Our bodies are thought to produce endocannabinoids by the billions every day. “We always thought the ‘runner’s high’ was due to the release of dopamine and endorphins. But now we know the euphoria is also from an endocannabinoid called anandamide,” its name derived from the Sanskrit word for bliss, says Joseph Maroon, MD, clinical professor and vice chairman of neurosurgery at the University of Pittsburgh Medical Center. We produce these natural chemicals all day, but they fade quickly because enzymes pop up to destroy them. That’s where CBD comes in: By blocking these enzymes, CBD allows the beneficial compounds to linger.
And we have a long way to go before we fully understand the relationship between CBD and pain regulation. But strong anecdotal evidence, combined with multiple lab tests and even some clinical trials, have established that CBD holds a lot of promise for pain relief. Or in science-speak, CBD “represents a novel class of therapeutic agents for the treatment of chronic pain.”
These are one of the most popular (and effective) choices for arthritis and other forms of localized pain and inflammation. Since the skin acts as an excellent semi-permeable membrane that “let’s the good stuff and keeps the bad stuff out,” rubbing CBD-infused creams into the affected area has proved to be quite effective in terms of both pain and inflammation reduction.
We have receptors for cannabinoids in the whole body, but the first type (CB1) are very dense in the pain pathways of the brain, spine, and nerves. The second type (CB2) are more important for the immune system but is also involved in inflammation. By gently acting on both pathways, our internal cannabinoids and CBD can balance both pain and inflammation [64].
Cannabidiol hemp oil, or CBD hemp oil, is made from high-CBD and low-THC hemp, unlike medical marijuana derivatives that often contain high quantities of tetrahydrocannabinol (THC). CBD hemp oil, a natural botanical extract of the common hemp plant, is therefore non-psychoactive. And, whereas in the cannabis plant CBD is the second most abundant cannabinoid after THC; in hemp it dominates the cannabinoid makeup, as THC is found only in trace amounts. CBD’s myriad of health benefits, however, are still present.
Lisa Hamilton, a jeweler and doula in Brooklyn, NY, knows about the side effects. She recently tried CBD for the shoulder pain that plagued her five years after an accident. Her doctor certified that she was in chronic pain, which under New York State law allowed her to buy from a state dispensary. One Friday, she swallowed two 10-mg capsules, the amount recommended at the dispensary, then took another two on Saturday. “By Sunday, it felt like I’d gotten hit by a truck. Every muscle and joint ached,” Hamilton says. She cut back to one pill a day the following week, but still felt hungover. She stopped after that.

Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level in your blood of the blood thinner coumadin, and it can raise levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does. A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other (unknown) elements. We also don’t know the most effective therapeutic dose of CBD for any particular medical condition.

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