CBD as a Treatment for Chronic Pain

Pain is a component of many chronic conditions, and chronic pain is emerging as a health concern on its own. Chronic pain is often difficult to treat and can be very disabling. According to the Centers for Disease Control, an estimated 20.4% of U.S. adults had chronic pain and 8.0% of U.S. adults had high-impact chronic pain in 2016. New approaches to targeting pain pathways are being developed, and the role of the cannabis plant and its components, cannabinoids, are among the advances proving effective in treating chronic pain.

The only pharmaceutical cannabis product approved for pain, Sativex, (Sativex has been approved by the equivalent of the FDA in 23 countries – but the U.S. FDA has not approved it and therefore it is not available in the U.S.) bears a 1:1 ratio of CBD to THC that has been used to treat neuropathic pain for over a decade. This is because of CBD’s ability to stimulate CB2 receptors within the endocannabinoid system, many of which are located in the nervous system. CBD’s effects are very complex; it influences the body to use its own endocannabinoids more effectively.

In a decade old study, the investigators put it like this: “The endocannabinoid system parallels and interacts at many points with the other major endogenous pain control systems: endorphin/enkephalin, vanilloid/transient receptor potential, and inflammatory.”  According to a more recent study posted to Neurotherapeutics, this is because CBD itself does very little to the ECS. Instead, it activates or inhibits other compounds in the endocannabinoid system. For example, CBD stops the body from absorbing anandamide, a compound associated with regulating pain. Increased levels of anandamide in the bloodstream may reduce the amount of pain somebody is feeling. CBD also limits inflammation in the brain and nervous system, which may benefit people experiencing pain. CBD has more of an antioxidant effect than Vitamins C & E, while modulating the CB1 receptors to not take in too many other cannabinoids.

In another report, researchers studied CBD use for general chronic pain by compiling the results of multiple systematic reviews covering dozens of trials and studies. Their research concluded that, “there is substantial evidence that cannabis is an effective treatment for chronic pain in adults.”  The evidence was strong enough that they titled this report, “In adults with chronic pain, patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms.”

A separate study in the Journal of Experimental Medicine supports these results, suggesting that CBD reduces pain and inflammation. The researchers also found that patients were not likely to build up a tolerance to the effects of CBD, so that, unlike those treating their pain with opioids, they would not need to increase their dosage over time. They noted that cannabinoids such as CBD could offer helpful new treatments for people with chronic pain. A final result of the research emphasized the potential importance of other compounds in cannabis, namely terpenes and flavonoids, in pain relief— meaning it’s important to go for a full spectrum cannabis oil versus a CBD isolate to paint the complete picture when it comes to pain relief.