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There is a lot of anecdotal evidence that supports the view that cannabidiol (CBD) can be used for chronic pain, but there is currently not enough reliable scientific evidence to this effect to make properly informed decisions.
There is significant stigma surrounding CBD and the plant it is derived from, cannabis; enough to prevent many people from exploring the effects and benefits that the drug could bring. This is a shame as CBD is a remarkably tolerable and safe drug with no psychoactive effects.
The Endocannabinoid System
The endocannabinoid system (ECS) is intimately involved in the management and transmission of pain in the body. The ECS is a vast system of ligands and receptors that uses cannabinoids to communicate. The ECS extends from the brain to the tips of the fingers. Cannabidiol does not bind directly to the CB1 or CB2 (the best studied receptors in the ECS) receptors, it has a broader, more regulatory effect on processes like food intake, the immune system, inflammation, behaviour, mood, and mental illness.
So far, there has been a disappointingly low amount of study regarding cannabinoids and the endocannabinoid system. It is being illuminated, but slowly. The therapeutic benefits of cannabis have been known for thousands of years.
The Siberian Ice Maiden, a 2,500 year old frozen corpse found in permafrost had a bag of cannabis near her body and a tumour on her breast, leading some to theorize that she was using it to alleviate the symptoms of her cancer and maybe even help fight it. In the 19th century, cannabis products were widely sold in the West for their medicinal properties, amongst them pain relief.
However, using CBD directly for pain relief is a relatively modern occurrence. It is only recently that CBD has been isolated and sold as a medicine in isolation, before then if you wanted CBD, you had to take cannabis. The continuing illegality of CBD is the main factor in why CBD is not well studied. There is enough evidence to make a relatively educated conclusion about its likely effects, but not for many scientific and medical authorities.
Chronic pain is often caused by chronic inflammation. Autoimmune conditions are all caused related to inflammation, including:
Inflammation causes neuropathic pain by causing neurons to swell, become irritated, and to lower the threshold at which they pass on a signal. This can turn an ordinary sensation signal into a much more powerful one. In other words, they may tell the brain that the damage is worse than it is.
In conditions like rheumatoid arthritis, the body is attacking itself. It has mistakenly labelled its own parts as foreign and tries to get rid of them. This causes the swelling and pain that people with rheumatoid arthritis experience. Some anti-inflammatories can reduce this pain and help people live more normal lives, but they often have serious side effects over the long-term. For example, ibuprofen can cause stomach ulcers, kidney failure and, at high doses, increase the risk of stroke and heart attacks.
The advantage of CBD over many other mild anti-inflammatories is that it is very tolerable and has few side effects. Because CBD is easily digested into the body (the body produces cannabinoids itself), it is almost impossible to poison yourself with it. Another consequence of CBD’s familiarity with the body is that side effects are rare. Usually less than 10% of people who take it notice any side effects at all and, when they do, they are usually mild and include:
It is because of this tolerability that CBD has attracted so much attention. Cannabidiol has a wide range of effects without many side effects. This is rare in medicine. Cannabidiol is one of the most potent anti-inflammatories to be discovered. It is so potent, in fact, that it can reduce inflammation so much it can stop our immune system from fighting viral infections effectively.
Chronic pain is usually not caused by viral infections, and there are other drugs for that if it is. Chronic pain is often a case of mistaken identity, with the immune system attacking the body as a supposed intruder. If this can be attenuated with a tolerable anti-inflammatory, the health prospects of the patient are going to improve radically.
Several studies have found that “patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms.” Treating the symptoms of multiple sclerosis with cannabis is popular. Even though some studies have shown it to be no more effective than a placebo, others have shown it to be effective.
Cannabinoids (not just CBD) have been found to suppress inflammatory and neuropathic pain by interacting with certain receptors called glycine receptors. These are important pain pathways in the spine and, while the effects are not fully understood, there is considerable interest in using cannabinoids this way. Cannabidiol appears to regulate the way that pain is perceived in the body. CBD also changes how the brain receives signals through modulating neurotransmitter release.
Currently, the scientific consensus, regarding CBD and pain, is that it looks hopeful. However, it still needs much more study before it can be properly understood. Nearly every study finds that it is a tolerable and safe drug, but the beneficial effects are not as pronounced as the hype on the internet would suggest.
Cannabidiol is easy to obtain if it is legal where you live. In some places, it can be prescribed as a medicine. In others, it is simply available from licensed vendors. If it is not legal, it is not recommended that you buy, possess, or sell it, regardless of your genuine need for it. This is a criminal offence and comes with serious consequences.
Cannabidiol can be applied to the affected area in a cream or ointment. It can also be vaporized or eaten. There are no guidelines for use as it has not been officially approved for treating chronic pain by any government.