While many companies now sell CBD oil online and in dispensaries, use of the oil isn’t legal in every state. Because state laws vary greatly when it comes to cannabis products, it’s crucial to confirm that use of CBD oil is legal in your state.
While very few clinical trials have explored the pain-relieving effects of CBD oil, a report published in the Cochrane Database of Systematic Reviews in 2018 examined the use of a variety of cannabis-based medicines and found they might be of some benefit in the treatment of chronic neuropathic pain.
Over-the-counter (OTC) and prescription pain medications are often recommended in the treatment of chronic pain, but many people seek out alternative forms of relief, such as herbs, nutritional supplements, and products like CBD oil.
Preclinical animal research suggests that CBD may have moderate pain-relieving effects for neuropathic pain without the cannabinoid-like side effects, however, there is currently a lack of large, well-designed clinical trials (the type of research you want to see to put full stock in a treatment) confirming these effects.
Some proponents suggest that CBD oil could provide a solution to opioid addiction as concerns over opioid overdoses continue to escalate.
In this report, researchers reviewed 16 previously published studies testing the use of various cannabis-based medicines in the treatment of chronic neuropathic pain and found some evidence that cannabis-based medicines may help with pain relief and reduce pain intensity, sleep difficulties, and psychological distress.
Common types of chronic pain include:
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.
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.
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.
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).
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.