CBD (cannabidiol) is a non-intoxicating compound derived from the hemp plant. Unlike THC, CBD does not produce a high and does not act on the brain receptors responsible for addiction and reward. Most addiction medicine clinicians do not classify CBD use as a relapse, though individual recovery programs, sober living houses, and 12-step communities may apply different definitions of sobriety that include or exclude CBD.
The question matters because early recovery involves significant anxiety, sleep disruption, and discomfort, and many people in recovery turn to CBD as a potential support tool. Understanding what the evidence actually says helps people make informed decisions alongside their treatment team.
What the Research Says About CBD in Recovery
Early research suggests CBD may help reduce anxiety, improve sleep, and lower cravings in people recovering from substance use disorders. A 2019 study published in the American Journal of Psychiatry found that CBD significantly reduced cue-induced craving and anxiety in people with heroin use disorder compared to placebo. These findings are promising but have not yet been replicated in large-scale clinical trials, and most research in this area is preliminary.
The National Center for Complementary and Integrative Health maintains an ongoing review of cannabis and cannabinoid research, noting that evidence for CBD in anxiety and sleep is more established than evidence for its role in addiction treatment specifically.
The most studied potential benefits relevant to recovery are reduced anxiety, improved sleep quality, and reduced craving intensity. These are among the most common and disruptive symptoms people experience in early recovery.
CBD and Specific Substances in Recovery
CBD and Alcohol Recovery
Alcohol recovery frequently involves anxiety, insomnia, mood instability, and in some cases post-acute withdrawal syndrome. CBD has shown signal in small studies for reducing alcohol consumption and associated anxiety in rodent models, with limited human data suggesting potential benefit for anxiety specifically.
CBD does not treat alcohol use disorder and is not a substitute for clinical treatment, therapy, or FDA-approved medications. It may have a supportive role for specific symptoms in people already engaged in evidence-based care.
CBD and Opioid Recovery
The craving reduction evidence is strongest in the opioid recovery context, driven by the 2019 Hurd et al. study. The researchers found that CBD reduced both the anxiety and cravings triggered by opioid-related cues, two of the most common drivers of relapse in early recovery.
For people on medication-assisted treatment with Suboxone or buprenorphine, there is no known dangerous interaction with CBD. However, both substances are metabolized through cytochrome P450 liver enzymes, meaning high CBD doses could theoretically affect buprenorphine levels. Anyone on MAT should consult their prescriber before adding CBD.
For a broader discussion of sobriety questions in the context of MAT, our post on sobriety and Suboxone covers the clinical and philosophical dimensions of this question.
CBD and Stimulant Recovery
There is less research on CBD in stimulant recovery specifically. Some preclinical data suggests CBD may support dopamine regulation, which is disrupted significantly by cocaine and methamphetamine use. No clinical trials have confirmed these effects in humans with stimulant use disorder.
For people in stimulant recovery, the general benefits of CBD for anxiety and sleep may still apply, but the evidence base is thinner than for opioid and alcohol recovery.
What 12-Step Programs Say About CBD
AA and NA do not have an official position prohibiting CBD. Both organizations leave medication and health decisions to members and their physicians, a stance reinforced in AA’s official literature.
Individual groups and sponsors vary. Some take a strict abstinence-from-everything position while others take a more clinical approach to medication. If this is a concern, it can help to explore different meetings or speak directly with your sponsor about how your recovery program defines sobriety.
People in recovery programs outside the 12-step model, including clinical programs like PHP and IOP, are generally guided by their treatment team rather than group norms.
How to Choose CBD Products Safely in Recovery
Product quality and composition vary widely. For people in recovery, certain product choices matter more than they might for general consumers.
- Choose CBD isolate or broad-spectrum products, not full-spectrum. Full-spectrum products contain trace THC that can accumulate with daily use and potentially trigger a positive drug test.
- Buy only from brands with a current Certificate of Analysis (COA) from an independent third-party lab, confirming cannabinoid content and absence of pesticides, heavy metals, and solvents.
- Start with low doses (10 to 25mg) and assess your response before increasing. CBD is generally well tolerated but can cause drowsiness, especially at higher doses.
- Inform your prescriber and treatment team that you are using CBD. This is relevant for anyone on MAT or other medications.
On the legal side, hemp-derived CBD containing less than 0.3% THC is federally legal and currently legal in New Hampshire. State laws can change, so verify your state’s current regulations before purchasing, and check the rules of any sober living facility or treatment program you are enrolled in, since some programs include CBD in their substance policies regardless of its legal status.
When CBD Is Not Enough
CBD is not addiction treatment. For people who are still experiencing significant cravings, mood dysregulation, sleep disruption, or anxiety in recovery, those are clinical symptoms that warrant professional support, not a supplement.
Heartfelt Recovery Centers provides dual diagnosis treatment for co-occurring anxiety, depression, and PTSD alongside addiction, which addresses these symptoms at a clinical level that CBD cannot match.
Our intensive outpatient program provides structured support including individual therapy, group programming, and medical management for people in New Hampshire and Northern Massachusetts.
Frequently Asked Questions
Is using CBD considered a relapse?
From a medical and addiction medicine standpoint, CBD is not classified as a relapse. It is non-intoxicating and does not act on the same receptors that drive substance use disorders. However, individual recovery programs, sponsors, and 12-step communities may define sobriety differently. The decision to use CBD is best made in discussion with your treatment provider and recovery support network.
Can CBD help with alcohol cravings?
Early research suggests CBD may help reduce anxiety and discomfort that contribute to alcohol cravings, though there are no large-scale clinical trials specifically on CBD and alcohol craving reduction. It should not replace evidence-based treatment for alcohol use disorder, but some people find it a useful adjunct alongside clinical care.
Will CBD show up on a drug test?
Pure CBD isolate products should not trigger a positive drug test. However, full-spectrum CBD products can contain trace amounts of THC that may accumulate with daily use and produce a positive result on standard urine drug screens. For people in recovery programs that include drug testing, CBD isolate products with third-party testing certificates are the safer choice.
Can you take CBD while on Suboxone?
CBD and buprenorphine (Suboxone) do not have a known dangerous interaction. However, both are processed through similar liver enzymes and there is a theoretical risk of altered medication levels with high CBD doses. Anyone taking MAT medications should consult their prescriber before adding CBD to their routine.
MD Mitchell Grant Cohen
Dr. Mitchell G. Cohen is a board-certified Internal Medicine specialist with over 34 years of experience in patient-centered healthcare. A graduate of Hahnemann University School of Medicine, Dr. Cohen completed his internship at the University Health Center of Pittsburgh, where he gained invaluable hands-on experience. He is also a certified addiction specialist, holding membership with the American Society of Addiction Medicine (ASAM).
Currently based in Nashua, NH, Dr. Cohen is affiliated with Saint Joseph Hospital, where he provides comprehensive care focusing on both internal medicine and addiction treatment. His expertise includes prevention, diagnosis, and management of adult diseases, as well as specialized care for individuals facing substance use disorders.
Dr. Cohen is committed to fostering open communication, ensuring his patients are fully informed and empowered to make confident decisions about their health and treatment options.
