No matter what kind of pain one has there’s always a remedy for it, and it’s typically as easy as taking a prescribed pharmaceutical or natural supplement to ease it. Every solution usually has a downside though, including side effects or even possible addictive properties. No wonder, then, the continuous search for that next new remedy, the magic elixir that promises pain relief but with minimal harm.
That may be why CBD (cannabidiol) has taken center stage recently, from celebs and natural healers to medical professionals touting its pain relief properties. But CBD is actually not new and has, in fact, been around for centuries. The hemp plant (derivative of cannabis sativa and what CBD oil is made from), was used as far back as 4,000 BCE in China and Turkestan for textiles. Today, CBD is recommended for healing everything from inflammation to sleep problems, and even for epileptic seizures.
An important distinction to understand in any discussion of CBD is that it is not THC (tetrahydrocannabinol) the psychoactive component in cannabis. While CBD can contain some THC, and they are both cannabinoids, the therapeutic CBD extracted from hemp does not get one high as it is naturally non-intoxicating. There are two kinds of CBD: CBD extracted from hemp which has high CBD versus low THC (typically lower than .3%), and CBD extracted from marijuana which is the reverse, with low CBD and high THC. If looking for pain relief without the high, make sure the CBD product used is extracted from hemp.
Issues with Over The Counter and Prescribed Pain Relievers
Typical pain relievers range from over the counter NSAIDs (non-steroidal anti-inflammatories) to stronger, narcotic options like codeine or hydrocodone. While they certainly knock out all types of pain, these remedies also come with a long list of side effects, including addiction.
While NSAIDs are helpful for acute pain, their usefulness for chronic pain isn’t entirely clear. And side effects of NSAIDs can range from less serious issues like rebound headaches to more serious gastric upset. Other side effects include:
- Medicine like aspirin, one of the oldest pain relievers, used too often can cause stomach bleeding.
- Acetaminophen can cause liver damage if taken too much.
- ibuprofen can cause kidney and stomach problems.
Stronger painkillers such as fentanyl, oxycodone and morphine not only have side effects but also addictive qualities. Many who are prescribed these narcotics for pain, whether it’s a bad knee or for post-operative pain, find themselves addicted to a drug they thought was helping them. According to the National Institute on Drug Abuse, roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.
Potential for Pain Relief in CBD
Considering the list of negative effects typical pharmaceuticals can have, CBD’s pain relief potential combined with minimal side effects and no addictive properties is certainly an exciting option. To understand how CBD works, it is helpful to also understand the endocannabinoid system in the human body, as the two are intimately linked.
Researchers discovered that humans have receptors in the body, both CB1 and CB2. CB1 receptors are found in the brain and central nervous system (CNS). The CNS controls motor activity, stress response and pain perception. CB2 receptors are concentrated in the immune system, cardiovascular system and muscular system.
Overall, the endocannabinoid system helps maintain the health of the body. If endocannabinoids decrease, so too it follows that overall health can decrease. This is where CBD comes in, because when CBD bonds with either CB1 or CB2 receptors, it helps increase functionality overall.
When it comes to pain relief specifically, multiple studies have shown CBD to be helpful in a variety of ways:
- Published in 2009, a study focusing on chronic inflammation found that CBD (cannabidiol) is indicated in suppression of inflammation.
- A study based on a rat model of arthritis concluded that transdermal CBD cream was effective in relieving arthritis pain with no effect on higher brain function.
- In a study of adults with multiple sclerosis (MS)-related spasticity, it was found that short-term use of oral cannabinoids improved spasticity symptoms.
Limitations of CBD
Limitations regarding CBD use is that there still isn’t enough long term safety data. Currently there is a lack of FDA regulation when it comes to CBD production, which can effect standardization and purity of products. When purchasing CBD products for pain relief its important to understand the percentage of CBD in the product that is beneficial for pain relief. Always buy from reputable manufacturers. Also, the confusion regarding the legality of CBD in different states could effect patient’s access to it.
Dangers of Using CBD for Pain Relief
According to a report from the World Health Organization, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD.”
This same report states that CBD is generally well tolerated, and any adverse effects may be attributed to drug to drug interaction between CBD and a patient’s other medications. If considering CBD always check with a doctor for any interactions.
Some side effects that have been reported, depending on the user, are hallucinations, low blood pressure, dizziness, depression, insomnia and irritability. Last, there drugs that are metabolized in the liver by CYP450 enzymes, which could potentially interact with cannabidiol (CBD).
Legality of CBD and Its Current Availability
Like much of the information about CBD, the legal status of growing and selling it continued to be a gray area. That was until the passing of the 2018 Farm Bill, which clarified it is now legal to grow industrialized hemp in the United States, and that CBD derived from hemp is considered a lawful substance.
When determining if CBD is legal the most important component to consider is whether it was derived from marijuana or hemp. CBD derived from cannabis is still considered a Schedule 1 drug (the most harmful) by the U.S. Drug Enforcement Administration (DEA). However, recently CBD with THC content below 0.1% was reclassified from a Schedule 1 drug to a Schedule 5 drug, as long as it has been approved by the FDA. A Schedule 5 drug means it is considered the least harmful.
Despite the recent Farm Bill, as reported in The Street the legality of CBD continues to evolve so when prescribing, buying or traveling with CBD it is still advised to research each state’s current position on it. It is also best practice to know what the CBD oil was extracted from, a hemp plant or marijuana, which also effects its legal status.