November 8, 2021

While many may still be skeptical about how cannabis can be used to treat pain, there is plenty of research to show how beneficial it can be. Cannabis has been used as a remedy for pain dating all the way back to 2900 BC. Could CBD (cannabidiol) potentially replace aspirin in your medicine cabinet? Research says, potentially, yes!

While the opioid epidemic rages on, it’s imperative that we explore alternatives to treat pain outside of pharmaceutical drugs. A study from 2014 by Bachuber et al, found that states with medical cannabis laws have a 24.8% lower mean annual opioid overdose mortality rate in comparison with states without medical cannabis laws; and there is a decline each year following the implementation of medical cannabis laws which continues for at least 6 years. CBD has been shown to be several hundred times more anti-inflammatory than aspirin in animal studies (Evans, 1991,  Williamson & Evans, 2000), and I know from my clinical experience with patients that CBD products (both oral and topical) have helped many of them avoid over the counter pain medications for common pain generators like: headaches, menstrual cramps, arthritis pain, and minor injuries. I have seen an incredibly positive impact on my pain patients since introducing water soluble CBD products, which tend to be more predictable in producing a positive result.

One of my favorite quotes by Samuel Hahnemann, founder of Homeopathy reads: “The highest ideal of cure is the speedy, gentle, and enduring restoration of health by the most trustworthy and least harmful way.” CBD, is just that. A fast, gentle, trustworthy, and safe way to bring the body into balance.

What about addiction or dependence?

In 2017 the World Health Organization (WHO) announced that CBD in humans exhibits no evidence for abuse or dependence potential, and that there is no evidence of public health related problems associated with the use of pure CBD (Cannabidiol Pre-Review Report, 2017). Furthermore, a recently published study found there was no evidence of withdrawal in healthy volunteers after abrupt cessation of CBD use at high doses. (Taylor et al., 2020)

CBD + Pain

Of the over 150 cannabinoids found in the cannabis plant, cannabidiol (CBD) is one of the most commonly used to treat pain. CBD effects and modulates pain in many different ways throughout the endocannabinoid system and more. CBD (along with many other cannabinoids) decrease pain and inflammation (and are generally active) at the level of:

  1. Receptors: endocannabinoid and TRP receptors that modulate pain
  2. Transcription: PPARs which play a role in inflammatory gene repression
  3. Enzymes: COX, LIPOX, etc. Helps inhibit and decrease inflammation

So far, CBD has been shown to reduce pain and symptoms in conditions such as: osteoarthritis, chronic pain, cancer related pain and symptoms, headache, trigeminal neuralgia, and more. While in this blog I focused on CBD and its effects on pain, it is important to note that many different cannabinoids also have an impact on pain reduction, including: CBN, CBG, CBC, CBL, THCa, CBDa, CBDV, and THCV.

How to Best Utilize CBD for Pain

Taking CBD orally will have the greatest systematic effect for pain modulation in the body, modulating pain through the receptors and processes mentioned above. For systematic pain and inflammation, or imbalances deeper in the system, I recommend oral CBD. For issues at or near the skin’s surface, topical CBD products can be very effective for modulating pain. For example, I would choose an oral CBD supplement to help provide relief to a patient with chronic inflammation from an autoimmune disease, and for a patient with a bruised and sore knee from a fall I may advise a topical treatment.

Have you tried using CBD products for pain for yourself or your patients/clients? Have you seen success? I’d love to hear about it!

Dr. Kramer’s mission is to empower others to feel and function as their most vibrant selves. Through her personal history of medical struggles, she realized that her symptoms were her bodies’ way of communicating deep physical, mental, and emotional imbalances. Dr. Abby has been inspired to bring that same type of healing transformation to her patients – becoming one of the foremost voices for progressive, holistic medicine in the Greater Chicago area. Dr. Abby can also be found talking with other thoughtful healthcare leaders on her podcast, “Coffee with the Docs,” or spearheading Medical Education and business development for Fringe Inc, a company committed to helping others regain their health through the power of natural medicines.


References: 

  1. Bachhuber, M.A., Saloner, B., Cunningham, C.O., & Barry, C.L. (2014) Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010. JAMA Internal Medicine, 174, 166-1673. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392651/pdf/nihms672222.pdf
  2. De Petrocellis, L., Vellani, V., Schiano-Moriello, A., Marini, P., Magherini, P. C., Orlando, P., & Di Marzo, V. (2008). Plant-derived cannabinoids modulate the activity of transient receptor potential channels of ankyrin type-1 and melastatin type-8. The Journal of pharmacology and experimental therapeutics325(3), 1007–1015. https://doi.org/10.1124/jpet.107.134809
  3. Evans, F.J. (1991) Cannabinoids: the separation of central from peripheral effects on a structural basis. Planta Medica, 57, S60-67. https://doi.org/10.1055/s-2006-960231
  4. O’Sullivan, S. E., Sun, Y., Bennett, A. J., Randall, M. D., & Kendall, D. A. (2009). Time-dependent vascular actions of cannabidiol in the rat aorta. European journal of pharmacology612(1-3), 61–68. https://doi.org/10.1016/j.ejphar.2009.03.010
  5. Takeda, S., Usami, N., Yamamoto, I., & Watanabe, K. (2009). Cannabidiol-2′,6′-dimethyl ether, a cannabidiol derivative, is a highly potent and selective 15-lipoxygenase inhibitor. Drug metabolism and disposition: the biological fate of chemicals37(8), 1733–1737. https://doi.org/10.1124/dmd.109.026930
  6. Taylor, L., Crockett, J., Tayo, B., Checketts, G., & Sommerville, K. (2020) Abrupt withdrawal of cannabidiol: A randomized trial. Epilepsy Behavior, 104(ptA), 106938. http://doi.org/10.1016/j.yebeh.2020.106938
  7. Williamson, E.M., & Evans, F.J. (2000) Cannabinoids in clinical practice. Drugs. 60(6), 1303-1314. https://doi.org/10.2165/00003495-200060060-00005


The contents in this blog; such as text, content, graphics are intended for educational purposes only. The Content is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider.

About the Author Dr. Abby Kramer

Dr. Abby’s mission is to empower others to feel and function as their most vibrant selves. Through her personal history of medical struggles, she realized that her symptoms were her bodies’ way of communicating deep physical, mental, and emotional imbalances. Dr. Abby has been inspired to bring that same type of healing transformation to her patients – becoming one of the foremost voices for progressive, holistic medicine in the Greater Chicago area. Dr. Abby can also be found talking with other thoughtful healthcare leaders on her podcast, “Coffee with the Docs”, or spearheading Medical Education and business development for Fringe Inc, a company committed to helping others regain their health through the power of natural medicines.

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