While many people use cannabidiol to relieve pain, more scientific research is needed to be sure it is safe. Understanding cannabidiol can help overcome the stigma associated with it.
Some people experience side effects when taking cannabidiol (CBD) and there are other factors to consider before using CBD oil for pain.
In this article, we look at how CBD oil works and how people can use it to relieve chronic pain.
CBD is one of more than 120 compounds called cannabinoids.
Many plants contain cannabinoids, but people most commonly link them to cannabis.
Unlike other cannabinoids — such as tetrahydrocannabinol (THC) — CBD does not produce a euphoric “high” or psychoactive effect. This is because CBD does not affect the same receptors as THC.
The human body has an endocannabinoid system (ECS) that receives and translates signals from cannabinoids. It produces some cannabinoids of its own, which are called endocannabinoids. The ECS helps to regulate functions such as sleep, immune-system responses, and pain.
When THC enters the body, it produces a “high” feeling by affecting the brain’s endocannabinoid receptors. This activates the brain’s reward system, producing pleasure chemicals such as dopamine.
Does CBD make you high?
CBD is an entirely different compound from THC, and its effects are very complex. It is not psychoactive, meaning it does not produce a “high” or change a person’s state of mind, but it influences the body to use its own endocannabinoids more effectively.
According to one study posted to Neurotherapeutics, this is because CBD itself does very little to the ECS. Instead, it activates or inhibits other compounds in the endocannabinoid system.
For example, CBD stops the body from absorbing anandamide, a compound associated with regulating pain. So, increased levels of anandamide in the bloodstream may reduce the amount of pain a person feels.
Cannabidiol may also limit inflammation in the brain and nervous system, which may benefit people experiencing pain, insomnia, and certain immune-system responses.
What is CBD oil?
Different cannabis plants — often called hemp or marijuana — contain different levels of chemical compounds.
How people breed the plant affects the CBD levels. Most CBD oil comes from industrial hemp, which usually has a higher CBD content than marijuana.
Makers of CBD oil use different methods to extract the compound. The extract is then added to a carrier oil and called CBD oil.
CBD oil comes in many different strengths, and people use it in various ways. It is best to discuss CBD oil with a doctor before using it.
People have used CBD for thousands of years to treat various types of pain, but the medical community have only recently begun to study it again.
Here are some of the possible benefits of CBD oil:
A study in the European Journal of Pain used an animal model to see if CBD could help people with arthritis manage their pain. Researchers applied a topical gel containing CBD to rats with arthritis for 4 days.
Their researchers note a significant drop in inflammation and signs of pain, without additional side effects.
People using CBD oil for arthritis may find relief from their pain, but more human studies need to be done to confirm these findings.
Multiple sclerosis (MS) is an autoimmune disease that affects the entire body through the nerves and brain.
Muscle spasms are one of the most common symptoms of MS. These spasms can be so great they cause constant pain in some people.
One report found that short-term use of CBD oil could reduce the levels of spasticity a person feels. The results are modest, but many people reported a reduction in symptoms. More studies on humans are needed to verify these results.
The same report studied CBD use for general chronic pain. Researchers compiled the results of multiple systematic reviews covering dozens of trials and studies. Their research concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults.
A separate study in the Journal of Experimental Medicine supports these results. This research suggests that using CBD can reduce pain and inflammation.
The researchers also found that subjects were not likely to build up a tolerance to the effects of CBD, so they would not need to increase their dose continually.
They noted that cannabinoids, such as CBD, could offer helpful new treatments for people with chronic pain.
CBD currently has a range of applications and promising possibilities.
Although more research is required to confirm some uses of CBD oil, it is shaping up as a potentially promising and versatile treatment.
In June 2018, the U.S. Food and Drug Administration (FDA) approved one form of CBD as a treatment for people with two rare and specific kinds of epilepsy, namely Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS).
The brand name of this drug is Epidiolex.
More generally, marijuana derived CBD products are not yet legal at the federal level but are legal under the laws of some states. Hemp derived CBD products that contain less than 0.3% THC are legal federally but are still illegal in certain states.
People must check their state’s laws and those of anywhere they intend to travel. They must keep in mind that the FDA do not approve or regulate nonprescription CBD products. As a result, labeling may be inaccurate.
The FDA does not regulate CBD for most conditions. As a result, dosages are currently open to interpretation, and people should treat them with caution.
Anyone who wishes to use CBD should first speak to a doctor about whether it is a good idea, and how much to take.
The FDA recently approved a purified form of CBD for some types of epilepsy, with the brand name Epidiolex. If you are using this medication, be sure to follow the doctor’s advice about doses.
Possible short-term side effects of using CBD oil include fatigue and changes in appetite.
Most people tolerate CBD oil well, but there are some possible side effects.
According to a review in Cannabis and Cannabinoid Research, the most common side effects include:
In addition, using CBD oil with other medications may make those medications more or less effective.
The review also notes that scientists have yet to study some aspects of CBD, such as its long-term effects on hormones. Further long-term studies will be helpful in determining any side effects CBD has on the body over time.
People who are considering using CBD oil should discuss this with their doctors. Doctors will want to monitor the person for any changes and make adjustments accordingly.
Consult a doctor before using CBD, as it may interact with certain over-the-counter dietary supplements and medicines, as well as some prescription medications — especially those that warn against consuming grapefruit.
CBD might also interfere with an enzyme called cytochrome P450 complex. This disruption can affect the liver’s ability to break down toxins, increasing the risk of liver toxicity.
The patient information leaflet for Epidiolex cautions that there is a risk of liver damage, lethargy, and possibly depression and thoughts of suicide, but these are true of other treatments for epilepsy, too.
CBD and other cannabinoids may also put the user at risk for lung problems.
One study in Frontiers in Pharmacology, suggested cannabinoids’ anti-inflammatory effect may reduce inflammation too much.
A large reduction in inflammation could diminish the lungs’ defense system, increasing the risk of infection.
Almost all research on CBD oil and pain comes from adult trials. Experts do not recommend CBD oil for use in children, as there is little research on the effects of CBD oil on a child’s developing brain.
However, people may use Epidiolex for children aged 2 years of age and upward who have rare forms of epilepsy.
A person should consult a doctor if they think a child needs to use CBD oil for seizures.
CBD oil is also not recommended during pregnancy or while breast-feeding.
While many studies have suggested CBD oil is helpful for pain, more research is necessary, especially in long-term studies with human subjects.
However, CBD oil does show a lot of potential for pain relief. Anecdotal evidence suggests that it can be used to help manage chronic pain in many cases.
CBD oil is especially promising due to its lack of intoxicating effects and a possible lower potential for side effects than many other pain medications.
People should discuss CBD oil with their doctor if they are considering using it for the first time.
Q: What precautions would you advise if someone wants to try CBD oil to treat pain?
A: Users should follow legal channels to obtain CBD.
The science is emerging to support its use, especially in a time where most people want to avoid the addicting opioids in chronic pain.
Because of the changes in social acceptance for the use of the marijuana plant and the urgency to address the opioid crisis, there is funding for clinical trials.
A 2017 study found CBD was effective for chronic neuropathy pain. It may have a role in reducing inflammation as well.
The individual should talk to a doctor first, start with the lowest doses possible, read the information available, and be an informed consumer.
Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHTAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.