Does CBD Work for Pain Management?

In recent years, Cannabidiol (CBD) has become a popular substance with a wide variety of uses. Many people use CBD to manage chronic and minor pain throughout their bodies as it presents a natural alternative to over-the-counter and prescription medications. However, scientific research is still lacking in many areas, and while there have been some encouraging studies that point to CBD being effective in managing pain, there is little definitive proof that it does so. That does not mean that CBD cannot help people manage their chronic and mild ailments, as there is a strong amount of anecdotal evidence that points to its potential use in pain relief, but you should be careful and cautious when considering using the compound. While anecdotal evidence shows that CBD has helped people, one should be wary of some of the more outlandish claims that have been made.

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CBD has shown potential in many areas, but there will need to be further research done to confirm its usefulness. The CBD industry is expected to grow significantly over the next couple of years, with some forecasts projecting that the market for CBD products in the U.S. could reach over $20 billion in revenue by 2024, so there will continue to be a flood of product hitting the market. Exercise caution and prudence when purchasing CBD products and be aware of the potential pitfalls.

What Is CBD?

Cannabidiol is a naturally-occurring chemical compound known as a cannabinoid. Many cannabinoids do not have any effect on the human body, though some of them, such as THC, do produce a psychoactive effect. CBD as well as THC are found in the cannabis plant, though industrial hemp plants have a higher concentration of CBD and do not contain any THC. Due to the lack of THC, CBD does not cause a psychoactive effect.

Cannabinoids such as THC produce their effects via the body’s endocannabinoid system, but CBD does not. Instead, CBD inhibits and activates different compounds in the body’s endocannabinoid system. The body’s endocannabinoid system has two receptors for cannabinoids: CB1 and CB2. CB1 receptors are located in the brain, and they impact cognitive function, which is why THC has a psychoactive effect on the brain. CB2 receptors are located outside of the brain, and CBD indirectly impacts them by causing the body to make more of its own cannabinoids, which is thought to help with the management of pain.

Does CBD Work for Pain Management?

Due to the explosion in CBD products, many people wonder if the compound actually decreases pain or if that decrease is due to the placebo effect. While there is still much ongoing research, preliminary studies show that CBD does affect the production of certain compounds in the body. For example, CBD inhibits the activity of an enzyme known as fatty acid amide hydrolase (FAAH). This enzyme inhibits anandamide production, one of the body’s naturally-produced cannabinoids, which is known as the “bliss molecule” for its anti-anxiety effects. It is theorized that increasing the production of anandamide can lead to a host of positive effects such as lower anxiety and better pain management.

Anecdotal evidence can be a powerful indicator of the effectiveness of a substance, but until there is more hard evidence in a controlled environment, exercise caution. The placebo effect can be incredibly powerful, and any worthwhile study will control for the placebo effect and look at the outcomes from the study with a careful eye for detail. Other studies have shown that there is potential for CBD to be used for pain management in patients with cancer and multiple sclerosis.

There have been other studies that have looked at a wider variety of cannabinoids found in the cannabis plant and the potential of those substances in relieving chronic pain. Initial results are positive but they are beyond the scope of this article. It is still unknown how the interaction of various cannabinoids found in cannabis results in pain relief.

Does CBD Reduce Inflammation?

Some recent research has shown the potential for CBD to reduce specific markers of inflammation in the body. While this was shown in a rat study, the mechanism by which CBD reduces inflammation—via targeting specific neurotransmitters— indicates that it is possible for a similar situation to occur in human studies.

How Effective Is CBD for Arthritis?

While there have yet to be any conclusive human studies, recent animal studies have shown the potential for CBD to help alleviate symptoms of arthritis. In a recent study in the European Journal of Pain, rats with arthritis were given CBD to help manage their pain. The study showed that the CBD reduced swelling and inflammation in the joint, along with reducing pro-inflammatory biomarkers.

However, the results have not been replicated in human trials as of yet, so it remains to be seen if CBD will help humans who have arthritis. While rat studies are useful as preliminary evidence for the effectiveness of a drug, the human body is far more complex. It will still be a while before any conclusive tests are run on human subjects, and though individuals may report that their pain has decreased due to their use of CBD, that alone is not enough to prove that it works.

Is CBD a Natural Substitute for Ibuprofen?

Ibuprofen is known for being one of the strongest over-the-counter medications for treating pain and inflammation, though the drug is also known for its strong negative side-effects. Ibuprofen strongly inhibits the production of certain compounds in the body that cause tissues to become inflamed and painful. Ibuprofen and CBD do not affect the same pathways in the body, and while CBD has been shown potential to help with pain management, it should not be used as a natural substitute for Ibuprofen.

Ibuprofen has been rigorously tested, it is regulated by the FDA, and the proper dosage is known. CBD is still in its infancy as a pain reliever, so caution must be exercised when using it. We still lack information on what the proper dosage of CBD is for pain relief whereas Ibuprofen and other painkillers have been rigorously tested and it is known what the proper dosage is to relieve pain.

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Is CBD as Effective in Pain Management as Opioids?

Since CBD is a cannabinoid, it affects different pathways in the body than opioids do. Opioids are known for their potent painkilling effects as they bind to opioid receptors in the brain, and lessen the pain signals from other parts of the body. Opioids are incredibly powerful at reducing pain, but they are dangerous because they are extremely addictive substances. CBD and other cannabinoids have shown some promise in reducing pain signals, and they are not as addictive as opioids. There are some in the medical community who hope to do more research on cannabinoids and their potential for pain relief, particularly as the US continues to struggle with an opioid addiction crisis. However, from a pure pain relief standpoint, opioids are more potent.

How Does CBD Affect or Interact With the Immune System?

While there is still much ongoing research into how CBD interacts with the body, some preliminary studies have shown that CBD suppresses T cell function, which in turn suppresses immune system functioning. This can make one more susceptible to illness and cancer as T cells are one of the body’s strongest defenders when it comes to destroying cancer cells and viruses. It’s important to note that this has only been shown in mice studies, and there is no evidence to show that the same thing would occur in humans.

How Should CBD Be Taken?

CBD products come in a variety of different forms, and you should consider what you’re using the CBD for before you buy a particular type of product. The type of CBD product you consume will change the effects it has due to the dosage and how quickly it is absorbed into your bloodstream. Smoking CBD will have the quickest impact, followed by sublingual oil tincture, topical balms/creams, and ingesting pills or edibles.

• Smoking: Either by smoking hemp or using a vape pen with CBD liquid, smoking is the quickest way to get the effects of CBD. Keep in mind that many CBD products that you can smoke in a vape pen may contain solvents that put the user at risk for developing lung disease and lung cancer. Dosage and purity is also an issue as it can be hard to judge what the dosage is from one puff of the vape pen.

• Oil Tincture: By blending the CBD in an oil tincture, it can be rapidly absorbed by placing a few drops or spraying underneath your tongue. Leaving the oil there and allowing it to be absorbed in the mouth before swallowing is the best method. Again, dosage concerns are there as it can be hard to determine how much CBD is in each drop. Asking a salesperson who is familiar with the product is a good way to go about figuring out the proper dosage.

• Topical Creams/Balms: These creams and ointments are applied topically to the area where you are experiencing pain. The benefit of this is that the CBD can go directly to the affected area and not the rest of your body. Preliminary studies have shown that applying a topical CBD solution can reduce inflammation and swelling and the affected area. The issue with using a topical cream is that there has to be a lot of CBD in the product in order to make it effective, which can prohibitively raise the cost of the balm.

• Pills/Edibles: The least efficient method for consuming CBD, ingesting either a pill or an edible can work, but it will take significantly longer than the other methods, and there is the potential for interaction between the food and the CBD. One major plus is that CBD-infused food and beverages are becoming very popular and they are easy to get a hold of.

What Are the Potential Side Effects and Downsides of CBD?

CBD products aren’t approved by the U.S. Food and Drug Administration (FDA) for any medical condition. Though, the FDA did recently approve a drug to treat epilepsy, Epidiolex, which is the first drug to contain CBD. This is an encouraging sign that the federal government has acknowledged the fact that CBD has potential as a legitimate medical supplement. It is also another step towards having CBD removed from the federal banned substances list, another major hurdle that would allow for easier access and more research.

The main issue with CBD products now is that they aren’t regulated for purity and dosage like other medications. The FDA doesn’t regulate supplements, so it is hard to determine how pure any of these CBD products are. In addition, these products could contain other chemical compounds that could interfere with the CBD. When it comes to dosages, the science is also murky. Due to the unregulated aspects of the supplement industry, there is not a consensus as to what the proper dosage of CBD is. Please be careful and cautious with any doses of CBD products and be sure to consult with a medical professional before taking any CBD products to make sure it does not interfere with any other medications you are taking.

CBD can cause adverse effects such as nausea, fatigue, changes in appetite, and intestinal issues. There have been no studies that look at the long term effects of prolonged CBD consumption, making those in the medical profession wary about patients taking the substance for long periods or indefinitely.

Works Cited

Dorbian, I. (2019, May 20). CBD Market Could Reach $20 Billion By 2024, Says New Study. Retrieved from https://www.forbes.com/sites/irisdorbian/2019/05/20/cbd-market-could-reach-20-billion-by-2024-says-new-study/#c29ee6349d05

FDA. (2018, September 27). FDA-approved drug Epidiolex placed in schedule V of Controlled Substance Act. Retrieved from https://www.dea.gov/press-releases/2018/09/27/fda-approved-drug-epidiolex-placed-schedule-v-controlled-substance-act

Gill, L. L. (2018, August 26). How to Safely Use CBD: Should You Inhale, Spray, Apply, or Eat It? Retrieved from https://www.consumerreports.org/cbd/how-to-use-cbd-inhale-spray-apply-eat/

Hammell, D. C., Zhang, L. P., Ma, F., Abshire, S. M., McIlwrath, S. L., Stinchcomb, A. L., & Westlund, K. N. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European journal of pain (London, England), 20(6), 936–948. doi:10.1002/ejp.818

Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154. doi:10.1089/can.2016.0034

Jacques, J. (2018, April 17). Beyond CBD – Supporting the Entire Endocannabinoid System. Retrieved from https://www.thorne.com/take-5-daily/article/beyond-cbd-supporting-the-entire-endocannabinoid-system

Kaplan, B. L., Springs, A. E., & Kaminski, N. E. (2008). The profile of immune modulation by cannabidiol (CBD) involves deregulation of nuclear factor of activated T cells (NFAT). Biochemical pharmacology, 76(6), 726–737. doi:10.1016/j.bcp.2008.06.022

Russo E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management, 4(1), 245–259. doi:10.2147/tcrm.s1928

Xiong, W., Cui, T., Cheng, K., Yang, F., Chen, S. R., Willenbring, D., … Zhang, L. (2012). Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. The Journal of experimental medicine, 209(6), 1121–1134. doi:10.1084/jem.20120242