Many people suffering from generalized pain use CBD, cannabidiol. Understandably, being non-psychoactive is part of CBD’s appeal to a wider audience. Still, the current scientific reality is that CBD is a bit of an enigma. This is because cannabis research focused mostly on THC, tetrahydrocannabinol, the psychoactive cannabinoid. We know that THC interacts with the endocannabinoid system by activating CB1 and CB2 receptors. CBD, however, hasn’t been studied as extensively. What has been observed about CBD in scientific studies is often mystifying. Its interactions with the endocannabinoid system aren’t as cut and dry as THC. What is clear is that CBD works to alleviate pain, particularly in its natural form.
Generalized and Neuropathic Pain
Generalized and neuropathic pain are two broad areas of suffering that CBD, along with THC, helps alleviate. For this reason, this article will look at these broad areas. It will then reference specific examples to discuss how CBD and THC reduce their painful symptoms. For instance, corneal neuropathic pain and injuries respond very favorably to topical CBD/THC treatment.
Addiction and Withdrawal Pain
This article will end with a study evaluating CBD’s effectiveness in treating cocaine addiction. Since cannabis has garnered much controversy over the last one hundred years, it still has some stigma attached. The most obvious one is addictiveness. Science busts this myth in two ways. One is that cannabis products offer a safe and non-addictive alternative to addictive, harmful pharmaceutical drugs. Second, CBD has shown efficacy in treating the painful side effects of cocaine, meth and crack addiction.
CBD for MS-Related Pain: How Does It Work to Treat Spasticity?
Multiple Sclerosis (MS) patients experience both generalized and neuropathic pain. Therefore, they can benefit from having a safe alternative to the pharmaceutical cornucopia they are regularly prescribed. CBD and THC successfully intervene with the chronic pain experienced by MS patients. This provides an interesting introduction to this broad topic.
What is spasticity? Spasticity, feelings of stiffness, is the most common symptom of MS. Involuntary muscle spasms are also common. The endocannabinoid system plays an important role in managing spasticity and spasms.
When it comes to MS, an important action of endocannabinoids is their interaction with presynaptic cannabinoid receptors. The central nervous system (CNS) is full of these receptors. Cannabinoid’s main targets for antispastic effects are CB1 receptors in specific regions of the CNS. They reduce the severity of both MS-induced spasticity and pain. These findings are already over a decade old. They gave rise to the development of specifically combined cannabinoids for the treatment of MS-induced spasticity.
THC-CBD oromucosal spray improved the quality of life for MS patients across several randomized, controlled clinical studies. They were able to undertake daily activities. Their side effects, such as dizziness, tiredness, and fatigue, were mild to moderate side effects. The same study concluded that there is no risk of addiction or abuse with this THC-CBD protocol.19
CBD for Generalized Pain
Generalized pain or Chronic Widespread Pain (CWP) is fibromyalgia’s main symptom but can occur as a symptom of other diseases.4
Generalized pain is a persistent, unpleasant sensory and emotional experience, characterized by nociception. Nociception is the sensory nervous system’s typical processing of harmful stimuli. Its absence makes generalized pain unrelenting. It lasts or reoccurs for more than 3 months and continues well past normal healing time from the injury that catalyzed it.
Currently, generalized pain affects around 20% of people worldwide. 15-20% of medical consultations are regarding generalized pain.18 This is too common and wide-spread an issue to rely so regularly on addictive, harmful pharmaceutical drugs for treatment.
CBD Is an Effective Add-on Treatment
One thorough scientific study analyzed data collected on 800 patients with severe chronic pain. Oromucosal spray containing high CBD and low THC doses “proved to be an efficacious add-on treatment for the relief of pain, especially if it was neuropathic in nature.”18
Add-on treatments like CBD can be used instead of upping the dosage of an addictive pharmaceutical pain killer. Regarding addictiveness and safety, the study added that the CBD: THC protocol “showed a good safety profile without any evidence of abuse, persistent patterns of deliberate overdose, misuse, psychiatric complications or tolerance development.” They concluded that the obvious benefits were too great to ignore.
Many safe, full-spectrum cannabis tinctures are made in small batches and laboratory tested for safety. Our article “CBD oil: what is it and how can it help relieve pain symptoms” gives you a primer on what to look for.
Neuropathic Pain and CBD
Neuropathic pain originates from diseases and injuries to the nervous system. It is a common symptom of nerve compression and trauma, certain infections, diabetes, and autoimmune diseases like rheumatoid arthritis, psoriasis, and hypothyroidism. A reoccurring scientific conclusion regarding cannabis concludes that “The potential benefits of cannabis-based medicine (herbal cannabis, plant-derived or synthetic THC, THC/CBD oromucosal spray) in chronic neuropathic pain might be outweighed by their potential harms.”10
CBD for Corneal Neuropathic Pain (CNP)
The cornea is the transparent covering over the pupil, iris, and anterior chamber of the eye. It is full of sensory nerve endings, providing protection, and light refraction. Corneal Neuropathic Pain (CNP) develops when these nerve endings are damaged through trauma, disease, infection, or surgery. The symptoms are distressing, ranging from persistent photoallodynia, burning, stinging, dryness, inflammation, and overall enhanced sensitivity to pain.
The existing prescriptions for CNP are topical corticosteroids, tricyclic antidepressants, and opioids. According to one study, it was stated that “these treatments, however, frequently fail to provide adequate pain relief and are associated with side effects.” In fact, one of the symptoms of CNP, hyperalgesia (an overactive response to pain), is linked to opioid exposure.9 A persistent danger with many pharmaceutical drugs is that they provably harm more than they help. A reoccurring conclusion about cannabis sativa is that it provably helps more than it harms.
The study, evaluating the efficacy of THC and CBD as safe alternatives concluded that their topical application “reduced corneal hyperalgesia and neutrophil infiltration…when used either as sole agents or in combination, these cannabinoids could be effective agents in the treatment of ocular pain and inflammation resulting from corneal surface injuries.”16
CBD for Side Effects Related to Cocaine Addiction
Some preclinical studies indicate that CBD might promote resilience to Cocaine and Methamphetamine Use Disorders. With proven efficacy in treating the inflammation associated with severe neuropathic pain, CBD therefore also shows promise in reducing the inflammation and seizures sometimes induced by METH, cocaine, and amphetamines.
Another interesting, albeit inconclusive finding of a review study, points out that “CBD induces a long-lasting prevention of reinstatement of cocaine and METH seeking behaviours.” Some studies, however, did not sufficiently prove this. Contrasted with positive findings, this indicates that CBD’s efficacy depends on many uncontrollable factors. Still, there is hope that CBD may reduce the pain associated with withdrawal symptoms, craving, impulsivity, and paranoia.1
CBD (with THC) For Many Types of Pain
The consensus across most scientific studies of CBD is that more research is needed fast. There is a widespread acknowledgment that patients suffering from arthritis, chronic pain, pain associated with MS, muscle pain, spinal cord injuries, and many more, are self-medicating with CBD. These self-medicating patients consistently self-report CBD’s efficacy to alleviate their symptoms.
Although scientists and laboratory technicians have their work cut out for them, plenty of research details and supports the use of CBD to manage pain. Furthermore, the most effective cannabis-based pain management protocols include THC. Low doses of THC accompanying higher concentrations of CBD go a long way in managing generalized pain.
At SacredMeds, we are dedicated to providing the highest quality CBD products, many containing low doses of THC. 800mg CBD:200mg THC by Daily follows a similar protocol to many of the studies cited in this article. Alternatively, vaporizing a CBD cannabis strain like CBD Death Bubba will provide a similar inhaled alternative. Combining vaped herb with tinctures and topicals is a safe, add-on approach to pain management with CBD.
1 Calpe-López, C., García-Pardo, M. P. and Aguilar, M. (2019) “Cannabidiol Treatment Might Promote Resilience to Cocaine and Methamphetamine Use Disorders: A Review of Possible Mechanisms,” PMC US National Library of Medicine, [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6680550/ (Accessed 17 March 2021).
2 Campbell, J. and Meyer, R. (2006) “Mechanisms of Neuropathic Pain,” Science Direct, Neuron Volume 52, Issue 1, Pages 77-92, [online] Available from: https://www.sciencedirect.com/science/article/pii/S0896627306007288 (Accessed 19 March 2021).
3 Cherney, K. (2020) “6 Benefits of CBD Oil,” Healthline, [online] Available from: https://www.healthline.com/health/cbd-oil-benefits (Accessed 16 March 2021).
4 Häuser, W., Perrot, S. and Sommer, C. (2017) “Diagnostic confounders of chronic widespread pain: not always fibromyalgia,” PMC US National Library of Medicine, [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741304/ (Accessed 19 March 2021).
5 He, Y. and Kim, P. (2020) “Allodynia,” PMC US National Library of Medicine, [online] Available from: https://www.ncbi.nlm.nih.gov/books/NBK537129/ (Accessed 19 March 2021).
6 Johns Hopkins Medicine (2021) “What Are Common Symptoms of Autoimmune Disease?,” Johns Hopkins Medicine, [online] Available from: https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-are-common-symptoms-of-autoimmune-disease (Accessed 19 March 2021).
7 Kosecki, D. (2019) “CBD for pain relief: What the science says,” CNET Health and Wellness, [online] Available from: https://www.cnet.com/health/cbd-for-pain-relief-what-the-science-says/ (Accessed 16 March 2021).
8 Lautieri, B.A., A. (2021) “Cocaine Withdrawal Symptoms, Timeline and Treatment,” American Addiction Centers, [online] Available from: https://americanaddictioncenters.org/cocaine-treatment/withdrawal (Accessed 19 March 2021).
9 Lee, M., Silverman, S. and Hansen, H. (2011) “A comprehensive review of opioid-induced hyperalgesia,” PMC US National Library of Medicine, [online] Available from: https://pubmed.ncbi.nlm.nih.gov/21412369/ (Accessed 19 March 2021).
10 Mücke, M., Phillips, T. and Radbruch, L. (2018) “Cannabis-based medicines for chronic neuropathic pain in adults,” PMC US National Library of Medicine, [online] Available from: https://pubmed.ncbi.nlm.nih.gov/29513392/ (Accessed 16 March 2021).
11 Nall, MSN, CRNA, R. (2017) “Hyperalgesia: What you need to know,” Medical News Today, [online] Available from: https://www.medicalnewstoday.com/articles/318791 (Accessed 19 March 2021).
12 NMSS (2020) “Pain & Itching,” The National Multiple Sclerosis Society, [online] Available from: https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Pain (Accessed 19 March 2021).
13 NMSS (2020) “Spasticity,” The National Multiple Sclerosis Society, [online] Available from: https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Spasticity (Accessed 19 March 2021).
14 Physiopedia (2021) “Nociception,” Physiopedia, [online] Available from: https://www.physio-pedia.com/Nociception (Accessed 19 March 2021).
15 Russo, E. B. (2008) “Cannabinoids in the management of difficult to treat pain,” PMC US National Library of Medicine, [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503660/ (Accessed 16 March 2021).
16 Thapa, D., Cairns, E. and Szczesniak, A.-M. (2018) “The Cannabinoids Δ8THC, CBD, and HU-308 Act via Distinct Receptors to Reduce Corneal Pain and Inflammation,” PMC US National Library of Medicine, [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812319/ (Accessed 17 March 2021).
17 UCI Health (2021) “Generalized Pain,” UCI Health, [online] Available from: http://www.ucihealth.org/medical-services/pain-wellness-center/generalized-pain (Accessed 19 March 2021).
18 Ueberall, M., Essner, U. and Mueller-Schwefe, G. (2019) “Effectiveness and tolerability of THC:CBD oromucosal spray as add-on measure in patients with severe chronic pain: analysis of 12-week open-label real-world data provided by the German Pain e-Registry,” PMC US National Library of Medicine, [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6535492/ (Accessed 17 March 2021).
19 Zettl, U., Rommer, P. and Hipp, P. (2016) “Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to multiple sclerosis,” PMC US National Library of Medicine, [online] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710104/ (Accessed 17 March 2021).