“It’s frustrating,” says Boehnke. “Because we’re in this space where people are using these things all the time, but the science is pretty far behind the policy.”
Sativex, a cannabis-based pharmaceutical product containing THC and CBD in a 1:1 ratio, is already approved in multiple countries to treat neuropathic pain, multiple sclerosis-related muscle spasms and stiffness, and severe pain from advanced cancer and is currently undergoing evaluation in clinical trials in the US.
And, unfortunately, researchers have reported that the cannabis grown by the university is low quality, contains mold and is genetically less like marijuana and more like hemp, a type of cannabis characterized by its extremely low levels of THC.
How cannabis may be beneficial
“That’s one hypothesis,” says Boehnke. “There’s lots of ways in which CBD might be encouraging these effects. It’s just tough to know because CBD is such a promiscuous molecule.”
“It seems like if you take them together, you can tolerate more THC without having the same types of side effects,” says Boehnke, referring to THC’s penchant for causing intoxication and impairment. “Also, taking CBD and THC together, compared to a similar amount of THC alone or CBD alone, seems to have better analgesic effects.”
“Lastly, there is centralized pain, which has very recently been called nociplastic,” says Boehnke. “And that’s something more like fibromyalgia or some of the other chronic overlapping pain conditions — migraines, tension headaches — that have been more difficult to characterize scientifically and clinically because there’s not a specific pathology that you can identify on an x-ray or fMRI.”
“In the [research] group that I’m part of, we think of pain as coming in three different flavors,” says Boehnke. “One of them is neuropathic pain, and that’s caused by damage to or inflammation of the nerves.” Think: carpal tunnel syndrome or sciatica.
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.
Specific conditions that may be helped by CBD include:
Get to Know the CBD Isolate, Broad, and Full Spectrum Products
3. FDA. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). Updated August 3, 2020. Available at: www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd.
That depends on how you take your CBD oil. The most predictable consumption method is sublingual (under the tongue) using a spray or tincture. According to the American Arthritis Foundation, 16 effects are usually felt within 15 to 45 minutes.
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
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.”
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?
Want to learn more on this topic? Listen to this podcast from the Rogel Cancer Center on Medical Marijuana for Cancer Patients.
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.
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.
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.