associated with great socioeconomic costs in the United States. Despite decades of research, the best treatments have proven to be only modestly successful. Mindfulness Based Relapse Prevention (MBRP) and Relapse Prevention (RP) have been shown to help regular alcohol users curb their drinking habits. The goal of the AIM Study is to compare these two effective treatments to see which is more effective at reducing drinking, and to learn more about how they work. To learn how the interventions work, we will compare their effectiveness at targeting the psychological, neurological, and physiological mechanisms that are related to alcohol use disorders. The neurological mechanisms we are interested in are those that result from adaptations to the brain’s structure and function as a result of alcohol use. Alcohol has also been shown to influence levels of inflammation in both the brain and body, and to cause changes to genetic material (DNA) through a process called epigenetics. By monitoring changes in all of these mechanisms, we will be able to which of the treatments better targets which of these important predictors of recovery from alcohol use disorder.

COSMIC: Cannabis Observational Study on Mood, Inflammation, and Cognition

“Marijuana Harm Reduction: Innovative Strategies for Developing New Knowledge”

Cannabis research can be dated back to the 1970’s where standardized smoking of low potency cannabis in a laboratory setting has been the primary method used to understand the effects of the drug. The objective of this program is to use a naturalistic design to advance a more nuanced understanding of the potential outcomes associated with using different strains of marijuana. Researchers need to understand the effects of commonly used cannabis strains, as they are used in every day life. Commonly available strains of cannabis sold in dispensaries in Colorado have 3-5x greater potency of cannabinoids, such as the psychoactive compound tetrahydrocannabinol (THC), than what has been used in laboratory settings. It is possible that laboratory based studies underestimate the effects of more potent strains that are widely available. Also, scientists have focused on the effects of THC while mostly ignoring other major cannabinoids (e.g. cannabidiol or CBD) and their synergistic relationship.