Legislation and Policy

CBD, Pain, & Opioid Use

Loren DeVito, PhD
Written by Loren DeVito, PhD

The majority of studies published on the relationship between medical cannabis and opioids have shown that cannabinoids can both treat pain and help people reduce or taper off of their opioid medications. Using a full-spectrum product or that contains a multitude of beneficial cannabinoids and terpenes may provide the most effective treatment. However, tetrahydrocannabinol (THC), a cannabinoid often found in high concentrations in certain cultivars/products, produces the intoxicating effects users refer to as the ”high” associated with cannabis.

While THC has been shown to be effective for pain, this intoxication may be disruptive for people who need treatment during the day, perhaps while at work. Therefore, it is certainly worth exploring the role of cannabidiol (CBD), the non-intoxicating cannabinoid, to determine if taking this as an isolate can produce similar benefits as either THC alone or a product where all cannabinoids and terpenes are present.

While much of the research on CBD (and all cannabinoids in general) have come from pre-clinical models, some studies have evaluated the effects of CBD in human trials. So let’s take a look at the CBD literature, with a focus on those trials, to see what studies have shown about using CBD to treat pain, as well as reduce opioid use:

  • A parallel group, double-arm, randomized, double blind clinical trial administered either topical CBD (2 g or 20%) or a placebo (non active) to 60 patients with myofascial pain. Following 14 days of treatment, those in the CBD group reported a significant reduction in pain compared to placebo (70.2% vs. 9.81%). Additionally, CBD reduced the abnormal muscular activity that causes this type of pain.[1]
  • In a prospective, single-arm cohort study of 97 patients with chronic pain who had been taking opioids for at least a year, the use full hemp extract CBD (15 mg capsules) was evaluated with regards to opioid use and quality of life. After eight weeks of treatment, over half of patients were able to reduce or stop taking their opioid medications. In addition, nearly all reported an increase in quality of life, as well as significant improvements in sleep and pain intensity.[2]
  • The potential role of CBD for heroin use disorder was studied in an exploratory double blind, randomized, placebo-controlled trial. The effect of CBD (400 or 800 mg, once daily for 3 consecutive days) on acute, short-term, and protracted effects on drug craving and anxiety was evaluated. CBD was found to be effective in reducing these behaviors compared to placebo; additionally, CBD also reduced heart rate and cortisol levels induced by drug withdrawal.[3]

These results are certainly encouraging and will need to be followed by larger trials replicating these effects. And greater access to quality CBD products will help patients get the treatment they need. But while CBD has potential for so many, as always, be sure to speak with your doctor before taking any new medication, including cannabinoids.

Image Source: https://pixabay.com/photos/drug-stamp-treat-tablet-health-5183407/

References

  1. Nitecka-Buchta A, et al. Myorelaxant effect of transdermal cannabidiol application in patients with TMD: A randomized, double-blind trial. J Clin Med. 2019;8(11):1886.
  2. Capano A, et al. Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgraduate Medicine. 2020;132(1):56-61.
  3. Hurd YL, et al. Cannabidiol for the reduction of cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder: A double-blind randomized placebo-controlled trial. Am J Psychiatry. 2019;176(11):911-922.

About the author

Loren DeVito, PhD

Loren DeVito, PhD

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