Is CBD oil effective for managing chronic pain?

● Effects
● What is CBD oil?
● Benefits
● Other uses
● Dosage
● Side effects
● Other considerations
● Summary
Some people take cannabidiol (CBD) to help with pain relief. But, the use of CBD still carries a stigma for other people, as they do not fully understand its potential benefits.
CBD oil comes from cannabis plants. Reports suggest that people use CBD oil to alleviate anxiety, pain, depression, and even sleep disorders.
Due to restrictions regarding the use of cannabis, and research into its potential uses, evidence to support the potential health benefits of CBD for humans is limited. Legal cannabis use is gradually spreading in various countries and the volume of research on its possible applications is growing, and revealing some beneficial results.
This article examines how CBD functions and why people use CBD to help manage chronic pain

The effects of CBD

CBD is a cannabinoid present in cannabis plants. There are at least 100 cannabinoids that have been identified in cannabis. Various plants have cannabinoids, but people are most likely to associate cannabinoids with cannabis plants.
Unlike the cannabinoid THC (tetrahydrocannabinol), there is no ‘high’ feeling associated with CBD, as CBD does not affect the same neuroreceptors as THC does.
The endocannabinoid system (ECS) in the body receives and interprets signals sent by cannabinoids. The body’s ECS produces its own cannabinoids, called endocannabinoids. The endocannabinoid system in the body helps in regulating certain bodily functions, for example, immune-system responses, pain, and sleep.
If THC is consumed, the result is a ‘high’ sensation because the endocannabinoid receptors of the brain are affected. And the brain produces chemicals such as dopamine, which are associated with feelings of pleasure.

Will CBD get you high?

The effects of CBD are very complex, and CBD as a compound is different from THC. There is no ‘high’ sensation associated with it and it does not adversely affect how a person functions. However, CBD is more effective in stimulating the body’s own endocannabinoids.
In 2015, a study published in Neurotherapeutics reported that CBD has an effect on various receptor systems in the body and other cannabinoids in the ECS.
One example is how CBD is able to increase the level of anandamide in the body. Anandamide is a compound that helps in regulating pain, by decreasing the perception of pain and improving mood.
It is also believed that cannabidiol limits inflammatory activity in the nervous system and brain. This is something that might be beneficial for people suffering from pain, insomnia, or a specific adverse immune system response.

CBD oil

Various strains of cannabis plants (hemp, marijuana, etc.) have different concentrations of chemical compounds present within them.
The cultivation method used for the plants influences the levels of CBD present. Most CBD oil used in products is derived from industrial hemp. This type of hemp generally contains more CBD than marijuana.
Manufacturers use various extraction methods to get CBD, which is then mixed with a carrier oil, producing the finished product – CBD oil.
CBD oil is available in various degrees of strength, for different purposes. Before taking a CBD oil product, you should consult your doctor.

Potential Benefits and pain relief

There is some evidence suggesting that CBD may help treat chronic pain, as noted by the National Center for Complementary and Integrative Health (NCCIH).
Despite the potential benefits of CBD associated with pain relief, current evidence does not confirm CBD’s effectiveness nor safety for treating pain. Currently, CBD remains unapproved by the European Medicines Agency (EMA) as a treatment for pain.
A review conducted in 2020 reported that CBD may have some effect on alleviating severe pain, improving sleep, and helping reduce inflammation. However, the results related to a limited scope of specific conditions.
Further research is still needed to establish the real therapeutic potential CBD offers, effective dosages and overall safety, as a treatment for pain.
Current research suggests that CBD oil may have the following possible applications:

Neuropathic pain

This type of pain results from nerve damage. It is commonly associated with the following conditions: multiple sclerosis, herniated discs, and shingles.
A review conducted in 2017 concluded that CBD can help treat severe neuropathy pain in people. The research examined eleven randomized controlled trials in which 1,219 people participated.
But another review in 2018 determined that any possible benefits of cannabis-based drugs would likely be outweighed by potential risks.
The review examined the impact of CBD and other cannabis-based treatments on severe neuropathic pain. It included 16 studies in which 1,750 people participated.
Further research is still needed in order to understand how CBD functions in managing chronic neuropathic pain, the potential risks, benefits, and optimal dosage.

Arthritis pain

In 2016, a study published in the European Journal of Pain reported how an animal model was used to examine if CBD was able to help treat people suffering from arthritis pain. In the study, a topical CBD gel was applied for 4 days to rats suffering from arthritis.
The research reported a considerable decrease in inflammation and pain symptoms, and no indication of any adverse side effects.
Some people taking CBD oil to help manage arthritis pain have reported experiencing a degree of pain relief, but further research based on humans is still needed to support such results.

Multiple sclerosis (MS)

MS is an autoimmune disease. It negatively affects the brain and nerves, and thus the whole body.
One of the most common symptoms associated with MS is muscle spasms. Such spasms may be so intense that they lead to patients suffering from constant pain.
Research details how short-term treatment with CBD oil was found to decrease the intensity of muscle spasms experienced by patients. Despite the results being modest, many patients reported experiencing reduced symptoms. But further human studies are needed to substantiate these outcomes.

Chronic pain

In the same study, CBD was examined as a treatment for general chronic pain. The study collated the results and outcomes of multiple trials and research studies. The study concluded that there is firm evidence to suggest the use of cannabis as an effective chronic pain treatment for adults.
The Journal of Experimental Medicine published another study that supports these results. The research concludes that the use of CBD helps to decrease pain and inflammation.
Also, the research revealed that participants were unlikely to build up a tolerance to CBD and its effects, which avoids the need for incremental dosage due to resistance.
The research concluded CBD and other cannabinoids may provide potential new treatment methods for patients suffering chronic pain.

Other uses

There are currently various potential applications and possibilities for the use of CBD.
Some of these are:
● combatting withdrawal symptoms for smokers who quit
● treating drug withdrawal symptoms
● reducing seizures and epilepsy
● managing anxiety
● treating some symptoms of Alzheimer’s disease
● decreasing antipsychotic effects
● helping patients manage schizophrenia
● possibly treating type 1 diabetes
● possibly treating cancer
Further research is still needed to establish the tangible benefits of using CBD oil in such cases, but CBD shows much potential to be a versatile treatment method for various conditions.
One such application of CBD-based medication has already been approved by the European Medicines Agency (EMA). Epidyolex received approval by the EMA in 2019 for use in treating two uncommon forms of epilepsy. It was also approved for use in treating seizures in another rare case, tuberous sclerosis complex.
However, CBD products derived from cannabis cannot be sold legally in many European Union countries.
Anyone wishing to buy CBD products should check the local laws governing their sale. Remember that non-prescription CBD products are unregulated, and may include inaccurate labelling.

Dosage

CBD is currently unregulated in most cases. So the correct dosage for any condition is undetermined and open to debate. Caution is therefore advised for anyone considering using CBD to treat a health condition.
You should consult your doctor before using any CBD product to determine if it will be beneficial and safe.

Side effects

Although only a few people experience any side effects from using CBD, they do exist.
Cannabis and Cannabinoid Research published a review in 2017 that outlined some of the side effects associated with CBD use. These include:
● changes in appetite
● weight gain/loss
● fatigue
● diarhea

Also, CBD oil may affect the efficacy of other medications if taken at the same time.
The study also states that further research is needed into other related aspects, such as how CBD might influence hormone levels in the long term. Longitudinal studies would be useful in establishing if long-term use of CBD leads to side effects for users.
Always consult your doctor before taking any CBD product. It might interact with some over-the-counter medications or dietary supplements, and even prescription medicines.
It is also thought that CBD might adversely affect the cytochrome P450 complex enzyme. Such disruption may inhibit the ability of the liver to effectively deal with toxins in the body. As a result, it might lead to an increase in the risk of developing a toxic liver.
The Epidyolex product information leaflet explains about possible side effects such as liver damage, fatigue, and possibly anxiety or depression. However, many of these possible side effects are also related to other epilepsy treatments.
Frontiers in Pharmacology published a study that noted the anti-inflammatory effects of cannabinoids may be too dramatic, resulting in diminishing the defence system of the lungs, which could lead to a higher risk of infection.

Other considerations

Existing research on CBD and its possible uses is generally based on adult subjects. Scientists are unable to recommend using CBD oil to treat children; currently, there is insufficient evidence regarding the possible effects that CBD oil may have on a child’s brain, which is still developing.
The exception at the moment is the use of Epidyolex to treat children over 2 years of age suffering from rare epilepsy variants.
It is not advised for pregnant people or those breastfeeding to take CBD products.
Also, care should be taken if ingesting CBD products orally with meals containing a lot of fat. High-fat food may significantly increase the concentration of CBD in the blood. This may, in turn, lead to a greater likelihood of side effects occurring.
CBD products are not regulated by the EMA like most drugs are. Also, dietary supplements containing CBD are not currently regulated by the European Food Safety Authority (EFSA). Some companies have been found to mislabel some products. Before purchasing any such CBD products, it is essential to research the supplier and ensure the quality of the product.

Summary

Although there is some evidence to suggest CBD oil might be useful for treating pain, further research including human studies is needed, especially regarding any possible long-term side effects for CBD users. Despite the lack of conclusive evidence, CBD oil appears to offer much hope as an effective pain treatment. The current evidence would suggest that CBD may be useful in treating patients suffering from chronic pain in some scenarios. The appeal of CBD oil as a possible pain treatment is primarily because it lacks any intoxicating effects. It also potentially poses a lower risk of side effects than various types of conventional pain medication.

What precautions should someone take before trying CBD oil for pain treatment?
Before trying CBD products, you should consult your doctor. Only purchase CBD products from legally registered suppliers.
Evidence is gradually becoming available that supports the use of CBD in chronic pain management and for other applications.
Due to social changes and the wider acceptance of marijuana use, and the urgent need to find a solution to the current opioid crisis, funding for clinical trials is becoming more readily available. This will help drive further research in the potential uses of CBD and other cannabinoids.
A study in 2017 revealed that CBD was effective in alleviating chronic neuropathy pain. CBD may also help reduce inflammation.
Anyone wishing to try CBD products should consult their doctor first. Read all available information on the product, and begin by taking the smallest dose possible