4. Philpott HT, et al. Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis. Pain. 2017 Dec; 158(12): 2442–2451.
A CBD isolate refers to a product that is composed of the CBD compound only and is extracted from the marijuana plant. CBD isolates can be extracted from both hemp and non-hemp species of marijuana. Remember, for it to be federally legal, it must come from the hemp species. In states where medicinal marijuana is legal, you can find CBD isolates in a marijuana dispensary. Additionally, certain CBD isolates are synthetic forms, such as those used in the pharmaceuticals Marinol and Syndros – both FDA approved to relieve chemotherapy-induced nausea and to improve appetite in people with AIDS. 3
8. Atalay S, Jarocka-Karpowicz I, Skrzydlewska E. Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants. 2020;9(1):21.
First, consider the source. Studies show that continuous CBD consumption is generally safe and can have many benefits. However, because of CBD’s complicated status, the compound itself may still be classified as an illegal substance. See the FDA’s FAQs on cannabis regulations (#9).
How does CBD help pain?
Clear? You likely still have questions. Read on for specific products and which symptoms they aid.
Although CBD is generally well tolerated, THC may decrease potential side effects of CBD. THC may also play an important role in CBD’s pain-relieving effects, by aiding its influence on the endocannabinoid system.
You can also vape a CBD isolate or broad spectrum oil, which should not induce a high.
HOW TO USE CBD FOR PAIN: WHICH PRODUCTS TO TRY
These days, it seems like you can purchase CBD just about anywhere, but if it’s an option, you may want to visit a medical marijuana dispensary. Buying CDB from a medical dispensary doesn’t guarantee the product’s quality but it’s a good place to start. Before you go:
The entourage effect also accounts for the terpenes 13 that can differ between various strains of marijuana and contribute to the plant’s effect. Some recent research points to the beneficial effects of this compound (think aromatherapy).
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.
Much of the research literature around CBD in particular supports its use as a treatment for childhood epilepsy. Indeed, in 2018 the FDA approved the CBD-based drug Epidiolex as a drug for childhood epileptic conditions. In a substantial policy shift, Epidiolex was designated as Schedule V, which is the least restrictive drug schedule and indicates little potential for abuse.
Route of administration matters. CBD is best taken in pill or capsule form for slow extended release or as an oral tincture (infused oil that contains CBD) for faster effect onset.
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Want to learn more on this topic? Listen to this podcast from the Rogel Cancer Center on Medical Marijuana for Cancer Patients.
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.”
Yet marijuana has been used as a medicinal plant for thousands of years, he notes. In fact, one of the first recorded uses of cannabis was for rheumatism, also known as arthritis. Cannabis products were widely used as medicines in the 19th and early 20th centuries, and were listed in the U.S. Pharmacopoeia before the onset of Federal restriction in 1937 under the Marijuana Tax Act.
They also provided guidance for the Arthritis Foundation, who recently surveyed 2,600 people with arthritis and found that 29% currently use CBD to treat arthritis symptoms.
Boehnke and Clauw recommend that people with chronic pain talk to their doctor about adding CBD to their treatment plan, and continue to use their prescribed medication. They offer the following advice for people wanting to try CBD:
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.