Dr. Amy Nett: Yeah, I think tolerance, there definitely can be. So for example we’ve talked about with Kavinace. A lot of people do really well with Kavinace, and occasionally patients will tell us they get to a point where it’s not as effective. And in that case we normally just tell patients stop the supplements for about two days or so, maybe use something else so it’s something that you’re using. Most of the time when we’re talking about tolerance or a little bit of an addictive quality to it, these tend to be like sleep or anxiety supplements. So Kavinace is one that we use for sleep and anxiety. So if patients are taking it pretty regularly, maybe they’re up to that six capsules, if it becomes less effective, then we say take two days off. Use something else during those couple days off, maybe a week off, depending on how long they’ve been using and what that tolerance looks like. Basically take some time off of it and then you can reintroduce it.
So tolerance yes. Addictive? I think this depends a little bit more on kind of the patient’s personality and where they’re at. And I say that because we talked about alcohol addiction last time and I think someone said, how many drinks a night do you consider alcoholism? Or how many drinks during the day? I shouldn’t assume we restrict them to night. And they said well, it’s more the relationship to the alcohol that I really think about in terms of thinking about whether or not it’s an addictive problem. Similarly, how do patients feel if you say, “Okay, I want you to go a week without CBD or Kavinace or some of these supplements, like back off of them.” If someone has a strong reaction to that, then that’s potentially indicating somewhat of an addictive quality. So I’ve heard some controversy in some of the psychology literature that I looked at. That some people think there’s an addictive personality or an addictive predisposition. Other people don’t think so. They think that it’s more of a learned behavior or coping mechanism. I don’t really know. I definitely see that some people do tend to have an easier time moving towards an addiction. Just meaning that they have a really strong reaction if you try to take away that supplement. And similarly, yes, when we’re looking at these supplements for anxiety and sleep, people can develop an addiction in the sense that there’s some anxiety around not taking those supplements.
So is there a physical addiction where someone’s going to go through withdrawal from CBD or Kavinace, something like that? No, I don’t really think that there’s a physical addiction of the supplements we’re using. I think that these are more psychological addictions, and for that reason what you could tell, if you suspect someone that they have a history of addiction, something like that, you might suggest, hey, do this supplement five days on, two days off. You know, do something so that you can naturally introduce some sort of break from it so they don’t have that every day, this is what I’m taking, what I need to take. Because people get a lot of anxiety around not being able to take those things that they feel attached or addicted to. So physical addiction, no. Psychological addiction, probably. But honestly, you can have a psychological addiction to almost anything, whether it’s coffee, exercise, etc., we can go on.
So Kavinace and CBD are potentially supplements that patients could develop a pretty strong attachment to. So great question. I don’t think you need to avoid them. Just be aware that yeah, that can happen.