Chronic Pain

What Is CBD?

Highlights From This Post: 
-CBD is a component of marijuana called a cannabinoid.
-CBD does not cause a high, but does appear to exert pain-relieving and anti-inflammatory effects.
-Several studies show that CBD significantly reduces chronic inflammation.
-CBD may also help people with anxiety and those trying to stop smoking.
-Most drug screens are not designed to detect CBD.

Marijuana, or cannabis, contains compounds that may relieve pain, nausea, and other symptoms. The components of marijuana that most studies focus on for pain relief are cannabidiol (CBD) and tetrahydrocannabinol (THC).

THC resembles the cannabinoid chemicals that occur naturally in the body. THC is a psychoactive compound as it binds to cannabinoid receptors and produces an elevated state of mind, known as a high. When people ingest or inhale THC, it stimulates the brain’s cannabinoid receptors. This activates the brain’s reward system and reduces pain levels. CBD does not cause a high, although it does appear to interact with pain receptors in the brain to exert pain-relieving and anti-inflammatory effects.

Currently, the U.S. Food and Drug Administration (FDA) does not recognize marijuana for any medical condition. And anyone requiring a federal license , such as a DOT (Department Of Transportation) card to drive commercially would be considered an illegal user.

Cannabidiol (CBD) is one of the 100+ cannabinoids found in cannabis and has been the subject of much research due to its many and varied medical applications. It’s not only the therapeutic attributes that have sparked such widespread interest in CBD in recent years. The compound is also nonpsychoactive (meaning it does not produce the ‘high’ associated with cannabis use), making it a safe and effective option for patients who may be concerned about the mind altering effects of other cannabinoids, such as THC.

Oils that are CBD dominant are referred to as CBD oils. However, the exact concentrations and ratio of CBD to THC can vary depending on the product and manufacturer. Regardless, CBD oils have been shown to offer a range of health benefits that could potentially improve the quality of life for patients around the world.

Where does CBD come from?

The least processed form of the cannabis plant is hemp. Hemp contains most of the CBD that people use medicinally. Hemp and marijuana come from the same plant, Cannabis sativa, but the two are very different. Over the years, marijuana farmers have selectively bred their plants to contain high levels of THC and other compounds that interested them, often because the compounds produced a smell or had another effect on the plant’s flowers. However, hemp farmers have rarely modified the plant. These hemp plants are used to create CBD oil.

How CBD works

All cannabinoids, including CBD, produce effects in the body by attaching to certain receptors. The human body produces certain cannabinoids on its own. It also has two receptors for cannabinoids, called the CB1 and CB2 receptors. CB1 receptors are present throughout the body, but many are in the brain. The CB1 receptors in the brain deal with coordination and movement, pain, emotions, mood, thinking, appetite, memories, and other functions. THC attaches to these receptors. CB2 receptors are more common in the immune system. They affect inflammation and pain. Researchers once believed that CBD attached to these CB2 receptors, but it now appears that CBD does not attach directly to either receptor. Instead, it seems to direct the body to use more of its own cannabinoids.

CBD may benefit a person’s health in a variety of ways:

  • Natural pain relief and anti-inflammatory properties:

People tend to use prescription or over-the-counter drugs to relieve stiffness and pain, including chronic pain. Some people believe that CBD offers a more natural alternative. Authors of a study published in the Journal of Experimental Medicine found that CBD significantly reduced chronic inflammation and pain in some mice and rats. The researchers suggested that the non-psychoactive compounds in marijuana, such as CBD, could provide a new treatment for chronic pain. A 2008 review highlighted that CBD offered effective pain relief without inducing adverse side effects in patients.

Anti-Seizure Properties:

Seizures occur when there’s a dramatic fluctuation of electrical activity in the brain. Over the years, a number of high profile cases have raised awareness of CBD’s anti-seizure properties, but it’s only recently that science has been able to confirm this link. A randomized, double-blind, placebo-controlled trial published in The England Journal of Medicine explored the effect of CBD medication on young adults with Dravet syndrome, a rare type of epilepsy with seizures that are often induced by fever. Those who received CBD saw their seizure frequency drop by a median of 38.9 percent. After researching the safety and effectiveness of CBD oil for treating epilepsy, the FDA approved the use of CBD (Epidiolex) as therapy for two rare conditions characterized by epileptic seizures in 2018. In the U.S., a doctor can prescribe Epidiolex to treat Dravet syndrome and Lennox-Gastaut syndrome (LGS), a condition that appears between the ages of 3 and 5 years and involves different kinds of seizures.

Combat Anxiety:

While CBD is most commonly used to treat physiological symptoms, there’s a growing body of research that indicates it can also be used in the therapy of a wide range of mental health conditions, including anxiety. Results from one study suggests that CBD reduces anxiety in social anxiety disorders due to its effects on activity in limbic and paralimbic brain areas. This may also have an effect on decreasing chronic pain since anxiety is often a concurring complaint. Doctors often advise people with chronic anxiety to avoid cannabis, as THC can trigger or amplify feelings of anxiousness and paranoia.

However, authors of a review from Neurotherapeutics found that CBD may help to reduce anxiety in people with certain related disorders. According to the review, CBD may reduce anxiety-related behaviors in people with conditions such as:

• post-traumatic stress disorder

• general anxiety disorder

• panic disorder

• social anxiety disorder

• obsessive-compulsive disorder

The authors noted that current treatments for these disorders can lead to additional symptoms and side effects, which can cause some people to stop taking them. But no definitive evidence currently links CBD to adverse effects, and the authors called for further studies of the compound as a treatment for anxiety.

Quitting smoking and drug withdrawals:

Some promising evidence suggests that CBD use may help people to quit smoking. A pilot study published in Addictive Behaviors found that smokers who used inhalers containing CBD smoked fewer cigarettes than usual and had no further cravings for nicotine. A similar review, published in Neurotherapeutics found that CBD may also be a promising treatment for people with opioid addiction disorders. The researchers noted that CBD reduced some symptoms associated with substance use disorders. These included anxiety, mood-related symptoms, pain, and insomnia. More research is necessary, but these findings suggest that CBD may help to prevent or reduce withdrawal symptoms.

Exciting new research shows the amazing and wide reaching effects CBD may have on numerous medical conditions. Some researchers have found that CBD may even prove to combat cancer. Authors of a review published in the British Journal of Clinical Pharmacology found evidence that CBD significantly helped to prevent the spread of cancer cells and promote their destruction without the same levels of toxicity in current treatments.

Research published in the Journal of Alzheimer’s Disease found that CBD was able to prevent the development of social recognition deficit in participants. This means that CBD could help people in the early stages of Alzheimer’s to keep the ability to recognize the faces of people that they know. This is the first evidence that CBD may slow the progression of Alzheimer’s disease.

Acne treatment is another promising use for CBD. The condition is caused, in part, by inflammation and overworked sebaceous glands in the body.

Type 1 diabetes results from inflammation that occurs when the immune system attacks cells in the pancreas. Research published in 2016 by Clinical Hemorheology and Microcirculation found that CBD may ease this inflammation in the pancreas, perhaps leading to the first step in finding a CBD-based treatment for type 1 diabetes. A paper presented in the same year in Lisbon, Portugal, suggested that CBD may reduce inflammation and protect against or delay the development of type 1 diabetes.

Many people ask, does using CBD cause a positive drug test?

There are many reasons an employer might require drug screening  – safety, legal protection, improved productivity, or even federal mandates – but the ultimate goal is to determine impairment, not a medical regimen. Therefore, most drug screens are not designed to detect CBD. Rather, most employers use either a 5-panel or 10-panel drug screen, both of which test for THC-COOH (what THC turns into after the body metabolizes it). In addition to THC, the 5-panel drug screen tests for cocaine, opiates, PCP, and amphetamines/methamphetamines, while the 10-panel screen also tests for barbiturates, propoxyphene, benzodiazepines, methadone, and propoxyphene. Though the 10-panel test contains more recreational drugs, it also contains more pharmaceutical drugs which have become a growing epidemic over the last few decades. Because hemp products can legally contain up to .3 percent THC, regularly consuming extremely high doses of CBD products (between 1,000 and 2,000 mg/day, in fact) could trigger a false-positive result. However, it is unlikely that even high daily doses of CBD would surpass the federal limit of 50 nanograms THC metabolite per milliliter of urine. A positive positive test would be the result of minute traces of THC in the body, not CBD.

Cannabis is legal for either medicinal or recreational use in some American states. Other states have approved the use of CBD oil as a hemp product but not the general use of medical marijuana. State and federal laws differ, and current marijuana and CBD legislation in the U.S. can be confusing, even in states where marijuana is legal. There is an ever changing number of states that do not necessarily consider marijuana to be legal but have laws directly related to the legality of CBD oil. The laws change frequently, so make sure you stay up to date on your states current legislation.

CBD oil is a potentially valuable medicine that may ultimately be used to treat a range of health conditions. This just highlighted a few of the ways CBD can potentially benefit our health. Anyone considering CBD oil should speak with a local healthcare provider. They can provide information about safe CBD sources and local laws surrounding usage. Also, research local state laws. Most states require a prescription.

dsc_0323-1    -Dr. Courtney

Sources:

-medicalnewstoday.com/articles/317221.php

-verywellhealth.com/medical-marijuana-pain-relief-and-the-law-2615372

-medicalnewstoday.com/articles/322051.php

-webmd.com/a-to-z-guides/news/20180420/can-marijuana-be-the-answer-for-pain

-ncbi.nlm.nih.gov/books/NBK224384/

-potguide.com/pot-guide-marijuana-news/article/will-cbd-show-up-on-a-drug-test/

-ncbi.nlm.nih.gov/pmc/articles/PMC3371734/

-adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain.

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