In short, the results of the survey (which were published in the Journal of Pain Research) showed that roughly 42% and 46% (respectively) of participants claimed they were able to use cannabis in place of traditional medical to effectively treat their specific medical ailment. So if you’re wondering how to know if you need CBD for pain, remember that you’re certainly not alone.
That leaves those touting CBD’s effectiveness pointing primarily to research in mice and petri dishes. There, CBD (sometimes combined with small amounts of THC) has shown promise for helping pain, neurological conditions like anxiety and PTSD, and the immune system—and therefore potentially arthritis, diabetes, multiple sclerosis, cancer, and more.
CBD is well tolerated in humans with doses up to 600 mg not resulting in psychotic symptoms (15). In the few small placebo-controlled studies performed, no significant CNS effects were noted. Oral CBD undergoes extensive first-pass metabolism via CYP3A4, with a bioavailability of 6%. Following single doses in humans, the half-life of CBD when taken orally is about 1 to 2 days.1 In vitro studies have shown that CBD is a potent inhibitor of multiple CYP isozymes, including CYP 2C and CYP3A (16, 17). Whether these in vitro observations are relevant at plasma concentrations likely to be seen in patients is unclear. In addition, given its metabolism via CYP3A4, clinical trials of CBD in patients receiving enzyme-inducing AEDs, such as carbamazepine or phenytoin, will require detailed pharmacokinetic studies.
Moreover, a patient survey conducted by Project CBD, declared that “…cannabis appears to be an effective pain management tool with few negative side effects.” The study went on to say that a “…significant decrease in opiate usage among elderly patients while taking medical cannabis [was observed during trial].” In short, it has been portrayed clearly numerous times through valid and well-publicized clinical studies that cannabis is a practical option in terms of efficient pain management.
Author Gerhard Nahler found it most surprising that an entire group of authors were “tempted to over-interpret results.” However, he felt that misinterpretations are not entirely uncommon, stating “People overlook quite frequently that “in vitro” results may differ significantly from conditions “in vivo”, particularly in man. In vitro results are suggestions, not proofs for processes in real life.”
The endocannabinoid system is spread throughout your brain and body, but primarily throughout your central nervous system. The interaction between cannabinoids and receptors is what produces effects like the regulation of mood, pain, appetite, inflammation, and memory. Plant-based cannabinoids, found in cannabis plants, also interact with the receptors (whimsically named CB1 and CB2) in the endocannabinoid system, and each affects your body in different ways. CBD and its infamous cousin THC are the 2 most well-known cannabinoids.
A number of difficulties exist in evaluating published data on CBD or marijuana use for epilepsy. The extremely limited published studies were small, poorly described, and not well designed. Contributing to the difficulty of interpreting published studies, CBD products are not produced under the guidance of good manufacturing practices (GMP) and are not subject to regulations governing labeling, purity, and reliability. In other words, currently, there is no guarantee of consistency between products, or even differing lots produced by the same manufacturer. Without independent testing (e.g. USP certification) of CBD products for content and purity, as well as bioavailability testing of specific products, uncertainty surrounds the use of available CBD products in routine clinical settings.
And then I woke up on the concrete, a worried crowd gathered around me. “You had a seizure,” my friend said gently as I blinked my eyes, trying to process this new information. I remember it was warm that night because I was wearing a sundress, and when I finally regained consciousness my first worry was that my dress flew up and everyone could see my underwear.