CBD, a non-psychoactive component in cannabis, is emerging as a promising pharmaceutical agent to treat pain and other conditions. Unfortunately, few studies in humans have examined its effectiveness, and the cannabis industry’s profit motive is driving a wave of dubious claims about what CBD can do. There are a variety of CBD products available, including oil, tinctures, creams, and capsules. There are a number of things that people should consider when purchasing CBD products.
CBD for chronic pain: The science doesn’t match the marketing
If you ask health care providers about the most challenging condition to treat, chronic pain is mentioned frequently. By its nature, chronic pain is a complex and multidimensional experience. Pain perception is affected by our unique biology, our mood, our social environment, and past experiences. If you or a loved one is suffering from chronic pain, you already know the heavy burden.
People are looking for novel, nonaddictive ways to treat pain
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.
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.
What’s the thinking behind using cannabis for chronic pain?
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.
What’s the research that CBD works in humans?
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!
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.
Why is CBD presented to the public this way, when it is not without risks?
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).
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.
Many of the CBD products on the market are unregulated
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.
Beware of powerful testimonials
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.
The bottom line: Don’t make CBD your first or only choice for pain relief
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.
About the Author
Shafik Boyaji, MD , Contributor
Dr. Boyaji earned his medical degree from University of Aleppo, Syria. He completed an Internal Medicine residency at Michigan State University and an Anesthesiology residency at the Brigham and Women’s Hospital. Currently he is in fellowship … See Full Bio
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Ive been in persistent ache for 10 years. I’ve been the usage of Kratom and marijuana to deal with the ache. I would not be alive these days with out the kratom. I became the usage of hydrocodone which became a terrible enjoy mentally and physically. Recently my canine evolved a hip trouble wherein she should not walk. The groomer started out making use of cbd oil and in quick time she became lots higher It’s an absolute miracle. Marijuana is a plant now no longer a drug and additionally hemp has come to be a superfood. Marijuana became maximum possibly made unlawful to guard the earnings of pharma.
Considering Different CBD Products for Back Pain
Many forms of cannabidiol (CBD) products are available and have potential for alleviating back pain. CBD is relatively new to the health and wellness industry. Some products may make claims not supported by scientific evidence or may not actually contain potent levels of CBD.
There are many types of CBD products available, including edibles, oils, tinctures, and creams. These products are available over-the-counter at stores and online.
Considerations When Choosing CBD Products
Because of the abundance of types and companies that produce them, there are certain testing and labeling elements a person should look for when considering CBD products.
- Third-party testing. Look for products that have been tested by a company other than the one selling it. Third-party testers are concerned with the ingredients regardless of what the manufacturer says.
- Clear and accurate labeling. Manufacturers should make testing results accessible and easy to understand on the label and online.
- Continuous testing. Each “batch” of a product can vary in quality and content. Reliable manufacturers regularly test their products and will update the testing results on the labels and online.
CBD products are unregulated by the FDA. Because of this, it is important to read labels carefully and discuss any concerns with a health care provider.
Types of CBD Products Available
Currently, there are no CBD products available that specifically treat back pain. Some of the most common CBD products that may be used to treat back pain include:
- Oils. CBD oil can be taken orally, vaporized, or mixed into beverages. Generally, oil is what is used in other CBD products, such as creams, and sprays, but can also be used alone. CBD oil-filled capsules are also available, which provide the ability to more accurately determine dosing (for example, taking 450 mg vs. 3000 mg).
- Tinctures. A tincture is made by soaking cannabis flowers in alcohol for an extended period of time. This process will extract the CBD into a more concentrated form than found in most CBD oil products. Generally, tincture bottles are designed with a built-in dropper so a person can take one drop or several. Tinctures can be used on their own or mixed with food or beverage.
- Edibles. CBD can be mixed into foods and drinks. They can also be made at home by mixing CBD oil or tinctures into food and drinks. Examples include baked goods, gummies, and chocolates.
- Creams and gels. CBD-infused lotions are considered topical because they are applied to the skin. CBD-infused creams and gels are absorbed by the skin, which makes them a good solution to back or neck pain, and they have been shown to reduce inflammatory and neuropathic pain.
Choosing the correct CBD product to alleviate back pain symptoms may require trial and error in order to find the correct delivery method and dosing.
Consumers of CBD are encouraged to stay informed about regulations surrounding products.