Our providers are frequently asked by patients about CBD, or Cannabidiol. Patients want to know if it can help manage their pain, whether they suffer from arthritis or another chronic disease. It’s a common question because hemp-based products made with less than .3% THC are now legal, based on the Farm Bill of 2018. Since its legalization, we are now seeing CBD being used in everything from sodas, to lotions, to baked goods, but not so much in mainstream healthcare. Because the federal government and Drug Enforcement Agency still consider marijuana an illegal drug, it is not accepted for medical use in the U.S., which means there is still a lack of research and evidence to support the use of CBD.
“There is very limited evidence to support its (CBD) use at this point given the fact that it is essentially illegal from a federal standpoint. Some studies have been done indicating that there are receptors associated with this substance in the human pain pathway. Many patients are using both topical and oral formulations. These are completely unregulated and many of the ingested products have been found to contain various, but often significant, amounts of THC,” states Dr. James Nelson, physiatrist, at The Center.
CBD is a chemical compound from the Cannabid sativa plant, which is also known as marijuana. The cannabis plant is made up of two main players: CBD and THC. CBD is the non-psychoactive portion of the plant, which means it does not produce a “high.” Some people swear by using CBD, saying that it has helped manage their osteoarthritis pain, back pain, etc.
“From my standpoint, I’m okay with patients utilizing CBD topically, but they need to understand that ingested supplements or CBD products are not subject to regulation and may not contain the expected products,” says Dr. Nelson.
Because CBD is still unregulated by the FDA and typically not held to any federal testing standards, there is no way of knowing that the purchased CBD product contains what the label claims. (1) A 2017 study found about 1 out of every 3 (31%) CBD products bought online had the same amount of CBD as noted on the label. The other 69% of the products had either too much or too little CBD when compared to the label.
CBD could be a promising non-opioid option for musculoskeletal pain, and using a CBD oil topically is seemingly a safe pain control option, as long as the patient understands that more research and substantial scientific data needs to be found to support its effectiveness and safety. Speaking with your provider is always recommended before using any supplements, topical oils, or other alternative medications.