Many of our customers (including me) use CBD for relief from chronic pain. Unfortunately, there is little in the way of clinic data on this use, and the FDA prevents us from promoting CBD for pain. None the less, the anecdotal evidence is quite compelling. We need a high-quality, controlled clinic trial to assess the effects of CBD.
In the meantime, let’s compare CBD to approved treatments for chronic pain.
Acetaminophen (Tylenol) is a common painkiller. It belongs in a class by itself, since its mechanism of action is not completely understood. A current line of investigation suggests that acetaminophen actually works though the endocannabinoid system. The issue with acetaminophen is that it is a liver toxin. At slightly higher doses than recommended, irreversible liver damage occurs, even after just one dose. Drinking alcohol with high dose acetaminophen can be fatal.
If acetaminophen were invented today, it would never be approved by the FDA due to liver toxicity.
The second class of analgesics are the NSAIDS (non-steroidal anti-inflammatory drugs) such as ibuprofen, naproxen and aspirin. These meds are cyclooxygenase inhibitors, reducing the production of prostaglandins, which are known to cause inflammation and pain. The main side effects of NSAIDS are gastric disturbances, including gastritis with continued use. Many chronic pain patients cannot tolerate the stomach issues. They are forced between choosing GI pain vs their chronic pain.
Next up the pain-relieving ladder is the opioids. We know the sad history of opioid use for chronic pain. They rapidly lose effectiveness, requiring dose escalation. Addiction is the result. Opioids are excellent for acute pain relief, and if used for three days max, are invaluable for trauma patients and for post-operative pain. The key is to use just enough to provide relief, without causing craving post treatment.
Opioids are not useful for chronic pain because of need for dose escalation for continued relief. The addictive properties of opiates preclude their use for chronic pain except for terminally ill patients.
Now let’s consider the anti-epileptics gabapentin and pregabalin. Originally developed as anticonvulsives for epilepsy, Pfizer pushed them into the pain arena. They seem to work, but not without serious side effects including weight gain, dizziness and drowsiness. The main indication is for “neuropathic pain” which can be a complication of diabetes. They have not been shown to be effective for chronic back pain.
What is very interesting is that these drugs are, in reality, anti-seizure medications. Sound familiar? CBD is an FDA approved anti-seizure medicine. The pain studies will come.
CBD has almost no side effects, and is safe to use. Let’s transform the large body of anecdotal evidence of CBD for chronic pain into clinical data.