Neuroimaging and CBD for Opiod Use Disorder

Eligibility Criteria

• 1. Individuals between 18 and 65 years old.
• 2. Current methadone maintenance in an opioid treatment program with a dose of =/\>40mg for at least 14 days prior to participation and prescribed take-home methadone medication.
• 3. Current opioid use disorder (OUD) or OUD in remission while on maintenance therapy with opioid agonist therapy (OAT), as determined by DSM-5 with the M.I.N.I. interview (Mini-International Neuropsychiatric Interview).
• 4. Urinary toxicology positive for methadone.
• 1. Non-English speaking.
• 2. Court mandate to treatment.
• 3. Participation in another pharmacotherapeutic trial in the past 3 months.
• 4. Poor physical health (as determined by medical screen) that would make study participation unsafe, or would prevent adherence to study procedures, including a history of cardiac disease, arrhythmias, head trauma, and seizures.
• 5. Psychiatric conditions under DSM-5 (examined with the MINI) that would make study participation unsafe or which would prevent adherence to study procedure; examples include: suicidal or homicidal ideation requiring immediate attention, or inadequately-treated mental health disorder (e.g. active psychosis or uncontrolled bipolar disorder).
• 6. History of impaired renal function or elevated liver enzymes \>2x the normal at prescreening.
• 7. QTc Frederica \>500ms.
• 8. Current pregnancy \[determined by positive urine test\] or breastfeeding.
• 9. Not using an appropriate method of contraception such as hormonal contraception (oral hormonal contraceptives, Depo-Provera, Nuva-Ring), intrauterine device (IUD), sterilization, or double barrier method (combination of any two barrier methods used simultaneously, i.e. condom, spermicide, diaphragm).
• 10. Medical or psychiatric contraindications for MRI (metal implants, stents, etc).
• 11. Medical or psychiatric contraindications for CBD administration (e.g., history of hypersensitivity to cannabinoids).
• 12. Current diagnosis of a moderate or severe substance use disorder (except for opioids and nicotine) in the past 3 months, based on DSM-5.
• 13. Acute drug intoxication as determined by clinician assessment.
• 14. Acute opioids withdrawal symptoms (observational and determined by the Clinical Opiate Withdrawal Scale (COWS). A Score of ≥#5 will be considered a positive result for withdrawal symptoms and/or by clinical judgment.
• 15. Breathalyzer/Alcohol salivary/urine strips positive for alcohol.