14. Bruni N, Della Pepa C, Oliaro-Bosso S, et al. Cannabinoid delivery systems for pain and inflammation treatment. Molecules. 2018;23(10):2478.
These tips and tricks may help ensure your CBD is the real deal, but they still don’t provide proof. The best way to be sure you are consuming what you want is to request third party testing. Some products will print a QR code on the packaging that links directly to their proof of third-party testing. You can also do your own third-party testing by bringing your CBD sample to a testing lab, although this may get a bit tedious (the USDA provides a searchable hemp testing laboratory list).
10. O’Sullivan SE. An update on PPAR activation by cannabinoids. Br J Pharmacol. 2016;173(12):1899–1910.
How long does it take for CBD oil to work for joint 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.
CBD may help to reduce pain by acting on a variety of biological processes in the body. CBD has been shown to work as an anti-inflammatory, antioxidant, and analgesic. CBD may also reduce the anxiety that people living with chronic pain often experience.
First, consider the source. Studies show that continuous CBD consumption is generally safe and can have many benefits. However, because of CBD’s complicated status, the compound itself may still be classified as an illegal substance. See the FDA’s FAQs on cannabis regulations (#9).
Is CBD Actually Marijuana or Hemp, or Both?
However, it should be noted that the studies used a variety of cannabis-based medicines (e.g., inhaled cannabis, sprays, and oral tablets containing THC and/or CBD from plant sources or made synthetically), some of which are more likely to result in these side effects than products without THC.
If you’re thinking of trying CBD oil for pain relief (and it is legal where you live), talk to your doctor to discuss whether it’s appropriate for you and the safest way to incorporate it into your pain management plan. Keep in mind that due to the lack of regulation, the purity and content of CBD oil products can vary.
What’s more, CBD oil may interact with certain medicines, such as medications changed by the liver (including chlorzoxazone, theophylline, clozapine, and progesterone) and sedative medications (including benzodiazepines, phenobarbital, fentanyl, and morphine).
Side Effects and Safety
When taken orally, CBD has poor bioavailability. Topical CBD application to localized areas of pain appears to provide more consistent levels of CBD with less systemic involvement.
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.
Preclinical animal research suggests that CBD may have moderate pain-relieving effects for neuropathic pain without the cannabinoid-like side effects, however, there is currently a lack of large, well-designed clinical trials (the type of research you want to see to put full stock in a treatment) confirming these effects.
To avoid interactions, tell your doctor and pharmacist about all prescription, over-the-counter, herbal, or recreational drugs you are taking.
In June 2018, the U.S. Food and Drug Administration (FDA) approved Epidiolex, a CBD oral solution used for the treatment of certain rare forms of epilepsy in children under 2—Dravet syndrome and Lennox-Gastaut syndrome. Both are exceptionally rare genetic disorders causing lifelong catastrophic seizures that begin during the first year of life.
Among the few human trials evaluating CBD’s anxiolytic effects was one published in the Brazilian Journal of Psychiatry in 2019. For this study, 57 men were given either CBD oil or a placebo before a public-speaking event. Anxiety was evaluated using physiological measures (such as blood pressure, heart rate, etc.) and a relatively reliable test for mood states known as the Visual Analog Mood Scale (VAMS).
Dosage and Preparation
Here is just some of what the current evidence says.
There are no guidelines for the appropriate use of CBD oil. CBD oil is usually delivered sublingually (under the tongue). Most oils are sold in 30-milliliter (mL) bottles with a dropper cap.
There is some evidence that CBD interacts with seizure medications such as Onfi (clobazam) and boosts their concentration in the blood. Further research is needed.
In all but a few studies, lower doses of CBD (10 milligrams per kilogram, mg/kg, or less) improved some symptoms of anxiety. Higher doses (100 mg/kg or more) exhibited virtually no effect.