CBD and Cannabis Options

Everyone has a cell-signaling system known as the endocannabinoid system (ECS).

Some researchers think that CBD interacts with a core component of the ECS — endocannabinoid receptors in your brain and immune system.

Receptors are tiny proteins attached to your cells. They receive signals, mostly chemical ones, from different stimuli and help your cells respond.

This response creates anti-inflammatory and pain-relieving effects that help with pain management. This means that CBD oil and other products may benefit people with chronic pain, such as chronic back pain.

One 2018 review assessed how well CBD works to relieve chronic pain. The review looked at studies conducted between 1975 and March 2018. These studies examined various types of pain, including:

• Cancer pain
• Neuropathic pain
• Fibromyalgia

Based on these studies, researchers concluded that CBD was effective in overall pain management and didn’t cause negative side effects.

A 2016 study looked at CBD use in rats with arthritis.

Researchers applied CBD gel to rats for four days in a row. The rats received either 0.6, 3.1, 6.2, or 62.3 milligrams (mg) per day. The researchers noted reduced inflammation and overall pain in the rats’ affected joints. There were no obvious side effects.

Rats who received low doses of 0.6 or 3.1 mg didn’t improve their pain scores. The researchers found that 6.2 mg/day was a high enough dose to reduce the rats’ pain and swelling.

In addition, rats who received 62.3 mg/day had similar outcomes to the rats that received 6.2 mg/day. Receiving a substantially larger dosage didn’t result in them having less pain.

The anti-inflammatory and pain-relieving effects of CBD gel could potentially help people with arthritis. However, more human studies are needed.

Some people with cancer also use CBD. Research on mice has shown that CBD can lead to the shrinking of cancerous tumors. However, most studies in humans have investigated the role of CBD in managing pain related to cancer and cancer treatment.

The National Cancer Institute (NCI) has pointed to CBD as a possible option for reducing chemotherapy side effects, such as:

• Pain
• Vomiting
• Lack of appetite

In a 2010 study on cancer-related pain, study subjects received oral sprays of a combination THC-CBD extract. The THC-CBD extract was used in conjunction with opioids. This study revealed that using the extract provided more effective pain relief than using the opioids alone.

A 2013 study on THC and THC-CBD oral sprays had a similar finding. Many researchers from the 2010 study worked on this study as well. More evidence is still needed.

Studies on CBD and migraine are limited. The studies that currently exist also look at CBD when it’s paired with THC, not when it’s used alone.

However, results from a 2017 study indicate that CBD and THC can lead to less acute pain and less intense pain for people with migraine.

In this two-phase study, some participants took a combination of two compounds. One compound contained 9 percent CBD and almost no THC. The other compound contained 19 percent THC. Doses were taken orally.

In phase I, there was no effect on pain when the doses were under 100 mg. When the doses were increased to 200 mg, acute pain fell by 55 percent.

In phase II, participants who received the combination of CBD and THC compounds saw the frequency of their migraine attacks fall by 40.4 percent. The daily dose was 200 mg.

The combination of compounds was slightly more effective than 25 mg of amitriptyline, a tricyclic antidepressant. Amitriptyline reduced migraine attacks by 40.1 percent in study participants.

Participants with cluster headaches also found pain relief with the combination of CBD and THC compounds, but only if they’d had a childhood history of migraine.

CBD doesn’t pose significant risks for users, and most topical CBD products don’t enter the bloodstream.

However, certain side effects are possible, such as:

• Fatigue
• Diarrhea
• Changes in appetite
• Changes in weight

CBD may interact with:

• Certain over-the-counter (OTC) drugs
• Prescription medications
• Dietary supplements

Proceed with caution if any of your medications or supplements contain a “grapefruit warning.” Grapefruit and CBD both interfere with enzymes that are crucial to drug metabolism.

Like other drugs and supplements, CBD may also increase your risk of liver toxicity.

One study on mice concluded that CBD-rich cannabis extract increased their risk of liver toxicity. However, some of the mice had been force-fed very large amounts of the CBD-rich cannabis extract.

Hemp-derived CBD products (with less than 0.3 percent THC) are legal on the federal level, but are still illegal under some state laws. Marijuana-derived CBD products are illegal on the federal level but are legal under some state laws. Check your state’s laws and those of anywhere you travel. Keep in mind that nonprescription CBD products are not FDA-approved and may be inaccurately labeled.