cbd marijuana for pain

December 15, 2021 By admin Off

C. sativa is associated with higher levels of THC while C. indica is associated with higher levels of CBD. The science is more complicated. A 2015 study 11 of genetic structures of marijuana and hemp suggests that “ C . sativa and C . indica may represent distinguishable pools of genetic diversity but that breeding has resulted in considerable admixture between the two.” Researchers also found that hemp has more in common genetically with C . indica than with C . sativa . Differences in THC production held true.

A growing body of clinical research and a history of anecdotal evidence support the use of cannabis for the relief of some types of chronic pain, including neuropathic pain, and spasticity (ie, stiffness or tightness) associated with multiple sclerosis. 1 In a recent comprehensive review of existing data on the health effects of cannabis and cannabinoids, the National Academies of Science concluded that adult patients with chronic pain who were treated with cannabis/cannabinoids were more likely to experience a clinically significant reduction in pain symptoms. 2 They rated these effects as “modest.”

California, for example, requires dispensaries to sell only marijuana that has been tested for pesticides, contaminants, and microbial impurities. Beginning in July 2018, California also began to require testing to determine plant potency (ie, levels of THC and CBD). This information is included on the product label. 12 In addition to t he above, 12 states have enacted legislation allowing for limited use of medical marijuana (ie, low CBD: THC ratios).

Hemp, which is primarily used for industrial purposes (particularly fiber products), is considered to be the Cannabis sativa species; marijuana (used for medicinal and recreational purposes) is considered to be the Cannabis indica species. The two species differ not only in appearance but also in levels of THC and CBD.

The key to using medical cannabis for pain is two-fold. For starters, a personalized approach is needed. Each person is different, and many adjustments may be needed to zero in on the dose that controls pain with minimal side effects. It’s also important to start on a low dose of THC and CBD.

Studies also suggest some efficacy for cancer-related pain, migraines, and fibromyalgia, and other pain conditions. 3 However, how different species, routes of administration, and doses differ in their effect is less clear, and more research is needed.

Dr. Bearman is also the co-founder of the American Academy of Cannabinoid Medicine, and a board member of Americans for Safe Access – a national member-based organization of patients, medical professionals, scientists and concerned citizens promoting safe and legal access to cannabis for therapeutic use and research,and of Patients Out of Time – a Virginia-based nonprofit that works to educate all disciplines of healthcare professionals, the legal profession, and the public about medical cannabis. It’s also important to know that dispensary cannabis is not regulated by the FDA so what you get in one state, or at one time, may be different from another.

Where does this leave chronic pain patients interested in trying medical cannabis? Regardless of the strain or form of cannabis, the key is the amount of THC and CBD in the final product, according to Dr. Bearman.

Medical cannabis is currently legal in 34 states (as of spring 2019), many of which require patient registry or identification cards for the purchase and use of the substance for specific diagnosed medical conditions. These conditions differ by state and continue to change. At the federal level, marijuana is classified as a Schedule I substance under the “Controlled Substances Act,” and there are no recognized medical uses. In many of the states with legalized cannabis, some type of product testing is required, however, testing varies by state and may be limited contamination tests or may include quantification of CBD and THC levels.

Chemically speaking, cannabis is complicated. To date, 568 unique molecules have been identified in the cannabis; of these, more than 60 are cannabinoids — these are compounds that act on receptors in the body’s endocannabinoid sy stem. This system plays a key role in endogenous pain control. 4.

For pain relief, he recommends a dose of 15mg THC (0.0005 oz) to 15 mg CBD. In his experience, doses of THC less than 15 mg generally don’t provide pain relief. Doses may be increased if necessary, best guided under a doctor’s orders, to achieve pain relief without unacceptable side effects.

Two of the cannabinoids found in cannabis, Δ 9 -tetrahydrocannabinol (THC) and cannabidiol (CBD), along with other cannabinoids, terpenes, and flavonoid compounds, are thought to exhibit synergistic effects that promote pain relief. 5 THC is the most psychoactive cannabinoid found in cannabis and is primarily responsible for the “high” associated with marijuana. It can also reduce nausea and increase appetite. CBD does not provide the euphoria associated with THC and is associated with reduced pain and inflammation. 6.

Strains of cannabis may come with names like Purple Diesel and Blue Sky. While the term “strain” is commonly used by dispensaries, medical cannabis users and even physicians, it’s not a term used for plant nomenclature. 9 A strain name may come from a grower, producer, processor, or dispensary. A 2018 study out of Washington state found that commercial Cannabis strains fell into three broad chemotypes (chemically distinct plants that otherwise appear indistinguishable) that were defined by the THC:CBD ratio. 10.

The FDA’s View on Cannabis for Pain.

Approval by the US Food and Drug Administration has, so far, been limited to synthetic or pharmaceutical-grade components of cannabis. In June 2018, the agency approved Epidiolex (GW Pharmaceuticals) — a high CBD, low THC whole-plant alcohol extract — for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome in patients age 2 and older. FDA has also approved Marinol (AbbVie) and Syndros (Insys Therapeutics), which both contain dronabinol, or synthetic THC. Both are indicated for weight loss associated with anorexia and HIV. Marinol is also indicated for severe nausea associated with cancer chemotherapy, as is FDA-approved Cesamet (Meda Pharmaceuticals). Cesamet contains the active ingredient nabilone, which has a chemical structure similar to THC.

Cannabis is Complex: CBD Versus THC.

A Word About Hemp.

These states, as of spring 2019, include: Alabama, Georgia, Indiana, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Virginia, Wisconsin, and Wyoming. It is important to know that consistency and quality of the product received may vary from dispensary to dispensary and from state to state. Stay up to date with the National Conference of Sttae Legislatures which lists current medical marijuana laws at http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx.

The Amount of CBD or THC You Use Matters.

Hemp products — including oils, extracts, and even “gummies” — aimed at relieving pain and anxiety abound on the internet. But what is hemp and how does it differ from marijuana? The conventional answer is that hemp and marijuana are two different species of the Cannabis genus of plants.

Dr. Bearman said he also prescribes dronabinol, the man-made or synthetic THC, for some patients. “It doesn’t work as well as cannabis, it’s more expensive than cannabis, and it has more side effects than cannabis. Nevertheless, there are some good reasons for prescribing it,” he noted. Specifically, because dronabinol is regulated by the FDA and must meet purity and manufacturing standards, he knows exactly how much THC a patient is getting.

Be sure to talk with your doctor about the right dose and route of administration before taking any prescribed of dispensed medical cannabis product for pain relief or related symptoms. Note that Medicare does not cover the product; check with your insurer for other program coverage.

The chemical complexity of cannabis itself has made it difficult for researchers to untangle its effects on pain and, at the same time, difficult for clinicians and patients to find the most effective species and route of administration. Cannabis is the genus name for a disputed number of plant species. The two most widely accepted species are Cannabis sativa and Cannabis indica , though hybrid species are also common.

See also, a 2019 blog on PainDr (managed by Jeff Fudin, PharmD, PPM editor-at-large) on hemp use and drug screenings).

State Legalization of Medical Marijuana.

“There is little consistency in plant constituents between products’ strain names,” said David Bearman, MD, a physician in private practice who specializes in pain management and has more than 40 years of experience in managing substance abuse. “These names are mainly marketing tools and tell little about the constituents of the product. The best advice is to read the label and understand it.”

In PPM online poll, about half of respondents said they had tried medical marijuana to help alleviate their pain and related symptoms.

Given the rapid change in the legality of cannabis coupled with the increased appetite for something new, and driven by unprecedented profit margins, the advertising for cannabinoids in general and CBD in particular has gone wild. The FDA is very clear that it is illegal to market CBD by adding it to a food or labeling it as a dietary supplement. And it warns the public about its potential side effects, as it’s often advertised in a way that may lead people to mistakenly believe using CBD “can’t hurt.” CBD can cause liver injury, and can affect the male reproductive system (as demonstrated in laboratory animal studies).

If you ask health care providers about the most challenging condition to treat, chronic pain is mentioned frequently. By its nature, chronic pain is a complex and multidimensional experience. Pain perception is affected by our unique biology, our mood, our social environment, and past experiences. If you or a loved one is suffering from chronic pain, you already know the heavy burden.

In fact, the FDA has issued several warning letters to companies and individuals that market unapproved new drugs that allegedly contain CBD. The FDA has tested the chemical content of cannabinoid compounds in some of the products, and many were found to not contain the levels of CBD the manufacturers had claimed they contain.

So far, pharmaceutical CBD is only approved by the FDA as adjunct therapy for the treatment of a special and rare form of epilepsy. Currently, CBD alone is not approved for treatment of pain in the United States. But a combination medication (that contains both THC and CBD in a 1:1 ratio) was approved by Health Canada for prescription for certain types of pain, specifically central neuropathic pain in multiple sclerosis, and the treatment of cancer pain unresponsive to optimized opioid therapy. There is currently no high-quality research study that supports the use of CBD alone for the treatment of pain.

If you or someone close to you is considering trying CBD, I would recommend Dr. Robert Shmerling’s advice about the dos and don’ts in choosing an appropriate product. Until there is high-quality scientific evidence in humans, it is difficult to make a recommendation for the regular use of CBD in chronic pain management.

Many of the CBD products on the market are unregulated.

Given the ongoing challenges of chronic pain management coupled with the consequences of the opioid epidemic, pain management practitioners and their patients are searching for effective and safer alternatives to opioids to alleviate pain. With the legalization of marijuana in many states and resulting cultural acceptance of this drug for recreational and medical use, there has been an increased interest in using cannabis for a myriad of medical problems, including pain.

Given its promising results in animal models, along with its relative safety, non-psychoactive properties, and low potential for abuse, CBD is an attractive candidate to relieve pain. Unfortunately, there is a lack of human studies about the effectiveness of CBD. However, there is an abundance of commercial advertisements about the magical effects of CBD, and it is frequently presented as a cure-it-all potion that will treat everything including diabetes, depression, cancer, chronic pain, and even your dog’s anxiety!

Finally, there is anecdotal wisdom, when experiences by patients and health professionals have positive results. While the experience or medication could be beneficial, that doesn’t mean it is going to work for everyone. That’s because each and every person is unique, and what works perfectly for one patient could have no effect on another patient. This is especially true for pain, where many other factors (our mood and stress level, our environment and other medical conditions, and our previous experiences) can affect the perception of pain. Please be careful, and keep in mind that some of these incredible-sounding testimonials are merely marketing materials meant to lure consumers to buy more products, as the CBD market is expected to hit $20 billion by 2024.

Most importantly, CBD can interact with other important medications like blood thinners, heart medications, and immunosuppressants (medications given after organ transplantation), potentially changing the levels of these important medications in the blood and leading to catastrophic results, including death. Also, more information needs to be gathered about its safety in special populations such as the elderly, children, those who are immunocompromised, and pregnant and breastfeeding women.

Cannabis (most commonly obtained from the Cannabis indica and Cannabis sativa plants) has three major components: cannabinoids, terpenoids, and flavonoids. While there are over a hundred different cannabinoids, the two major components are tetrahydrocannabional (THC) and cannabidiol (CBD). Historically more attention has been paid to the psychoactive (euphoric “getting high”) component of the cannabis plant, THC; there have been fewer scientific studies on the medical use of CBD, a non-psychoactive component of the plant.

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CBD is emerging as a promising pharmaceutical agent to treat pain, inflammation, seizures, and anxiety without the psychoactive effects of THC. Our understanding of the role of CBD in pain management continues to evolve, and evidence from animal studies has shown that CBD exerts its pain-relieving effects through its various interactions and modulation of the endocannabinoid, inflammatory, and nociceptive (pain sensing) systems. The endocannabinoid system consists of cannabinoid receptors that interact with our own naturally occurring cannabinoids. This system is involved in regulating many functions in the body, including metabolism and appetite, mood and anxiety, and pain perception.

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People are looking for novel, nonaddictive ways to treat pain.

Beware of powerful testimonials.