Cannabidiol (CBD) for Pain: An Opioid Alternative?

During the late 1990s, pharmaceutical corporations reassured the medical community that patients wouldn’t become obsessed with prescription opioid pain relievers, and health care suppliers began to prescribe them at higher rates. This afterward led to widespread diversion and misuse of these medications before it became clear that these medications may indeed be extremely addictive.

Worst results of the opioid epidemic cover increases in opioid misuse and related overdoses, also as the increased incidence of newborns having withdrawal syndrome due to opioid use and misuse during pregnancy. Opioid overdoses are involved for over 42,000 deaths during 2016,  more than any preceding year on record. It was known that 40% of opioid dose deaths result from the prescription of opioids

Counteract and access to treatment for opioid addiction and overdose reversal medicine are crucial to fighting this epidemic. Primary care set up has progressively become an opening to higher care for people with both behavioral health (as well as substance use) and primary care needs.

Cannabidiol CBD for Pain

What is The Opioid Pain Relievers Crisis?

Opioid pain relievers are safe once taken for a short time and as prescribed by a doctor, however since they turn out euphoria additionally to pain relief, they’ll be abused (taken during a different way or taken without a doctor’s prescription). Regular use, when prescribed by a doctor, will result in independence, and once abused, opioid pain relief may result in serious side effects, addiction, overdose incidents, and deaths.

Enhancements are observed in several regions of the country within the sort of reducing the supply of prescription opioid pain relievers and declining misuse along with the teens. But since 2007, overdose deaths related to heroin are increasing. Serious consequences of the opioid pandemic include an increase in opioid abuse and associated overdose, as well as the rising incidence of newborns experiencing withdrawal syndrome due to opioid use and misuse during pregnancy.

The Cost of Pain, Study Shows

Based on the research of the information, the authors determined that the entire cost for pain within the US ranged from $560 to $635 billion. Total progressive prices of health care because of pain ranged from $261 to $300 billion, and also the price of lost productivity ranged from $299 to $334 billion. Compared with different major sickness conditions, the per-person value of pain is lower but the overall price is higher.

Furthermore, adults with pain announced missing more days from work than individuals with no pain. Pain negatively affected three parts of productivity: workdays missed, the number of annual hours worked, and hourly wages.

American’s Use of CBD Products

Who usually uses CBD products in their daily lives? You may think that many people use it more than you may expect. However, experts found that 14% of American citizens using CBD, While a common fraction of our respondents stated that they presently use or have used CBD products.

Amazingly, among the individuals who have using CBD products, 35 to 44-year-olds are the group possibly to continue using them, while younger individuals usually use them for a short amount of your time, then stop. These numbers taper off in older populations. Almost 70% of respondents aged 55 to 64 and 80% of respondents aged 65 and older the same that they need never use CBD products.

What Types of Pain Can Cannabidiol (CBD) Treat?

Neuropathic pain is created and sustained because of the glutaminergic system, which could be a major excitatory neuronal pathway. Glutamate is the neurotransmitter that’s accountable for turning neurons on, which is better, sometimes.

Inflammatory pain has something to do with neuropathic pain, except it’s not restricted to neurons. Examples of inflammatory pain cover all kinds of arthritis, a couple of autoimmune diseases like Crohn’s and ulcerative colitis, and common conditions like headaches, cramps, muscle aches, and pains.

CBD For IBS (Irritable Bowel Syndrome)

The IBS (Irritable Bowel Syndrome) medical condition which greatly affects your digestive system and cause of abdominal pain and altered bowel habits. It may happen to anyone regardless of their age and gender. 

Cannabis is believed to act within the gastrointestinal tract through tetrahydrocannabinol (CBD and THC), which connects to G-protein coupled cannabinoid receptors, CB1, and CB2. These modify gut motility and colonic tone by lowering the presynaptic release of excitatory neurotransmitters, primarily acetylcholine and substance P, from myenteric neurons.  

Many studies have evaluated the results of dronabinol, an artificial THC oral agent, on intestinal motility and compliance and visceral perception in IBS patients and healthy volunteers [1].

Scientists are still unraveling the complexities of irritable bowel syndrome, and personalized medical advice could take years to come. Until then, trial-and-error through careful trial is the best we can all do.

Cancer Pain & Treatment-Related

A study involving 21 patients suffering from chronic pain we’re given vaporized CBD given with morphine pain relief better than morphine alone, While if it is consumed with oxycodone, it won’t much give changes but still more studies are needed. 

Controlled cases of inhaled Cannabis in those with peripheral neuropathy or other nerve pain showed that the pain was reduced in patients who received inhaled Cannabis compared with those who received an ineffective pill.

Research of Cannabis extract [2] that was used by holding a few drops beneath the tongue found that CBD may help patients with advanced cancer whose pain wasn’t eased by robust opioids only. In another study, patients who received lower doses of cannabinoid spray showed higher pain relief and reducing insomnia than patients who received a placebo.

Management of cancer-related pain in several patients was higher without the requirement for higher doses of THC CBD extract spray or higher doses of their different pain medicines.

Another study [3] shows that delta-9 THC may relieve pain as well as codeine. It shows that patients had good pain relief, less nausea and vomiting, and better appetite.

For an excellent comprehensive review of the endocannabinoid system, Walker and Huang[4] have provided a key review of the antinociceptive effects of CBD in models of acute and persistent pain.

Nerve Pain & Neuropathy

When neuropathy involves injury to the motor nerves, quality of life is reduced in which some patients suffer muscle weakness, uncontrolled twitching, and painful cramps in line with the NINDS.

CBD has been validated as an anti-inflammatory agent in several studies—it also has neuroprotective properties. Endocannabinoids flow in the bloodstream and cause their effects by joining our cannabinoid receptors. Currently, there are two well-researched cannabinoid receptors: CB1 and CB2. The ones that are necessary for relation to anti-inflammatory are our CB1 receptors. These are found in nerve endings and also the brain and are connected to the origin of the pain sensation.

Experts from the Research Institute of the McGill University Health Center and McGill University in Quebec [5], Canada, state that, when conducting numerous studies on animals, “low doses of CBD given for 7 days to relieve both pain and anxiety,  these two symptoms often connected in neuropathic pain or chronic pain.”

When consuming full-spectrum CBD oil for neuropathic pain, it’s best to consume it sublingually, which suggests applying it below your tongue and holding it for a couple of seconds to let the body absorb it. This process works best because it is connected to bioavailability and how your body is able or ready to receive and using CBD oil.

Migraines

Clinical publications between 1839 and 1937 [6] give valuable insights into the most effective practices, challenges, and advantages during an era when cannabis was normally used to treat headaches.

After cannabis was considered illegal by the U.S. government, its therapeutic use and research into its medical edges were mostly interrupted. Currently, there are few clinical investigations of the utilization of cannabis for headache; however, the studies that have emerged demonstrate potential effectiveness.

Furthermore, various pre-clinical investigations have verified the role of endocannabinoids in preventing headache pathophysiology, which implies a mechanistic role of cannabis within the treatment of these disorders.

Cannabis also shows the potential to interrupt specific stages within the pathogenesis of headaches, together with glutamate signaling resulting in CSD, cranial blood vessel dilation caused by NO and CGRP, serotonin unleashes from platelets, and afferent trigeminovascular nociceptive inputs.

Chronic Back Pain

Although a less serious condition, it will cause plenty of discomfort and disturbance within the lives of individuals affected by back pain.

One report proves [7] that the momentary use of CBD oil may lessen the amount of spasticity an individual feels. The results are modest, but many individuals stated a relieved of symptoms. More studies on humans are needed to verify these results.

Several researchers [8] assume that CBD communicates with a core element of the endocannabinoid receptors in your brain and immune system. Receptors are small proteins connected to your cells. They receive signals, mostly chemical ones, from completely different stimuli and help your cells respond.

This response produces anti-inflammatory and pain relief results that help with managing pain. This implies that CBD oil and other products may benefit individuals suffering from chronic pain.

Fibromyalgia

Fibromyalgia is a kind of chronic pain disorder that makes musculoskeletal pain additionally to fatigue, insomnia, and cognitive problems. It mostly affects women, and presently, there’s no identified cure for the condition. However, treatment choices are possible which targets pain management. 

CBD was normally used to relieve chronic pain symptoms and lessen inflammation. It’s presented as an alternative to using opioid medicines which might be addictive.

However, the FDA (Food and Drug Administration) didn’t yet approve CBD as a treatment for fibromyalgia or other different conditions. The CBD-based medication Epidiolex is the only CBD products that are FDA-approved and regulated.

There are presently no published studies on fibromyalgia that examine the results of CBD on its own. But some research [9] does verify the effects of CBD, which may contain multiple cannabinoids, on fibromyalgia.

Can CBD Replace Traditional Opioids?

The research, written in the Journal of Psychoactive Drugs [10], which checked out 1,000 individuals using medical marijuana in the USA found that between 65% of individuals consuming or using cannabis for pain, 80% found it was very or exceptionally effective.

74% of the 1,000 interviewees bought it to assist them to sleep, 84% think CBD may replace opioids. inline with those supporting CBD oil as an alternative to opioids, the two biggest benefits of CBD compared to opioids are:

  • CBD has fewer/less dangerous side effects
  • CBD free the addiction and/or overdose

The research [11] suggests that cannabis may lower opioid use. However, the researchers caution that a lot more has to be done to know the potential therapeutic advantages of cannabis. It additionally adds importance to the idea that widening access to CBD may lower the use of prescription painkillers, allowing more individuals to handle and cure their pain without counting on opioid prescription medicines that have dangerous side effects.

How to Use CBD for Pain?

How to Determine Your CBD Dosage?

The amount of CBD you should take depends on a range of factors, including:

  • Your body weight
  • The condition you’re treating
  • Your body chemistry
  • The concentration of CBD in each pill, capsule, and more

In other words, there are a lot of variables that go into deciding how much CBD to take. 

We recommended that you start with a low dosage and if that doesn’t work increase from there. The COR standard could be a product of an intensive analysis of numerous CBD products. You are capable of increasing the quantity of CBD oil intake by 25mg every 4 weeks till you’re alleviated. However, if the symptoms worsen, reduce it by 25mg.

If you’re using CBD oil, it’ll probably be available in a dropper bottle. The packaging would possibly specify what quantity CBD is in a single drop. From there, you’ll find out what number drops you wish to use. In pain management, it is recommended to use CBD Oil or Topicals for easier use and faster relief. 

Before trying CBD, be sure to talk to your doctor about the right dosage and any possible problems. If your doctor tells you how much to use, follow their prescription.

How to Find the Right CBD for Your Pain Management Needs

CBD is simply one of more than a hundred cannabinoids found in hemp plants. As more analysis is poured into determining the most effective ways to use CBD oil for pain relief, companies are also providing different formulations within the market these days.

You need to know where the CBD needs to reach. If your target is anywhere near the skin, you can try a product like a topical first. This provides the highest CBD concentration exactly where you want it.

Otherwise, CBD needs to move through your bloodstream to reach its goal – whether it’s your brain, your immune system, or other locations. CBD oil, vaporizers, and oral products are best for this purpose.

To find the right CBD use for pain, be sure to check if pain CBD products are approved by FDA and provides third-party lab tests. It would also be better to consult your doctor regarding this matter.

Final Thoughts

There are differences between CBD and THC, but an additional concern with “medical marijuana” is that little is understood concerning the long-run impact of its use by individuals with health- and/or age-related vulnerabilities—such as older adults or individuals with cancer, AIDS, cardiovascular disease, multiple sclerosis, or different neurodegenerative diseases.

Further research will be needed to determine whether people whose health has been compromised by disease or its treatment are at greater risk for adverse health outcomes from marijuana use.

Resource

[1] Parth Desai, Chimezie Mbachi, Ishaan Vohra, Miguel Salazar, Madhu Mathew, Tejinder Randhawa, Zohaib Haque, Yuchen Wang, Bashar Attar, and Isaac Paintsil (2020): Association Between Cannabis Use and Healthcare Utilization in Patients With Irritable Bowel Syndrome: A Retrospective Cohort Study. Cureus. PMID: 32528750
[2] Cannabis and Cannabinoids (PDQ®)–Patient Version (2020): Cancer.gov
[3] Fiona A Campbell, consultant in anesthetics and pain management, Martin R Tramèr, staff anesthetist, Dawn Carroll, senior research nurse, D John M Reynolds, consultant clinical pharmacologist, R Andrew Moore, consultant biochemist, and Henry J McQuay, professor of pain relief (2001): Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review. The BMJ. PMID: 11440935
[4] J.MichaelWalker, Susan M Huang (2002): Cannabinoid analgesia. Pharmacology & Therapeutics. pp. 127-135
[5] Safe Cannabis Pain Relief Without The “High” (2018): The Research Institute of the McGill University Health Centre (RI-MUHC)
[6] Bryson C. Lochte, Alexander Beletsky, Nebiyou K. Samuel, and Igor Grant (2017): The Use of Cannabis for Headache Disorders. Cannabis and Cannabinoid Research. PMID: 28861505
[7] Thorsten Rudroff, and Jacob Sosnoff (2018): Cannabidiol to Improve Mobility in People with Multiple Sclerosis. Front Neurol. PMID: 29623067
[8] Shenglong Zou and Ujendra Kumar (2018): Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. Int J Mol Sci. PMID: 29533978
[9] Ethan B Russo (2008): Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome, and other treatment-resistant conditions? Neuro Endocrinol Lett. [PubMed]. PMID: 18404144
[10] Marcus Bachhuber (2019): Use of Cannabis to Relieve Pain and Promote Sleep by Customers at an Adult Use Dispensary. Journal of Psychoactive Drugs, Taylor & Francis Group
[11] Marcus A. Bachhuber, MD; Brendan Saloner, PhD; Chinazo O. Cunningham, MD, MS (2014): Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010. JAMA Intern Med

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About Keith Myers

Keith J. Myers is Editor in Chief of the Health Canal. He has overseen and directed the editorial growth and skill of this website since 2012. Before joining Health Canal, Keith was a writer and editor who covered topics in CBD, health, science, and wellness.