CBD has been credited with relieving anxiety, inflammation, insomnia, and pain, although currently, the most scientific proof rests with its effects in people with epilepsy. Epidiolex is a prescription CBD oil that was FDA approved in June 2018 for two rare and severe forms of epilepsy, Lennox-Gastaut syndrome (LGS) and Dravet syndrome.
Preliminary studies have shown a favorable effect for CBD for reducing pain; however, more research is needed in the form of larger well-designed trials of longer duration to determine its long-term efficacy and safety.
Medically reviewed by Carmen Fookes, BPharm. Last updated on Oct 17, 2019.
Many plants contain cannabinoids, and people often confuse CBD with THC (tetrahydrocannabinol) which is another type of cannabinoid. Unlike THC, CBD does not cause a “high” or euphoric effect because it does not affect the same receptors as THC.
CBD (cannabidiol) is a compound that is usually extracted from industrial hemp.
By law, industrial hemp from which CBD is extracted must contain no more than 0.3 percent THC to be considered hemp, otherwise, growers are at risk of prosecution under federal law.
An extensive 2018 review on the use of cannabis and cannabidiol products for pain relief stated:
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.
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What’s the thinking behind using cannabis for chronic pain?
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.
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.
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.