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.
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.
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.
Beware of powerful testimonials
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!
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.
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.
What’s the research that CBD works in humans?
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.
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).
Chronic pain is the most common reason for medicinal cannabis use, according to a recent survey. If you have a chronic pain condition and have not been able to manage it with standard treatment (or wish to avoid the adverse effects of other medications), you may be considering CBD oil for pain relief.
Another study, published in the European Journal of Pain in 2016, found that topical CBD gel significantly reduced joint swelling and measures of pain and inflammation in rats with arthritis.
In a report published in Pediatric Dermatology in 2018, scientists reported three cases of topical CBD (applied as an oil, cream, and spray) use in children with a rare, blistering skin condition known as epidermolysis bullosa.
Lana Butner, ND, LAc, is a board-certified naturopathic doctor and licensed acupuncturist in private practice in New York City .
What’s more, CBD oil may interact with certain medicines, such as medications changed by the liver (including chlorzoxazone, theophylline, clozapine, and progesterone) and sedative medications (including benzodiazepines, phenobarbital, fentanyl, and morphine).
CBD oil should not be used as a substitute for standard care. In the case of chronic inflammatory conditions like arthritis, for instance, chronic inflammation can lead to joint damage (causing destruction and disability) if the condition is not effectively managed.
According to the Institute of Medicine of The National Academies, 100 million Americans live with chronic pain. Along with drastically reducing quality of life, chronic pain can increase healthcare costs and have a negative impact on productivity at work.
Scientists are still trying to determine how CBD oil might alleviate pain. However, there’s some evidence that cannabidiol may affect the body’s endocannabinoid system (a complex system of cell-to-cell communication). Along with contributing to brain functions like memory and mood, the endocannabinoid system influences how we experience 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.