CBD has anti-inflammatory and pain-relieving properties
Researchers have identified that cannabidiol (CBD) acts on cannabinoid receptors in the endocannabinoid system (ECS) to reduce inflammation and pain perception. Many studies into the effect of CBD-based treatments on chronic pain patients have reported that CBD significantly reduces pain levels.
CBD may be more effective than current pain relief treatments
Prescription painkillers, such as opioids, have a high abuse potential. Due to their psychoactive side effects, instances of opioid addiction are on the rise. CBD is a non-psychoactive substance; it is safe, well-tolerated and shows no potential for abuse.
Although CBD acts as a more subtle pain relief than painkillers, some researchers argue that its naturally therapeutic properties are a more desirable way to treat chronic pain.
You don’t need to be prescribed CBD to use it
Unlike most strong painkillers, CBD is not a prescription drug. There are numerous CBD products available to buy that contain low levels of THC, which is both completely safe and legal. At Mee, our water-soluble formula even has up to 9x the bioavailability of oil-based CBD products.
CBD could be used to reduce pain-related sleep disturbances
Chronic pain will often compromise sleep quality, which can massively impact the physical and mental wellbeing of those suffering. CBD has a well-researched role in improving symptoms of sleep disorders. Promisingly, multiple studies have shown that CBD improves sleep quality for the majority of chronic pain patients.
Much more research is needed
There is not yet enough scientific evidence to say that CBD can and will cure chronic pain. The existing evidence is hugely promising, but further research is needed into the long-term effects of CBD use on pain symptoms across a variety of chronic conditions.
Bridges et al., 2001: Mechanisms of neuropathic pain
The paper describes that, following nerve injury, there is a significant loss of opioid receptors in the dorsal horn. This observation has not been recorded for cannabinoid CB1 receptors. The preservation of CB1 receptors suggests that cannabinoids may be more effective than opioids at treating chronic, neuropathic pain.
‘Recent advances in the understanding of cannabinoid analgesia appear to indicate a therapeutic advance of cannabinoids over opioids in the management of painful neuropathy.’
‘Cannabinoid CB1 are located in areas of the spinal dorsal intimately associated with nociception’
Boyaji et al., 2020: The role of CBD in chronic pain management: an assessment of current evidence
This paper reviews studies into CBD-based treatments in the context of various types of chronic pain. There are various summaries of notable studies that can easily be lifted and quoted. Most of the existing evidence into CBD in pain treatment uses drugs that also contain THC.
Although this makes it difficult to draw solid conclusions about the effectiveness of CBD on its own, this review highlights the clinical potential of CBD and the need for further research.
WHITE PAPER 2020: The Critical Role of Hemp-Derived Cannabinoids
This white paper explores the link between the ECS and chronic pain. It also reviews some of the key findings about CBD and chronic pain, including the results of Capano et al., 2019, a very encouraging study for the future of CBD in pain treatment.
‘Preclinical models demonstrate CBD’s ability to decrease relapse risk by reducing opioid seeking behaviour, and early human trials confirm CBD’s potential in reducing opioid withdrawal symptoms. A recent survey study concluded that 44% of hemp CBD users reported it helped reduce the use of their opioid pain medication.’
‘This study was “aim[ed] at investigating the impact of hemp CBD use on opioid use in chronic pain, disability, physical and psychosocial symptoms, sleep, and motivation to taper opioids. This study concluded that using CBD for chronic pain in patients using opioids has a significant effect on reducing opioid intake, reducing pain and improving quality of life (QoL).
Over half of the participants who added CBD hemp extract reduced or eliminated opioids over the course of 8 weeks, and almost all CBD users reported improvements in QoL.’
Capano et al., 2019: Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study
This is a particularly exciting study as the majority of existing research is into CBD products that contain high levels of THC. These results support the evidence that CBD can relieve chronic pain. Note that PSQI equates to sleep quality, PDI represents pain disability, PEG is pain intensity, and PHQ is the ‘patient health questionnaire’.
‘Results: Over half of chronic pain patients (53%) reduced or eliminated their opioids within 8 weeks after adding CBD-rich hemp extract to their regimens. Almost all CBD users (94%) reported quality of life improvements. The results indicated a significant relationship between CBD and PSQI (p = 0.003), and PEG (p = 0.006). There was a trend toward improvement but no significant relationship between CBD use and PHQ and PDI.’
Argueta et al., 2020: a balanced approach for cannabidiol use in chronic pain
This review explores the evidence for and against the use of CBD to treat chronic pain. The nuanced take on the future of CBD makes their conclusions hugely credible. In general, the authors argue that CBD is a promising pain relief treatment in some contexts but can have adverse effects if used during pregnancy. See Table 1 for a summary of these findings.
Xiong et al., 2012: Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors
These quotes explain one mechanism by which CBD has anti-inflammatory and pain-relieving (antinociceptive) action.
‘Recent studies have shown that glycine receptors (GlyRs) are an important target for cannabinoids in the central nervous system. For instance, several synthetic and phytocannabinoids, including THC and CBD, can potentiate glycine currents (IGly) in native neurons isolated from the ventral tegmental area, amygdala, hippocampus, and spinal cord and in various heterologous cells expressing recombinant GlyRs’
‘GlyRs are thought to play an important role in the antinociceptive process.’
‘Our findings suggest that the alpha-3 GlyRs mediate glycinergic cannabinoid-induced suppression of chronic pain.’
Schilling et al., 2021: Cannabidiol as a Treatment for Chronic Pain: A Survey of Patients’ Perspectives and Attitudes
‘Results: A total of 253 participants answered the survey. Participants were 45.4 ± 13.8 (Mean ± SD) years of age. Among participants, 62.0% reported trying a CBD product [including products containing THC]. The majority responded that these products have helped their pain (59.0%) and allowed them to reduce their pain medications (67.6%), including opioids (53.7%).
They reported believing that CBD was a good treatment option (71.1%), not harmful (74.9%), and not addictive (65.3%). About half of participants (51.9%) report that they would be more comfortable with their physician prescribing CBD products. The overall attitude and experience of participants regarding CBD is reported as positive, while 91.9% of people expressed a desire to learn more about it.’
Russo, 2008: Cannabinoids in the management of difficult to treat pain
This paper extensively reviews studies into cannabinoids, primarily CBD and THC, and their effect on pain. The two extracts above provide another scientific explanation for CBDs anti-inflammatory action. TNF-a is a pro-inflammatory mediator so, when inhibited by CBD, this prevents the onset of an inflammatory response. Similarly, the A2A is a receptor in immune cells that, when activated, has primarily anti-inflammatory action.
‘CBD is able to inhibit tumor necrosis factor-alpha (TNF-α) in its own right in a rodent model of rheumatoid arthritis’
‘A new explanation of inflammatory and analgesic effects of CBD has recently come to light with the discovery that it is able to promote signaling of the adenosine receptor A2A by inhibiting the adenosine transporter’
Fine & Rosenfeld, 2013: The Endocannabinoid System, Cannabinoids, and Pain
‘Cannabidiol agonist activity at CB2 receptors seems to account for its anti-inflammatory proper- ties and both primary and secondary influences on pain. As well, memory impairments associated with THC are not apparent with CBD, and, when combined, CBD reduces the negative impact of THC on memory. This mitigating effect also has been attributed to the inverse agonist effect at CB1 receptors by CBD. Anxiolytic effects of CBD may also be attributed to its agonist effect at the 5-HT1A receptor.’
Berger et al., 2020: Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia
This paper reviews the research into the use of cannabis in the treatment of fibromyalgia, a primary example of chronic pain. The study concludes that research into CBD alone, compared to high-THC CBD products, is lacking. However, the quotes above provide evidence for why CBD may advantageous in comparison to THC for the treatment of pain.
‘In this study of MS patients, medical cannabis and CBD-derived products produced different side effect profiles. CBD showed a better side effect profile, such as tiredness, diarrhoea, and the change of appetite and weight, when studies were compared for other drugs for epilepsy, such as benzodiazepines, and other anti-epileptics’
‘Other studies suggest that CBD has a protective role in the negative THC effect on hippocampal-dependent memory’
CBD and Chronic Pain
This is an informative presentation in which Dr Dawn Elise Snipes, a USA-based mental health counsellor, reviews the scientific literature about the use of CBD to alleviate chronic pain.
She uses a very science-based approach and avoids bold claims. She also provides a disclaimer at the end of the presentation that the research, albeit promising, is still in its early stages and there is a lack of concrete evidence.,