CBD for pain? TOP 10 Most Frequent Questions. Dr Hunter Vincent hosts Facebook Live with the Arthritis Foundation to educate community on CBD.

1.What is CBD? 

  • CBD is short for cannabidiol
  • 1 of over 80 different Cannabinoids with potential clinical benefit from the cannabis plant
  • A Cannabinoid is a small active compound within the plant, essentially the building blocks of the cannabis plant
  • CBD is a non-psychoactive cannabinoid present in cannabis.
  • The CBD in most products is extracted from hemp, a variant of cannabis plant

 

  1. Is CBD the same as marijuana? 
  • These are very different! CBD is a component of the cannabis plant, and Marijuana is a type of cannabis plant.
  • Remember, The plant Cannabis Contains over 80 relevant types of Cannabinoids
  • Two major types of Cannabis
  1. Hemp = (Cannabis Sativa) less than 0.3% THC
  2. Marijuana = (Cannabis sativa or indica) greater than 0.3% THC

3.How is CBD Different from THC?

  • CBD and THC are both cannabinoids from the cannabis plant
  • THC (Delta 9 – Tetrahydrocannabinol) is the most well known cannabinoid from the cannabis plant, because of its psychoactive properties
  • CBD is typically derived from HEMP, while THC is typically extracted from marijuana which has higher levels of the psychoactive cannabinoid THC

 

  1. Will I get high from CBD? 
  • No.
  • the psychoactive cannabinoid in cannabis, known to produce feelings of euphoria is associated with Delta 9 Tetrahydrocannabinol (THC)
  • CBD is different cannabinoid, that is non psychoactive

 

5.How does CBD Work? ( Pain Relieving Mechanisms)

  • Important to remember that the effectiveness of CBD in any form has yet to be validated for pain relief.
  • Cannabis and cannabinoids act on multiple central and peripheral targets
    • CB1/CB2 receptors
    • G- Protein coupled receptors (opioid/serotonin receptors)
    • TRPV1

 

  • Animal studies have suggested that Cannabinoids have pain-relieving and anti-inflammatory properties, particularly with nociceptive pain, chronic neuropathic pain and chronic inflammation

 

  1. Is CBD safe to use?
  • Research evaluating the safety of CBD is currently underway. But so far, no serious safety concerns have been associated with moderate doses.

 

  • The FDA notes liver toxicity as a potential adverse effect of CBD. In controlled studies on Epidiolex® (FDA approved CBD Seizure Medication), the incidence of ALT elevation 3 times that of normal values was 13%, compared with 1% for placebo.
  • CBD could potentially interact with some drugs commonly taken by people with arthritis, including corticosteroids, NSAIDs, antidepressants, or some nerve medications
  1. Are there any FDA Approved cannabinoid medications?
  • It has approved Epidiolex® for certain seizures and Marinol® and Syndros® (dronabinol) for nausea and anorexia under certain conditions. Cesamet® (nabilone) is also approved.
    • Dronabinol and Nabilone = Oral THC preparations approved for N/V in chemotherapy and anorexia with AIDS
  • Sativex (Nabiximols) is a 50% CBD and 50% THC solution, is largely used for Cancer pain

 

  1. Are Cannabinoids ADDICTIVE?
  • Cannabis Use Disorder is a DSM 5 diagnosis under substance related and addictive disorder. Also incidence of  CUD has increased with potency of cannabis products (increased THC potency)
  • CBD, the non psychoactive cannabinoid, appears to have low addiction potential
  • Randomized, double blind, placebo controlled Clinical trial by Shroeder et. al  in 2018, showed CBD at over 750 mg/day had significantly low, if not absent abuse potential in polysubstance abusers.

 

  1. Are CBD products legal?
  • Yes. CBD products derived from hemp are no longer considered Schedule I drugs under the federal Controlled Substances Act
  • December 2018, per the Farm Bill signed into law, hemp derived CBD products (<0.3% THC by dry weight) are exempt from the Controlled Substance Act

 

  • All states have legalized hemp derived CBD (full-spectrum), except South Dakota and Idaho, which allow CBD, but only the isolate (zero-THC). Important to check state laws when purchasing and using CBD products.

 

  1. How do I choose a good CBD product?
  • CBD manufacturing is largely unregulated (similar to vitamins / supplements) and products may not have standardized CBD dosing or undocumented THC content (up to 30%). Insure the highest production quality!!

 

  • Buy from companies that test each batch and provide a certificate of analysis from an independent lab that uses validated, standardized testing methods approved by the American Herbal Pharmacopoeia (AHP), the U.S. Pharmacopeia (USP) or the Association of Official Agricultural Chemists (AOAC).
  • Avoid companies that claim their products have disease benefits.

 

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