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cbd oil and chronic pain

The dosage of CBD that works for your pain will depend on the amount/percentage of CBD in the product, how you take it (whether by mouth, inhalation, or topical application) and your body weight and chemistry (several websites offer CBD calculators to determine a starting dose). The best thing is to speak with your doctor or a budtender (essentially a dispensary pharmacist) before choosing a CBD dosage. If your doctor does not recommend a dose, it is best to start small and gradually increase the dose from there until you achieve the desired effect.

You can vape a full spectrum CBD, which may get you a bit high, even when using a strain with trace amounts of THC.

What about all those CBD products you’re seeing in line at the supermarket, the local health food store, and online? The market for CBD has basically exploded in the past few years but is completely unregulated. The CBD you buy may come from hemp or may not. It may contain the amount of CBD it claims or may not. It also may contain more THC than it claims. Welcome to the budding world (pun intended) of medicinal CBD.

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Topicals include CBD creams, lotions, salves, and ointments. These are usually best to treat localized pain, arthritic pain, and neuropathic or nerve pain. 14 Applied directly to the skin, one advantage of topicals is that they do not seem to exert any psychotropic effects. Studies have shown potential benefit of topicals in the treatment of arthritic pain in particular.

OK, so we know that taking it won’t get you high, but taking enough (often based on your weight), can have a calming effect. And the side effects are minimal, with some people experiencing drowsiness, nausea, or tiredness. It is unlikely to negatively impact your mood or cognitive ability, making it a seemingly safer and preferred product for many.

CBD is not marijuana ­­– even though it can be derived from the marijuana plant. Still, some CBD products contain THC, and for some people these products may work better (remember the entourage effect). The stigma surrounding marijuana-derived treatments can be difficult for people who benefit from their medicinal effects. Having honest conversations with family members (including how to talk to your kids about CBD and medical marijuana use) about the science and history of medicinal cannabis use is often a good place to start.

6. De Petrocellis L, et al. Effects of cannabinoids and cannabinoid-enriched Cannabis extracts on TRP channels and endocannabinoid metabolic enzymes. Br J Pharmacol. 2011;163(7):1479-1494.

When smoked, cannabis has been found to contain Aspergillus (a type of fungus).   People with suppressed immune systems should be aware of the risk of fungal infection when using this form of cannabis. Topical CBD application may also cause skin irritation.

Side effects included sleepiness, dizziness, and mental confusion. The authors concluded that the potential harm of such medicines may outweigh their possible benefit.

Common types of chronic pain include:

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A type of pain triggered by damage to the somatosensory system (i.e., the system responsible for processing sensory stimuli), neuropathic pain often occurs in people with conditions like diabetes and multiple sclerosis.

In studies using varied doses, routes of administration, and combination or whole products with THC, a number of side effects have been reported. These include anxiety, changes in appetite and mood, diarrhea, dizziness, drowsiness, dry mouth, low blood pressure, mental confusion, nausea, and vomiting.  

There’s also some concern that taking high doses of cannabidiol may make muscle movement and tremors worse in people with Parkinson’s disease.

While many companies now sell CBD oil online and in dispensaries, use of the oil isn’t legal in every state. Because state laws vary greatly when it comes to cannabis products, it’s crucial to confirm that use of CBD oil is legal in your state.

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Cannabis (most commonly obtained from the Cannabis indica and Cannabis sativa plants) has three major components: cannabinoids, terpenoids, and flavonoids. While there are over a hundred different cannabinoids, the two major components are tetrahydrocannabional (THC) and cannabidiol (CBD). Historically more attention has been paid to the psychoactive (euphoric “getting high”) component of the cannabis plant, THC; there have been fewer scientific studies on the medical use of CBD, a non-psychoactive component of the plant.

In fact, the FDA has issued several warning letters to companies and individuals that market unapproved new drugs that allegedly contain CBD. The FDA has tested the chemical content of cannabinoid compounds in some of the products, and many were found to not contain the levels of CBD the manufacturers had claimed they contain.

Disclaimer:

Given its promising results in animal models, along with its relative safety, non-psychoactive properties, and low potential for abuse, CBD is an attractive candidate to relieve pain. Unfortunately, there is a lack of human studies about the effectiveness of CBD. However, there is an abundance of commercial advertisements about the magical effects of CBD, and it is frequently presented as a cure-it-all potion that will treat everything including diabetes, depression, cancer, chronic pain, and even your dog’s anxiety!

If you or someone close to you is considering trying CBD, I would recommend Dr. Robert Shmerling’s advice about the dos and don’ts in choosing an appropriate product. Until there is high-quality scientific evidence in humans, it is difficult to make a recommendation for the regular use of CBD in chronic pain management.

Given the rapid change in the legality of cannabis coupled with the increased appetite for something new, and driven by unprecedented profit margins, the advertising for cannabinoids in general and CBD in particular has gone wild. The FDA is very clear that it is illegal to market CBD by adding it to a food or labeling it as a dietary supplement. And it warns the public about its potential side effects, as it’s often advertised in a way that may lead people to mistakenly believe using CBD “can’t hurt.” CBD can cause liver injury, and can affect the male reproductive system (as demonstrated in laboratory animal studies).

If you ask health care providers about the most challenging condition to treat, chronic pain is mentioned frequently. By its nature, chronic pain is a complex and multidimensional experience. Pain perception is affected by our unique biology, our mood, our social environment, and past experiences. If you or a loved one is suffering from chronic pain, you already know the heavy burden.