Cannabidiol, commonly known as CBD, is a promising alternative to opioids when it comes to pain management and physical therapy. CBD is a compound extracted from the cannabis plant, which includes marijuana and hemp. However, CBD oil itself contains no THC (tetrahydrocannabinol) and has no psychoactive properties. CBD oil has been shown to help ease seizures, pain, and anxiety.
Researchers across the country are conducting more and more studies into the way that CBD oil can help ease pain and whether it can help the country fighting the ongoing opioid crisis. According to Shereef Elnahal, commissioner of New Jersey’s Department of Health, CBD shows the most potential for being an opioid substitute for pain management. He points to studies that on states where medical marijuana has been legalized.
According to studies from the Journal of the American Medical Association, states that have legalized marijuana have seen more significant drops in opioid prescriptions than elsewhere, with lower rates of opioid overdose and death. Although researchers cannot draw a direct line between cannabis legalization and overdose rates, the correlation is promising. This type of research has been promising enough for several states to allow hospitalized patients to substitute their opioids prescriptions with medical marijuana.
In New York, for example, patients enrolled in treatment programs for opioid use disorder are now being allowed to try marijuana as an alternative. While the research is still relatively young, scientists are hopeful to see more in-depth studies.
Jeffrey Selzer M.D., chair of the public policy committee for the American Society of Addiction Medicine suggests that the evidence is not full fledged quite yet in favor of CBD. “Early research suggests that some cannabinoids or combinations of cannabinoids may have the potential to help people wean off opioids, but more rigorous studies are needed”.
What is CBD Oil?
CBD comes in a variety of forms, including oils, tinctures, vaping cartridges, edible candies, dog treats, and lotions. Cannabidiol is the second most prevalent chemical found in cannabis, marijuana, and hemp, right behind THC. CBD is non-hallucinogenic, so unlike its chemical counterpart THC, it does not get users high. So far, the FDA has declared CBD unharmful, but as far as medical use goes, only one drug containing CBD has been approved by the FDA to treat seizure disorders in children.
As it stands, the current market for CBD products and edibles is rife with competing companies and loads of unverified claims. Some minor pain relieving effects may be possible, but most verified studies include THC as well as CBD. Some companies claim neuroprotective benefits and anti-cancer properties, but these outcomes are still being investigated and remain unverified by the FDA.
What Does the Research Say?
A survey from April of 2018 showed that roughly 55% of Americans regularly take prescription medication. While that percentage may not seem overly alarming, the rate of medical prescriptions is rising higher and higher every year and becoming more normalized. This is part of the reason why the opioid crisis exploded into the national consciousness. We need to find better, more natural methods for pain management, and that starts with exploring products such as CBD oil.
While there is considerable evidence available showing that CBD and THC can help treat pain when given together, there is simply not enough evidence proving CBD alone works. So far, almost all research into the field comes from animal studies. What we do know is that CBD helps fight inflammation, which can play a role in easing pain.
One study in the European Journal of Pain utilized animal testing to see if CBD could help people with arthritis to manage their pain. After applying a topical CBD gel to rats with arthritis for four days, researchers noted significant drops in inflammation and signs of pain. In a meta analysis of cannabis pain studies, researchers concluded that there is a substantial amount of evidence supporting cannabis as an effective treatment for chronic pain in adults. An entirely different study in the Journal of Experimental Medicine found that CBD oil by itself could reduce pain and inflammation.
Julia Arnsten, M.D., chief of general internal medicine at Montefiore Medical Center in New York City, has utilized marijuana in her practice since it was it legalized five years ago in her state. Using a combination of both THC and CBD, she has successfully integrated cannabis into effective treatment for chronic pain. For those patients that struggle with the psychoactive effects of THC, Arnsten suggests they use CBD mainly and take THC at night.
So far, an overwhelming portion of research points to the following conclusions about the efficacy of CBD oil for pain management, epilepsy, anxiety, and more.
- CBD is safe to use
- There is a major need for more research as the majority of studies were performed for treatment of epilepsy and psychotic disorders
- Most common side effects reported are tiredness, diarrhea, and changes of appetite/weight.
- CBD has comparatively fewer side-effects compared with prescription medication
- The fewer side-effects could help increase patient-adherence to treatment
- CBD can be used as a supplemental therapy
CBD for Pain Management
In one large study conducted at Kent State University, researchers set out to find an alternative to heavy pain medication. Using nearly 3,000 survey participants, researchers examined the effects of introducing cannabis to patients on opioid medication. The response was overwhelmingly in favor of cannabis, with 97% of users saying they were able to decrease the amount of opiates they were taking by substituting cannabis. 81% agreed that taking cannabis by itself was more effective in treating their pain than taking cannabis with opioids. However, it should be noted that this research was with cannabis, not CBD alone.
In another study on how CBD affects liver injuries resulting from alcohol consumption, analysis demonstrated that CBD lessened the elevated liver enzymes and increased triglyceride. In other words, CBD helped liver metabolism and retention of lipids, presenting a possible therapeutic solution for alcohol liver disease. More research has also pointed to CBD helping reduce brain damage and improve recovery following a stroke. Evidence has emerged that CBD administration after artery blockage can lead to long-term functional recovery.
CBD has also shown promise in reducing symptoms of IBS and regulating colitis. This is important as many medications approved to treat IBS currently have several varying negative side effects.
For CBD alone, evidence has also emerged that application has had several varied effects on pain. Systemic application of CBD reduces mechanical allodynia in injured subjects, which could help sufferers from neuropathy. While no solid evidence indicates an effect on pain alone, some studies show that perceptions of pain can be lowered, though more human research is needed.
CBD for Seizures
Refractory epilepsy is what is known as an uncontrolled and drug-resistant epilepsy. This means that those who suffer from it are unable to effectively manage the symptoms of this neurological disorder. More than 50 million people worldwide suffer from some form of epilepsy, making it the 4th most common neurological disorder in the United States. Over one third of this population, or 16 million, suffer from refractory epilepsy and do not respond to medication.
In one study on refractory epilepsy and CBD, research showed that taking CBD oil over one month to one year created positive changes. There was a decrease in seizures for 40% of patients, while they disappeared completely in 27% of patients. 60% of patients were also able to control their seizures. 100% of patients reported an improved mood after using CBD. The impact of this study is important, but it needs to be replicated on a larger scale to draw any conclusive evidence.
Another study exploring the effects of CBD therapy for seizures of children with Dravet Syndrome, found similar positive results. Dravet Syndrome is a rare neurological disorder that occurs in the first year of a child’s life. It has the potential to cause developmental disabilities and is currently treated through a mixture of medications to help manage seizures. In the study, CBD-treated convulsive seizures decreased from 12.4% to 5.9%, with 5% of patients becoming seizure free.
Of CBD’s potential medical applications, the strongest promise appears to be for the treatment of seizures. Multiple Sclerosis, for example, is an autoimmune disease that can be helped with the application of CBD oil. Muscle Spasms are one of the most common symptoms of MS, but CBD oil reduces the level of spasticity that a person feels. More human studies are needed to verify the efficacy of these results.
CBD for Anxiety
Some proponents claim that CBD oil can be helpful for issues such as anxiety, depression, and PTSD. More than 25 million people in the U.S. will experience PTSD at some point in their lives. In one study on CBD oil’s effect on fear, researchers suggested that CBD oil could one day be an effective medication for managing the fear response. CBD treated rats were found to spend less time frozen with fear after being shocked by electric prods.
Another study on CBD and fear found that CBD significantly reduced anxiety during public speaking. While not as effective as Clonazepam, CBD was the second most anxiety-reducing product. Also of note is that CBD oil was only effective at a medium dosage of 300mg, not a lower or higher dosage. This means that CBD could be an alternative treatment for panic disorder. In another randomized, placebo-controlled, double-blind study, researchers found that CBD oil reduced stroke volume and reduced resting systolic blood pressure.
Overall, it seems as though CBD oil has been shown to improve cognition in multiple preclinical model of cognitive impairment, including reducing symptoms of schizophrenia, Alzheimer's disease, fibromyalgia, and neurological disorders such as epilepsy. CBD oil could be a promising alternative to heavy medications for these conditions that produce noteworthy, negative consequences.
How Does CBD Work?
Both CBD and THC work by interacting with the body in a variety of ways. The primary pathway that these substances interact with the body are by mimicking and augmenting endogenous cannabinoids in the body. These endocannabinoids are part of the body’s regulatory system. So far, studies into the endocannabinoid system have advanced our understanding of health and the autoimmune system. As a relatively young and less understood part of medical science, CBD represents an exciting new prospect.
The endocannabinoid system plays an integral role in the regulation of a broad range of physiological processes such as mood, energy level, intestinal fortitude, immune activity, blood pressure, metabolism, bone density, and even how we respond to hunger, pain, and stress. It truly impacts our entire body’s function.
Can CBD Oil Help Addiction Recovery?
There is a compelling evidence available showing that CBD oil could be an effective treatment method for helping with substance use disorder symptoms. As with other chronic diseases, addiction can have multiple episodes of relapse and remission. SAMHSA, the Substance Abuse and Mental Health Services Administration has reported that over 21 million Americans are in need of therapeutic, clinical treatment for addiction.
With CBD being non-psychoactive and non-addictive, it could serve as a potential MAT option to help reduce cravings, anxiety, and more. CBD’s ability to regulate dopamine receptors means it can help individuals in addiction recovery with symptoms such as excessive hunger, sleep issues, lethargy, muscle pain, disorientation, nausea, agitation, and outbreaks. In one study by the Scripps Research Institute in San Diego found that receptors in the mind were ignited by CBD and were found to be directly related to drug-seeking behavior. Taking CBD oil was associated lower levels of drug seeking behavior over five months.
CBD oil has also shown to be useful in breaking a smoking habit. Researchers at the University of London conducted a study that found a relationship between cannabinoids and nicotine. At the end of the study, habitual smokers treated with CBD showed a radical reduction in tobacco consumption and decreased craving for nicotine.
If you wish to learn more about CBD and advances in addiction treatment methods, visit the Landmark Recovery website. Our patients are provided with the tools, resources, and support they need to find clarity in the fight against addiction. We provide residential treatment, outpatient treatment, and medical detox services to individuals struggling with a substance use disorder. If your or someone you love is struggling with an addiction, don’t hesitate to call our admissions team.