Cannabidiol (CBD), a non-intoxicating compound in cannabis, is everywhere lately. Despite only having FDA approval as a treatment for two rare forms of seizures, CBD has grown in over-the-counter popularity for anxiety, depression, nausea, chronic pain and more.
It’s still difficult to say how effective cannabidiol really is for these conditions since most of the evidence comes from anecdotal experiences or animal studies.
Treatment of chronic pain is one of the most common uses for this cannabinoid. We’ve broken down the facts about CBD and chronic pain to see if it really is an effective treatment.
Pain and inflammation
The human body naturally reacts to injury, illness, or infection with inflammation. This stimulates nerves and causes sensations of pain that either go away over time or persist. Pain can be attributed to one of two types of inflammation: acute or chronic.
Acute inflammation only sticks around until the body has recovered. When you see redness and swelling from minor injuries, you’re experiencing acute inflammation.
The best way to manage chronic pain is to reduce inflammation in the body. We know that CBD can help reduce inflammation. But to fully understand CBD’s role in chronic pain, we have to first understand the endocannabinoid system.
The endocannabinoid system
The endocannabinoid system (ECS) consists of receptors and agonists called endocannabinoids. Within the ECS, the body produces its own cannabinoids. In humans, the ECS includes cannabinoid receptors known as CB1 and CB2 receptors.
The ECS plays a vital role in regulating mood, appetite, cognition, and even inflammation. A properly functioning endocannabinoid system will maintain homeostasis, keeping the body well balanced.
In one study published in the Rambam Maimonides Medical Journal, the effects of CBD on the endocannabinoid system were evaluated. Researchers found that CBD worked as an agonist for CB2 receptors, which caused an anti-inflammatory response and a reduction in pain.
Why does this happen? Upon entering the body, cannabidiol acts on neurotransmitters, causing an analgesic response against pro-inflammatory cytokines. From there, it reduces inflammation and disease progression.
Very few endogenous cannabinoids produced by our own bodies have been studied extensively, but there is one that is well understood: anandamide. Sometimes referred to as the “bliss molecule,” anandamide is a neurotransmitter produced by the brain that binds to cannabinoid receptors.
Anandamide is broken down by the body quickly. Unfortunately, this means the bodily processes that it regulates can be thrown out of balance quickly, allowing inflammation and other ailments to pop up.
CBD helps anandamide stay in the body longer by binding to the proteins responsible for breaking it down. As a result, the endocannabinoid system can stay better regulated, which in turn reduces inflammation.
Endorphins, pain, and CBD
By regulating anandamide, CBD is also regulating the body’s release of endorphins, the feel-good chemicals that are released when we exercise, laugh, and more.
Endorphins play a major and well-documented role in managing chronic pain. When endorphins are released, they interact with our pain receptors to reduce our perception of pain. Unlike opiate painkillers, which work to mimic natural endorphins, CBD regulates the release of natural endorphins.
Opiate painkillers can cause dependence and addiction because they suppress the natural production of endorphins. CBD, on the other hand, increases natural production, so it doesn’t have the same potential to cause dependence. Its role as a non-addictive painkiller is so promising, it’s being used to help curb narcotic addictions.
Final thoughts on CBD and chronic pain
While anecdotal evidence points to cannabidiol being helpful for anxiety, depression, pain, and more, solid research on the subject is still lacking.
CBD has a relatively good safety profile, but its lack of definitive evidence makes it a promising treatment for chronic pain, not a surefire cure. The side effects experienced in trials for the FDA-approved CBD seizure medication are rarely discussed. Those side effects include increased infections, diarrhea, rashes, and fatigue.
Daniel Claw, M.D., Professor of Anesthesiology, Rheumatology, and Psychiatry at the University of Michigan, stated: “If I have an elderly patient with arthritis and a little bit of CBD can make their knees feel better, I’d prefer they take that than some other drugs.”