CBD for chronic pain: The science doesn’t match the marketing
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.
People are looking for novel, nonaddictive ways to treat pain
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.
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.
What’s the thinking behind using cannabis for chronic pain?
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.
What’s the research that CBD works in humans?
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!
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.
Why is CBD presented to the public this way, when it is not without risks?
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).
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.
Many of the CBD products on the market are unregulated
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.
Beware of powerful testimonials
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.
The bottom line: Don’t make CBD your first or only choice for pain relief
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.
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Cbd oil for paincomes from
Mary Jane, weed, herb, pot, grass, bud, hooch, ganja, and choof – marijuana sure comes with many monikers. All around the world, the intoxicating effect of the greenish-grey mixture of the dried flowers of Cannabis sativa is well-established. The cannabis community can vouch for this, regardless of the weed-slang they use.
But more than its intoxicating effect, the cannabis plant actually has great medicinal value as it can help with pain management . The world is still coming to terms with this, especially in Australia. It was not until 2016 that medical marijuana became legal in the country.
Cannabis Oil: What is it?
Cannabidiol (CBD) is a type of “cannabinoid,” the chemicals naturally found in marijuana. The main takeaway is that it doesn’t create the “high” feeling or any form of intoxication that’s typically sought out by recreational marijuana users. It’s THC (tetrahydrocannabinol), one of the 113 cannabinoids identified in cannabis, that causes intoxication.
Hemp and marijuana contain different levels of chemical compounds, much like different varieties of cannabis plants. The way people breed Cannabis sativa affects the CBD levels. Most CBD oil products come from industrial hemp containing higher CBD levels than the usual marijuana.
Makers of cannabidiol oil use different methods to extract the CBD compound: steam distillation, extraction by solvent, CO2 extraction, olive oil extraction, among others. The extracted cannabinoids are then added to a carrier oil. This gives you the final CBD oil product.
Potential Cannabis Oil Benefits for Pain Management
Surprisingly, the human body produces endocannabinoids which are similar to cannabinoids in the Cannabis sativa plant. Not everyone knows it, but we all have a cell-signalling system known as the endocannabinoid system. Endocannabinoid receptors in our brains and immune systems receive chemical signals from different stimuli and help the cells respond.
This response triggers anti-inflammatory and pain-relieving effects. CBD oil may help people with chronic pain relief, including those with chronic back pain.
- Arthritis Pain Relief
In 2016, a study in the European Journal of Pain showed that there was a significant drop in inflammation among rats with arthritis. Researchers applied CBD topical gel to these rats for 4 days and found out that CBD could help relive arthritis pain without side effects.
People with arthritis may find relief from pain with the help of topical CBD gels, but more studies conducted on humans need to be done to confirm these findings.
- Multiple Sclerosis Pain Relief
Autoimmune conditions like multiple sclerosis affecting the entire body through the nerves and brain may be tough to bear. Muscle spasms can be so strong and cause constant pain. One research found that CBD oil could reduce the levels of muscle spasms a person feels, and many people using CBD products reported a reduction in symptoms.
- Cancer Treatment Relief
The side effects of chemotherapy cause pain in most cancer patients. These effects include pain, vomiting, and loss of appetite. Although more evidence is needed, CBD may be used to manage pain related to cancer and cancer treatment.
In the 2010s, studies have shown that cancer patients found relief after receiving oral sprays of a combination THC-CBD extract. A research on mice has reported that CBD is a potential treatment for malignant melanoma.
CBD Side Effects
CBD doesn’t pose severe side effects for users, whether it be in an oral spray or topical gel form. Certain side effects are still possible which include, but not limited to, the following:
- changes in weight
- changes in appetite
Types of CBD Oil You Should Know
CBD oil products available today come in many different strengths. If you have tried searching for CBD oils on the internet, you may have already come across terms like isolate, full-spectrum, and broad spectrum. CBD oils can be categorised based on their list of ingredients and their method of usage.
- Full Spectrum
This is one of the more common forms of CBD oil out there. It contains more than just CBD and contains other cannabinoids like CBDA, CBG, and CBA and 0.03% of THC (which is an insufficient amount to produce intoxicating effects). Full-spectrum CBD oil elicits a more pronounced and well-rounded effect as the non-intoxicating cannabinoids work synergistically with the CBD.
- Broad Spectrum
It is similar to full-spectrum ones in that it also contains more cannabinoids than just CBD. The only difference is that the THC has been chemically removed.
- CBD Isolate
This type is pure CBD, making it extremely powerful. It is mostly recommended for those suffering from insomnia.
Where to Get and How to Use Cannabis Oil for Pain Relief
CBS is extracted from Cannabis Sativa in powder or oil form, which can be mixed into topical creams and gels. CBD can also be taken orally when put into capsules and mouth sprays.
CBD is legal in Australia now. You can buy CBD oil products over-the-counter in any pharmacy in the Central Coast of NSW. But then, there are currently no products approved for sale by the Australian Register of Therapeutic Goods (ARTG) . You can talk to a doctor or visit a medical centre in Erina to discuss where and how you can get access to medical marijuana in the area.