Does CBD Oil Work For Pain And Anxiety

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Cannabidiol (CBD) is an active ingredient in cannabis that is derived from the hemp plant, but it does not cause a high and is not addictive. CBD has been shown to be effective in treating conditions like pain, insomnia, and anxiety. Hearing a lot about CBD oil for pain management or anxiety? Many CBD products might not be the cure-all they claim to be. Learn more here.

Cannabidiol (CBD): What we know and what we don’t

Cannabidiol (CBD) is often covered in the media, and you may see it touted as an add-in booster to your post-workout smoothie or morning coffee. You can even buy a CBD-infused sports bra. But what exactly is CBD? And why is it so popular?

How is cannabidiol different from marijuana, cannabis and hemp?

CBD, or cannabidiol, is the second most prevalent active ingredient in cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, a cousin of marijuana, or manufactured in a laboratory. One of hundreds of components in marijuana, CBD does not cause a “high” by itself. According to a report from the World Health Organization, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD.”

Is cannabidiol legal?

CBD is readily obtainable in most parts of the United States, though its exact legal status has been in flux. All 50 states have laws legalizing CBD with varying degrees of restriction. In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials. In 2018, the Farm Bill made hemp legal in the United States, making it virtually impossible to keep CBD illegal – that would be like making oranges legal, but keeping orange juice illegal.

The Farm Bill removed all hemp-derived products, including CBD, from the Controlled Substances Act, which criminalizes the possession of drugs. In essence, this means that CBD is legal if it comes from hemp, but not if it comes from cannabis (marijuana) – even though it is the exact same molecule. Currently, many people obtain CBD online without a medical marijuana license, which is legal in most states.

The evidence for cannabidiol health benefits

CBD has been touted for a wide variety of health issues, but the strongest scientific evidence is for its effectiveness in treating some of the cruelest childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), which typically don’t respond to antiseizure medications. In numerous studies, CBD was able to reduce the number of seizures, and, in some cases, stop them altogether. Epidiolex, which contains CBD, is the first cannabis-derived medicine approved by the FDA for these conditions.

Animal studies, and self-reports or research in humans, suggest CBD may also help with:

    Studies and clinical trials are exploring the common report that CBD can reduce anxiety.
  • Insomnia. Studies suggest that CBD may help with both falling asleep and staying asleep.
  • Chronic pain. Further human studies are needed to substantiate claims that CBD helps control pain. One animal study from the European Journal of Pain suggests CBD could help lower pain and inflammation due to arthritis when applied to skin. Other research identifies how CBD may inhibit inflammatory and neuropathic pain, which are difficult treat.
  • Addiction. CBD can help lower cravings for tobacco and heroin under certain conditions, according to some research in humans. Animal models of addiction suggest it may also help lessen cravings for alcohol, cannabis, opiates, and stimulants.
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Is CBD safe?

Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level of blood thinning and other medicines in your blood by competing for the liver enzymes that break down these drugs. Grapefruit has a similar effect with certain medicines.

People taking high doses of CBD may show abnormalities in liver related blood tests. Many non-prescription drugs, such as acetaminophen (Tylenol), have this same effect. So, you should let your doctor know if you are regularly using CBD.

A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So, you cannot be sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other unknown elements. We also don’t know the most effective therapeutic dose of CBD for any particular medical condition.

How can CBD be taken?

CBD comes in many forms, including oils, extracts, capsules, patches, vapes, and topical preparations for use on skin. If you’re hoping to reduce inflammation and relieve muscle and joint pain, a topical CBD-infused oil, lotion or cream – or even a bath bomb — may be the best option. Alternatively, a CBC patch or a tincture or spray designed to be placed under the tongue allows CBD to directly enter the bloodstream.

Outside of the US, the prescription drug Sativex, which uses CBD as an active ingredient, is approved for muscle spasticity associated with multiple sclerosis and for cancer pain. Within the US, Epidiolex is approved for certain types of epilepsy and tuberous sclerosis.

The bottom line on cannabidiol

Some CBD manufacturers have come under government scrutiny for wild, indefensible claims, such that CBD is a cure-all for cancer or COVID-19, which it is not. We need more research but CBD may prove to be a helpful, relatively non-toxic option for managing anxiety, insomnia, and chronic pain. Without sufficient high-quality evidence in human studies, we can’t pinpoint effective doses, and because CBD currently is typically available as an unregulated supplement, it’s hard to know exactly what you are getting.

If you decide to try CBD, make sure you are getting it from a reputable source. And talk with your doctor to make sure that it won’t affect any other medicines you take.

CBD Oil — Are the Benefits Claimed Too Good To Be True?

These days, many of us could certainly go for a miracle cure-all, especially those of us who struggle with chronic pain, overwhelming anxiety, cancer-related symptoms and/or hard-to-treat neurological disorders. So, it’s no wonder that CBD oil is popping up in our search results. But can we really count on CBD oil to positively impact our symptoms in the ways we hope? Internal medicine specialist Paul Terpeluk, DO, explains why CBD oil may not be as effective as we’d like.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

What is CBD?

CBD, or cannabidiol, is just one of more than 100 chemical compounds found in the cannabis sativa plant. But it’s THC (tetrahydrocannabinol), not CBD, that’s the main psychoactive compound in cannabis that gives you a euphoric high.

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CBD is pulled from hemp, a type of cannabis plant that contains very low levels of THC, so it doesn’t get you high. CBD oil is simply a product that contains CBD extract and an oil, like coconut oil, typically for topical use.

It’s important to know that since the implementation of the 2018 Farm Bill, the production and sale of CBD products in the U.S. has been legalized on the federal level as long as they contain less than .3% of THC. However, it’s still illegal under some state laws.

Plus, Dr. Terpeluk explains the market has been oversaturated with CBD products — from bath bombs to gummies, lotions, creams, tinctures and oil — none of which are Food and Drug Administration (FDA) approved and may not be 100% pure CBD. As of mid-December 2021, the FDA has only approved one cannabis-derived and three cannabis-related products, all of which you can safely get with a prescription from a licensed healthcare provider.

“There’s no oversight of the majority of CBD products from a regulatory authority,” says Dr. Terpeluk. “Most of the CBD that you’re buying, unless they have a rigorous marketing campaign and quality control that says it’s 100% CBD oil, more than likely, it’s contaminated with other cannabinoids, including THC.”

What are some of the benefits of CBD?

Several studies show the benefits of pure CBD may have wide-ranging positive effects, though. To understand those benefits, it’s important to consider our body’s endocannabinoid system, a complex system of enzymes, neurotransmitters and receptors that plays an important role in the development of our central nervous system. This system helps regulate a variety of functions, including pain, motor control, memory, appetite, inflammation and more. By further studying CBD’s effects in these specific areas, we may better understand how CBD impacts a variety of conditions and disorders.

Helps with neurological-related disorders

The FDA has approved Epidiolex as a treatment for several seizure disorders, including two rare disorders known as Duvet syndrome and Lennox-Gastaut syndrome. Several case studies suggest CBD may also be beneficial to patients who are resistant to anti-epileptic drugs. “With epilepsy, there’s a threshold in your brain that gets excitatory, and you go into a seizure,” says Dr. Terpeluk. “CBD increases that threshold.”

Other studies suggest CBD may also be useful in managing symptoms of multiple sclerosis, Parkinson’s disease and Alzheimer’s disease, as it has neuroprotective, anti-inflammatory properties. More studies are needed, however, as many suggest that it’s not just CBD alone, but a combination of CBD and other cannabinoids, that may help reduce many of these symptoms.

It may assist with pain relief

By interacting with neurotransmitters in your central nervous system, CBD could potentially relieve pain related to inflammation, arthritis and nerve damage (peripheral neuropathy). In one four-week trial, people who had nerve damage in the lower half of their body reported a significant reduction of intense, sharp pain after using a topical CBD oil.

“All of our different anti-pain drugs affect some section of our pain system, whether it’s Tylenol®, Aspirin®, morphine or opioids,” explains Dr. Terpeluk. “No one wants to be addicted to opioids, so if there’s a cannabinoid you can take that’s not addictive but can repress the pain, that would be the Holy Grail with chronic pain.”

Still, he cautions, there’s a lot left to be studied, including whether there are significant adverse long-term effects of CBD when used for pain relief.

“If you’re taking it in an unregulated fashion, you don’t know how much is in there, and you’re not quite sure how it affects you outside of your particular pain,” says Dr. Terpeluk.

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It may help with anxiety and mood disorders

Anxiety and mood disorders like depression or post-traumatic stress disorder can have a severe effect on your daily life and may often cause both physical and emotional stress that could lead to other underlying conditions like sleep disorders, high blood pressure, chronic pain and heart disease. It’s too early to understand the full gamut of effects that CBD may have on anxiety and mood disorders, but individual studies seem to suggest varying positive results. In one study of 57 men who received either oral CBD or a placebo 90 minutes before participating in a simulated public speaking test, researchers learned that a 300-mg dose of CBD significantly reduced social anxiety during the test.

And while there are a wide variety of treatments available for anxiety and mood disorders — ranging from talk therapy and counseling to prescribed medications — Dr. Terpeluk suggests the most important thing is to get at the root of the underlying causes of the anxiety you’re experiencing.

“Anxiety is better approached by looking at what’s causing it in your life rather than trying to figure out which drugs can reduce it,” says Dr. Terpeluk.

It might help with cancer-related symptoms

CBD may help with nausea, vomiting and weight loss caused by chemotherapy treatments. The FDA has approved three cannabis-related products to help alleviate these symptoms, as well as help increase the appetite for those who have AIDS. These drugs all contain some level of THC or synthetic THC and are not purely CBD alone.

But some studies seem to suggest that CBD can help decrease the size of tumors and help stop the spread of cancerous cells in skin cancer, breast cancer, prostate cancer and more. As with other areas of study, further human clinical trials are needed to understand the full effect CBD has on various kinds of cancer.

What are the side effects or risks of CBD?

If you’re purchasing CBD oil and other products online or from a local vendor, Dr. Terpeluk says there’s no real way of knowing the purity of the CBD you’re using, as it could be mixed with other cannabinoids, such as the dangerous delta-8, or THC.

“It’s a little bit mysterious. It’s not as harmless as you think,” says Dr. Terpeluk. “If you take CBD oil because you buy it on the market, you have a very high likelihood that you could turn a drug test positive for THC because it could actually contain THC.”

CBD can also affect a variety of medications, including pain medications, antidepressants, antipsychotics and more. It could also cause several side effects that may include:

  • Issues with coordination. .
  • Drowsiness or fatigue. .

The best advice? Before considering CBD oil or other CBD products, make sure you talk to your healthcare provider to decide whether it’s safe for you and to ensure it doesn’t have harmful interactions with any medications you’re currently taking.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

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