cbd

Posted on Fibromyalgia

People with fibromyalgia are substituting CBD for opioids to manage pain

The cannabis-derived substance provides fewer side effects, with less potential for abuse

CBD for Fibromyalgia
CBD for Fibromyalgia

Fibromyalgia is one of many chronic pain conditions that remains stubbornly difficult to treat.

As the ravages of the opioid epidemic lead many to avoid these powerful painkillers, a significant number of people with fibromyalgia are finding an effective replacement in CBD-containing products, finds a new Michigan Medicine study.

CBD, short for cannabidiol, is the second most common cannabinoid in the cannabis plant, and has been marketed for everything from mood stabilization to pain relief, without the intoxicating effects produced by the most common cannabinoid, THC. THC, which stands for delta-9-tetrahydrocannabinol, is the ingredient in marijuana that causes people to feel high.

The cannabis industry has exploded, aided by the legalization of medical and recreational marijuana in states around the United States and the removal of hemp-derived CBD from Schedule 1 status–reserved for drugs with no currently accepted medical use and a high potential for abuse–at the federal level.

Previous research shows that some people substitute medical cannabis (often with high concentrations of THC) for opioids and other pain medications, reporting that cannabis provides better pain relief and fewer side effects. However, there is far less data on CBD use.

“CBD is less harmful than THC, as it is non-intoxicating and has less potential for abuse,” said Kevin Boehnke, Ph.D., a research investigator in the Department of Anesthesiology and the Chronic Pain and Fatigue Research Center. “If people can find the same relief without THC’s side effects, CBD may represent a useful as a harm reduction strategy.”

Boehnke and his team surveyed people with fibromyalgia about their use of CBD for treatment of chronic pain.

“Fibromyalgia is not easy to treat, often involving several medications with significant side effects and modest benefits,” Boehnke explained. “Further, many alternative therapies, like acupuncture and massage, are not covered by insurance.”

For this study, the team focused on 878 people with fibromyalgia who said they used CBD to get more insight into how they used CBD products.

The U-M team found that more than 70% of people with fibromyalgia who used CBD substituted CBD for opioids or other pain medications. Of these participants, many reported that they either decreased use or stopped taking opioids and other pain medications as a result.

“I was not expecting that level of substitution,” said Boehnke, noting that the rate is quite similar to the substitution rate reported in the medical cannabis literature. People who said they used CBD products that also contained THC had higher odds of substitution and reported greater symptom relief.

Yet the finding that products containing only CBD also provided pain relief and were substituted for pain medications is promising and merits future study, noted Boehnke.

The team noted that much of the widespread use of CBD is occurring without physician guidance and in the absence of relevant clinical trials. “Even with that lack of evidence, people are using CBD, substituting it for medication and doing so saying it’s less harmful and more effective,” he said.

Boehnke stressed the need for more controlled research into how CBD may provide these benefits, as well as whether these benefits may be due to the placebo effect.

Clinically, opening up lines of discussion around CBD use for chronic pain is imperative, said Boehnke, for medication safety reasons as well as for “enhancing the therapeutic alliance and improving patient care.”


Posted on Pain Management

Research shows pain relieving effects of CBD

A new study led by researchers at Syracuse University sheds light on the ability of CBD to reduce pain along with the impact that the so-called placebo effect may have on pain outcomes


Dezarie Moskal is a doctoral candidate at Syracuse University and assisted in the CBD pain relief study.

It’s been hailed as a wonder drug and it’s certainly creating wonder profits. By some estimates, the Cannabidiol (or CBD) market could be worth $20 billion dollars by 2024. While users tout its effectiveness in pain relief, up until now there’s been limited experimental human research on the actual effectiveness of the drug. However, a new study led by researchers at Syracuse University sheds light on the ability of CBD to reduce pain along with the impact that the so-called placebo effect may have on pain outcomes.

“For science and the public at large the question remained, is the pain relief that CBD users claim to experience due to pharmacological effects or placebo effects,” asked Martin De Vita, a researcher in the psychology department at Syracuse University’s College of Arts and Sciences. “That’s a fair question because we know that simply telling someone that a substance has the ability to relieve their pain can actually cause robust changes in their pain sensitivity. These are called expectancy effects.” De Vita, along with Syracuse Emeritus Psychology Professor Stephen Maisto, were uniquely prepared to answer that exact question. The pair, along with fellow lab member and doctoral candidate Dezarie Moskal, previously conducted the first systematic review and meta-analysis of experimental research examining the effects cannabinoid drugs on pain. As the first experimental pain trial to examine CBD, their study yielded consistent and noteworthy results. Among other findings, the data showed that CBD and expectancies for receiving CBD do not appear to reduce experimental pain intensity, but do make the pain feel less unpleasant.

Martin De Vita is a researcher in the psychology department at Syracuse University’s College of Arts and Sciences and coauthor of the study.

De Vita and Maisto used sophisticated equipment that safely induces experimental heat pain, allowing them to measure how the recipient’s nervous system reacts and responds to it. “Then we administer a drug, like pure CBD, or a placebo and then re-assess their pain responses and see how they change based on which substance was administered,” said De Vita. Researchers then took it a step farther by manipulating the information given to participants about which substances they received. In some cases, participants were told that they got CBD when they actually received a placebo, or told they would be getting a placebo when they actually got CBD. “That way we could parse out whether it was the drug that relieved the pain, or whether it was the expectation that they had received the drug that reduced their pain,” according to De Vita. “We hypothesized that we would primarily detect expectancy-induced placebo analgesia (pain relief). What we found though after measuring several different pain outcomes is that it’s actually a little bit of both. That is, we found improvements in pain measures caused by the pharmacological effects of CBD and the psychological effects of just expecting that they had gotten CBD. It was pretty remarkable and surprising.”

“The data is exciting but pretty complex in that different pain measures responded differently to the drug effect, to the expectancy, or both the drug and expectancy combined–so we’re still trying to figure out what is behind the differential data with different kinds of pain measures,” said Maisto. “The next step is studying the mechanisms underlying these findings and figuring out why giving instructions or CBD itself causes certain reactions to a pain stimulus.”

Most people think of pain as an on and off switch, you either have it or you don’t. But pain, as De Vita describes it, is a complex phenomenon with several dimensions influenced by psychological and biological factors. For example, whereas pain intensity reflects a “sensory” dimension of pain, unpleasantness represents an “affective,” or emotional, aspect of pain. “If you think of pain as the noxious noise coming from a radio the volume can represent the intensity of the pain, while the station can represent the quality,” said De Vita. Results from his previous study showed that while cannabinoid drugs weren’t reducing the volume of pain, they were “changing the channel making it a little less unpleasant.” According to De Vita, “It’s not sunshine and rainbows pleasant, but something slightly less bothersome. We replicated that in this study and found that CBD and expectancies didn’t significantly reduce the volume of the pain, but they did make it less unpleasant–it didn’t bother them as much.” As part of the study De Vita and Maisto developed advanced experimental pain measurement protocols “to pop the hood and start looking at some of these other mechanistic pain processes,” said De Vita. “It’s not just pain, yes or no, but there are these other dimensions of pain, and it would be interesting to see which ones are being targeted. We found that sometimes pharmacological effects of CBD brought down some of those, but the expectancies did not. Sometimes they both did it. Sometimes it was just the expectancy. And so, we were going into this thinking we were going to primarily detect the expectancy-induced pain relief but what we found out was way more complex than that and that’s exciting.”

One important note to also consider is the source of the CBD. “What we used in our study was pure CBD isolate oil,” said De Vita. “Commercially available CBD products differ in their content and purity, so results might be different for different CBD products, depending on what other compounds they may or may not contain.”


Posted on Arthritis

Researchers find CBD improves arthritis symptoms (in dogs)

CBD for Fibromyalgia
CBD


A team led by researchers at Baylor College of Medicine in collaboration with Medterra CBD conducted the first scientific studies to assess the potential therapeutic effects of cannabidiol (CBD) for arthritic pain in dogs, and the results could lead the way to studying its effect in humans. Researchers focused first on these animals because their condition closely mimics the characteristics of human arthritis, the leading cause of pain and disability in the U.S. for which there is no effective treatment.

Published in the journal PAIN, the study first showed both in laboratory tests and mouse models that CBD, a non-addictive product derived from hemp (cannabis), can significantly reduce the production of inflammatory molecules and immune cells associated with arthritis. Subsequently, the study showed that in dogs diagnosed with the condition, CBD treatment significantly improved quality of life as documented by both owner and veterinarian assessments. This work supports future scientific evaluation of CBD for human arthritis.

“CBD is rapidly increasing in popularity due to its anecdotal health benefits for a variety of conditions, from reducing anxiety to helping with movement disorders,” said corresponding author Dr. Matthew Halpert, research faculty in the Department of Pathology and Immunology at Baylor. “In 2019, Medterra CBD approached Baylor to conduct independent scientific studies to determine the biological capabilities of several of its products.”

In the current study, Halpert and his colleagues first measured the effect of CBD on immune responses associated with arthritis, both in human and murine cells grown in the lab and in mouse models. Using Medterra tinctures, they found that CBD treatment resulted in reduced production of both inflammatory molecules and immune cells linked to arthritis.

The researchers also determined that the effect was quicker and more effective when CBD was delivered encapsulated in liposomes than when it was administered ‘naked.’ Liposomes are artificially formed tiny spherical sacs that are used to deliver drugs and other substances into tissues at higher rates of absorption.

Halpert and colleagues next assessed the effect of naked and liposome-encapsulated CBD on the quality of life of dogs diagnosed with arthritis.

“We studied dogs because experimental evidence shows that spontaneous models of arthritis, particularly in domesticated canine models, are more appropriate for assessing human arthritis pain treatments than other animal models. The biological characteristics of arthritis in dogs closely resemble those of the human condition,” Halpert said.

Arthritis is a common condition in dogs. According to the American Kennel Club, it affects one out of five dogs in the United States.

The 20 client-owned dogs enrolled in the study were seen at Sunset Animal Hospital in Houston. The dog owners were randomly provided with identical unidentified medication bottles that contained CBD, liposomal CBD, or a placebo. Neither the owners nor the veterinarian knew which treatment each dog received.

After four weeks of daily treatment, owners and veterinarians reported on the condition of the dogs, whether they observed changes in the animals’ level of pain, such as changes related to running or gait. The dogs’ cell blood count and blood indicators of liver and kidney function also were evaluated before and after the four weeks of treatment.

“We found encouraging results,” Halpert said. “Nine of the 10 dogs on CBD showed benefits, which remained for two weeks after the treatment stopped. We did not detect alterations in the blood markers we measured, suggesting that, under the conditions of our study, the treatment seems to be safe.”