cbd pills for pain reliefDecember 15, 2021
6. De Petrocellis L, et al. Effects of cannabinoids and cannabinoid-enriched Cannabis extracts on TRP channels and endocannabinoid metabolic enzymes. Br J Pharmacol . 2011;163(7):1479-1494.
Keep in mind that while CBD can have many benefits, it is not a cure-all and should not be viewed as an alternative to your other pain care treatments. Rather, CBD should be considered a complementary treatment to add to your pain management toolbox.
7. De Gregorio D, McLaughlin R, Posa L, et al.Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain. 2019;160(1):136-150.
Specific conditions that may be helped by CBD include:
2. Rudroff T, Sosnoff J. Cannabidiol to improve mobility in people with multiple sclerosis. Front Neurol . 2018;9:183.
What is the best CBD oil for pain?
The entourage effect also accounts for the terpenes 13 that can differ between various strains of marijuana and contribute to the plant’s effect. Some recent research points to the beneficial effects of this compound (think aromatherapy).
What can CBD (aka: cannabidiol) do for your chronic pain? This natural compound extracted from the Cannabis sativa plant will not get you high, since it does not produce the same psychotropic effects as its cannabinoid sibling, tetrahydrocannabinol (THC), but many people are finding that it can complement their pain care plan. In fact, research shows that of the 62% of people who use CBD for a medical condition, the majority are treating chronic pain, arthritis, and joint pain, as well as anxiety. 1.
But it’s not that simple. CBD has been shown to decrease the psychotropic effects of THC , meaning that if a full spectrum extract has a greater ratio of THC to CBD, you won’t necessarily feel so high. Of course, everyone responds differently to marijuana and this will involve a lot of trial and error.
CBD is a cannabinoid found in marijuana plants that has many beneficial effects, without the psychotropic effects of its cannabinoid counterpart, THC. (Image: iStock)
Tell me all I need to know about using cannabidiol for chronic pain.
CBD itself does not bind to receptors but is thought to work by inducing other components of the cannabinoid system.
What’s more, CBD has minimal side effects and a low-risk, zero-addiction profile. But before you pop a gummy or ingest an oil, you’ll want to read on.
Full Spectrum CBD products maintain the full profile of the marijuana plant and in addition to CBD, contain a variety of other cannabinoids including: THC, CBDa, CBG, and CBN, as well as terpenes and other compounds such as flavonoids, proteins, phenols, sterols, and esters. Technically, full spectrum products can contain 0.3% or less THC, if they are derived from the hemp species, however, full spectrum CBD products derived from non-hemp marijuana tend to have a wider cannabinoid and terpene profile.
Our natural endocannabinoids function on demand, meaning that when our body senses inflammation, or needs to return to homeostasis (a state of stable balance) it will release endocannabinoids that bind to cannabinoid receptors.
Vaping has become a popular form of taking CBD. Unlike rolling a joint, vaping involves a CBD oil cartridge that is inserted into a vaping pen. While some may assume that vaping is safer than smoking, there are dangers associated with both practices regarding lung health.
CBD’s Potential Benefits.
Oral ingestions come in many forms such as:
OK, so we know that taking it won’t get you high, but taking enough (often based on your weight), can have a calming effect. And the side effects are minimal, with some people experiencing drowsiness, nausea, or tiredness. It is unlikely to negatively impact your mood or cognitive ability, making it a seemingly safer and preferred product for many.
These tips and tricks may help ensure your CBD is the real deal, but they still don’t provide proof. The best way to be sure you are consuming what you want is to request third party testing . Some products will print a QR code on the packaging that links directly to their proof of third-party testing. You can also do your own third-party testing by bringing your CBD sample to a testing lab, although this may get a bit tedious (the USDA provides a searchable hemp testing laboratory list).
Here’s a quick cheat sheet but note that efficacy of each is still up for debate.
In fact, CBD exerts a wide array of effects on the body’s central and peripheral nervous systems, as well as the immune system. It works in conjunction with our endocannabinoid system to function in an antioxidant capacity, to decrease inflammation, and to act as an analgesic or pain reliever. CBD may even slow the progression of osteoarthritis and prevent nerve damage, according to early model studies. 4.
The 2018 US Farm Bill legalized the growing of hemp and sale of hemp-derived products, which made CBD legal at the federal level (mostly). As noted, hemp is a species of the marijuana plant with one very important distinction: the variety must have less than 0.3% THC. So, if the CBD you buy comes from a hemp plant with less than 0.3% CBD and is grown in accordance with the 2018 Farm Bill regulations, and you live in a state where CBD is legal, you are in full abidance of the law.
The dosage of CBD that works for your pain will depend on the amount/percentage of CBD in the product, how you take it (whether by mouth, inhalation, or topical application) and your body weight and chemistry (several websites offer CBD calculators to determine a starting dose). The best thing is to speak with your doctor or a budtender (essentially a dispensary pharmacist) before choosing a CBD dosage. If your doctor does not recommend a dose, it is best to start small and gradually increase the dose from there until you achieve the desired effect.
How does CBD help pain?
The CBD compound itself is still classified as Schedule I drug (along with LSD and heroin). Federally, CBD derived from non-hemp marijuana is illegal. If you live in a state that has legalized marijuana, you can find non-hemp derived CBD products at a medical marijuana dispensary.
Overall, the risks of taking CBD are very low, and the rewards can be quite promising. Still, it’s important to remember that more research is needed to understand the full effects of CBD. Your treatment is a personal choice and for many, a personal journey.
1. Corroon J, Phillips JA. A cross-sectional study of cannabidiol users. Cannabis Cannabinoid Res. 2018;3(1):152-161.
Remember that CBD use for pain and related symptoms is not an exact science, so you may need to try more than one brand and method before feeling relief. The good news is that, to date, CBD is not considered to be physically addictive, and there’s no history of anyone overdosing on it, so a little trial and error likely won’t hurt as long as you are sourcing safely.
10. O’Sullivan SE. An update on PPAR activation by cannabinoids. Br J Pharmacol. 2016;173(12):1899–1910.
There is no one best CBD oil for pain. The type will depend on your pain condition, how you consume the CBD, and your body chemistry. An important consideration will be whether the oil is a CBD isolate, a full spectrum extract, or a broad spectrum extract. It is also important to know you are buying a trustworthy product, especially because the CBD market is not regulated.
CBD is thought to be helpful in easing the symptoms of the following conditions.
A budtender – that’s what they call dispensary pharmacists – or your doctor can guide you, but here’s a quick overview.
Boehnke and Clauw recommend that people with chronic pain talk to their doctor about adding CBD to their treatment plan, and continue to use their prescribed medication. They offer the following advice for people wanting to try CBD:
Don’t smoke or vape. Bottom line is smoking anything harms the lungs. Vaping has been associated with a recent epidemic of lung disease, according to the Centers for Disease Control & Prevention.
Yet marijuana has been used as a medicinal plant for thousands of years, he notes. In fact, one of the first recorded uses of cannabis was for rheumatism, also known as arthritis. Cannabis products were widely used as medicines in the 19th and early 20th centuries, and were listed in the U.S. Pharmacopoeia before the onset of Federal restriction in 1937 under the Marijuana Tax Act.
The scientific evidence around CBD use is thin, a fact that is mainly due to politics. “Cannabis has been a Schedule 1 drug for a long time, which has limited the type of research needed to figure out how best to use it therapeutically,” says Kevin Boehnke, Ph.D., research investigator in the department of anesthesiology and the Michigan Medicine Chronic Pain and Fatigue Research Center. Under the U.S. Federal Controlled Substances Act, Schedule 1 drugs are defined as having no currently accepted medical use and a high potential for abuse.
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Want to learn more on this topic? Listen to this podcast from the Rogel Cancer Center on Medical Marijuana for Cancer Patients.
So many people are turning to CBD as an alternative pain reliever, especially in light of the opioid crisis, that in a commentary published in Annals of Internal Medicine , Boehnke and Daniel Clauw, M.D., director of the Chronic Pain and Fatigue Research Center, provided advice for clinicians on how to counsel their patients about CBD and cannabis use.
Purchase from reputable sources. Like vitamins and other supplements, CBD products aren’t regulated or FDA approved to treat disease, so buyer beware. Look for products that have been tested by an independent third party lab “so you don’t end up with a product that has THC in it or a product contaminated with heavy metals or pesticides,” says Boehnke.
Start low, go slow. Take a small amount and slowly increase your dosage until you start to get symptom relief over a matter of weeks. Track your symptoms to get a sense of whether or not CBD is a helpful part of your treatment plan.
Route of administration matters. CBD is best taken in pill or capsule form for slow extended release or as an oral tincture (infused oil that contains CBD) for faster effect onset.
Much of the research literature around CBD in particular supports its use as a treatment for childhood epilepsy. Indeed, in 2018 the FDA approved the CBD-based drug Epidiolex as a drug for childhood epileptic conditions. In a substantial policy shift, Epidiolex was designated as Schedule V, which is the least restrictive drug schedule and indicates little potential for abuse.
CBD, short for cannabidiol, is undergoing a surge in popularity as the hot new supplement, with a promise to treat a variety of conditions including pain, anxiety, and insomnia, just to name a few. It’s also available in all manner of forms, from lotions and oils to CBD-infused food and drink. But does it work?
While there aren’t any published clinical trials on CBD in pain, Boehnke notes that ongoing preclinical studies in animals have demonstrated that CBD reduces pain and inflammation, and studies of CBD in humans show that it is well-tolerated and has few negative side effects. “There are also observational studies that ask why people use CBD and if it’s effective, and results tend to be quite positive. People report using CBD for anxiety, pain, sleep — all things that go hand-in-hand with chronic pain,” he says. The passage of the 2018 Farm Bill removed hemp-derived CBD (<0.3% THC) from the Controlled Substances Act, and many people are since testing it out. Boehnke says, “Even though there isn’t clinical trial literature for most common uses of CBD, people don’t necessarily follow what clinical trials say.”
They also provided guidance for the Arthritis Foundation, who recently surveyed 2,600 people with arthritis and found that 29% currently use CBD to treat arthritis symptoms.
People looking for a safer pain reliever are turning to cannabis-derived CBD. Michigan Medicine experts weigh in on what’s currently known about the trendy supplement.
CBD is one of the compounds in the cannabis plant, better known as marijuana. Unlike the famous cannabinoid tetrahydrocannabinol (THC), CBD doesn’t cause the psychological effects typical of being “high”. Both CBD and THC act on the body’s natural endocannabinoid system, which plays a role in many processes including appetite, pain and memory.
Check your state laws. While medical marijuana is legal in many states, it’s still illegal at the Federal level, putting CBD in a legal gray zone in many areas.
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.
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.
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.
People are looking for novel, nonaddictive ways to treat pain.
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.
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.
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!
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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.
Many of the CBD products on the market are unregulated.
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.
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.
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).
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