Nature's Analgesic: Evaluating CBD's Effectiveness in Chronic Pain Management
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The Centers for Disease Control and Prevention estimates that approximately 50 million U.S. adults have chronic pain and 20 million of these adults have high-impact chronic pain. The most debilitating symptoms include the stiffness and the decreased movement of their joints which can be severe over time.
Unfortunately, current treatments for chronic pain often have serious side effects. Acetaminophen can damage liver function and is largely ineffective for arthritis. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, carry the risk of significant gastrointestinal effects, and opioid pain medications have fueled an epidemic of addiction.
Pain Relief without Addiction
Against this backdrop, unregulated CBD (cannabidiol) is becoming the treatment of choice in the US for many people wanting effective pain relief without psychotropic or addictive effects. Sales of CBD oils, vapes, creams, gummies, drinks, are expected to reach more than $60 billion by 2030.
In 2022, the National Institute of Health conducted a systematic review on the “Efficacy, Safety, and Regulation of Cannabidiol on Chronic Pain.” The conclusion: “CBD is an excellent alternative to an opioid in chronic pain because CBD is non-intoxicating in its pure form.”
The Arthritis Foundation reports that “Animal studies have suggested CBD has pain-relieving and anti-inflammatory properties. Anecdotally, some people with arthritis who have tried CBD report noticeable pain relief, sleep improvement and/or anxiety reduction. However, like any medication for arthritis, some people do not report any symptom improvements when taking CBD.”
According to Forbes Health, CBD is approved in the U.K. for multiple sclerosis, and in Canada for cancer pain. Ongoing research suggests CBD oil for pain can aid medical conditions, including fibromyalgia, at varying doses. Some pain may not be treatable by CBD alone, but it can help when paired with THC or Western medication applications.
Legal Considerations
CBD is readily available in this country, and all 50 states have laws legalizing CBD with varying degrees of restriction.
According to the Harvard Medical School, the CBD in most products is extracted from hemp, a variety of cannabis. One of hundreds of components in marijuana, CBD does not cause a high by itself. But, legally, CBD products may have up to 0.3 percent of THC, the active compound that gets people high, so taking too much may still cause THC-type effects.
A recent paper in JAMA Psychiatry reported that people taking a legal CBD product still had measurable quantities of THC in their urine, which could create employment repercussions.
Safety Considerations
Writing for the Harvard Medical School in April of this year, Dr. Peter Grinspoon said, “CBD can increase the level of blood thinning and other medicines in your blood by competing for the liver enzymes that break down these drugs. This interaction is particularly important if you are taking a blood thinner, an anti-epileptic, or an immunosuppressant medication, all of which need to have stable levels in your blood. People taking high doses of CBD may show abnormalities in liver-related blood tests. Let your doctor know if you are regularly using CBD so that he or she can check your liver enzymes periodically.”
Bottom Line: Be a Cautious Shopper
CBD products are largely unregulated in the US and independent testing has shown mislabeling and lack of quality control. The biggest issues are strength of CBD (significantly more or less than the label says), the presence of undeclared THC, and contamination with pesticides, metals and solvents. Here’s what to look for:
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Products manufactured in the US with ingredients grown domestically.
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Companies that follow good manufacturing practices established by the FDA for pharmaceuticals or dietary supplements or required by the state where they are manufactured.
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Products from companies that test each batch and provide a certificate of analysis from an independent lab that uses validated standardized testing methods approved by the American Herbal Pharmacopoeia (AHP), the U.S. Pharmacopeia (USP), or the Association of Official Agricultural Chemists (AOAC).
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Avoid companies that claim their products have disease benefits.
