Does CBD Oil Work For Pain And Anxiety

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CBD and THC are both found in cannabis plants but are very different compounds. Learn more about how each treats pain here. Despite some claims, there’s no scientific evidence that conclusively proves that CBD can help relieve anxiety.

THC vs. CBD for Pain Relief: What’s Better?

People with arthritis and other chronic musculoskeletal pain are increasingly turning to cannabis products for relief from different symptoms, such as pain, fatigue, insomnia, and anxiety. In fact, a recent CreakyJoints survey of people with arthritis found that more than half had tried marijuana or CBD for a medical reason.

While cannabis plants are complex and different varieties have different chemical compositions, almost all of them contain some combination of two medically important compounds: tetrahydrocannabinol (THC) and cannabidiol (CBD).

THC is responsible for that “high” that people get from marijuana, which may also play a role in pain relief. CBD doesn’t usually cause an intoxicating feeling, but research suggests it, too, may help ease arthritis symptoms.

These two chemicals both show potential in easing pain, but in different ways. Choosing a product rich in THC, CBD, or both could make a difference in the kind of pain relief you experience — if any. (Here are reasons your CBD product might not be working for you.)

Here’s what experts say about the differences between THC and CBD for pain relief.

How THC and CBD May Offer Pain Relief

CBD and THC activate different cannabinoid receptors in your body that can stimulate or inhibit brain chemicals and cause certain effects.

“We know a lot more about how THC works in terms of the molecular mechanism [than CBD],” says Steve Alexander, associate professor of molecular pharmacology at the University of Nottingham Medical School, who researches cannabinoids.

“THC activates certain cannabinoid receptors, one of which is in the nerve cells and the other is in the immune cells. When it activates the one in the nerve cells, it reduces the sensation of pain,” he adds.

The high that THC provides can also play a role in how people experience pain. “A little bit of euphoria can help us not care that we’re experiencing quite as much pain, much in the same way that other pain medications work,” says Angela D. Bryan, PhD, professor of psychology and neuroscience at the University of Colorado Boulder, who has studied cannabis and health.

CBD is much less understood than THC by researchers, although there is anecdotal evidence that it may provide pain relief in some people.

“We’ve got a hypothesis that CBD might have some interference with [the brain chemical] serotonin and some influence on glycine receptors, which may be involved with pain. We think it may do what it does by hitting multiple targets with a fairly light touch,” says Dr. Alexander. “It’s difficult to pick apart — lots of people are trying [to study it], but no one has yet succeeded.”

Researchers have not found much evidence that CBD can offer mental relief from pain. However, the placebo effect may help some individuals experience less pain after taking CBD.

“The human mind is a very powerful thing, and a lot of the ways we experience medication is related to our expectancies about that medication,” says Dr. Bryan.

How CBD Can Help with Anxiety

Scientists suspect that CBD may help relieve anxiety, though. That, in turn, could affect someone’s perception of pain and potentially make them more comfortable. The research is still developing, though, and it’s too early to draw anything conclusive.

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“We know that chronic pain patients also have a number of other morbidities, like stress, anxiety, and depression. I’m interested in the possibility that cannabidiol might also have mechanisms by which we can relieve some of those additional problems,” says Dr. Alexander.

That said, CBD may offer pain relief in more physical ways. It seems to show promise in reducing inflammation, which could provide pain relief from autoimmune diseases like rheumatoid arthritis, says Dr. Bryan.

The bottom line: THC seems to have a greater effect on the way the mind perceives pain, whereas CBD may work to ease pain at the local source.

Which Is Better for Pain Relief: THC or CBD?

There’s no definitive answer to the debate between THC and CBD for pain relief. Cannabis is still considered a Schedule 1 drug by the federal government — a legal status that limits the kinds of research that can be conducted.

Using the current research available, Dr. Bryan says she believes that a combination of THC and CBD together shows the most promise for pain relief.

“To the extent that we have good data, it’s unlikely that either THC or CBD on its own is going to be particularly effective for pain. It probably needs to be a combination of the two,” she explained. “We’re totally speculating at this point, but the way they work together might be that CBD has anti-inflammatory properties while THC has properties that can help us better cope with pain.”

CBD and THC: Side Effects and Legal Concerns

THC might not be an option for everyone, though. Some people may live in states where THC is illegal; while others simply don’t want the psychoactive effects of the substance. In those cases, it might be worth trying CBD on its own to see if it offers pain relief for you.

CBD isn’t legal everywhere either. And in states where CBD is legal, laws can vary as to how much THC is permissible in CBD products in order for them to be legally sold. Many states in which certain CBD products are legal require them to contain less than 0.3 percent THC.

Before trying either substance, it’s worth considering potential side effects they may cause. Side effects of CBD include nausea, fatigue, and irritability, according to Harvard Health. CBD can also interact with certain medications (such as blood thinners) and either increase or decrease the concentration of certain drugs in the bloodstream.

THC has its own set of side effects, including sleepiness and lethargy, increased appetite, increased heart rate, coordination problems, dry mouth, red eyes, slower reaction times, memory loss, anxiety, and mood changes.

“It’s quite likely that individuals will respond to different versions of these cannabinoids, and some may not respond at all,” says Dr. Alexander. “There’s a tendency for anecdotal evidence to highlight the positives of people who do respond [to CBD], which is useful, but it’s difficult to measure the numbers of people who don’t get a lasting benefit.”

If you’re interested in trying CBD or THC to manage your pain, talk to your doctor and experiment to see whether CBD or THC (or both) relieves some pain.

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You can also learn more in a new, free course on the health effects of THC and CBD, created by Kent Hutchison, PhD, professor of psychology and neuroscience at the University of Colorado in Boulder.

“Start with low doses and go slowly to find out what works for you,” says Dr. Alexander. “I find it difficult to believe that there is one version of cannabis or CBD that will be best for everyone.” Learn more here about how to find your optimal CBD dose.

Does CBD Help With Anxiety?

It’s likely that in the last few years, you’ve come across a lot of discussion and anecdotes about cannabidiol, also known as CBD. Availability and sales of CBD have exploded across the U.S. since it became legalized on the federal level and is now legal in most states.

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You can find CBD on shelves in many stores, with various brands promoting benefits that range from alleviating pain to aiding sleep. It also comes in many forms like CBD gummies, CBD oils, CBD lotions and even CBD-infused sodas. And one big claim CBD supporters tout is its ability to relieve anxiety, a feeling many of us have experienced over the last few years thanks in part to the COVID-19 pandemic.

But not all CBD is created equally, and the truth about the benefits is kind of, well, complicated. To dig deeper into whether or not CBD actually curbs anxiety and what else you should know before trying it, we spoke to psychiatrist David Streem, MD.

What is CBD?

“CBD is one of the chemicals present in cannabis-containing plants,” explains Dr. Streem. CBD mostly comes from hemp and, notably, contains very small traces of tetrahydrocannabinol (THC), the psychoactive ingredient that causes the “high” in marijuana. In fact, the U.S. government limits hemp-derived products from having a THC content of more than 0.3%.

As far as proven health benefits, there has been some evidence that CBD might serve as a treatment for chronic pain, but data is still mixed. More substantially, though, Dr. Streem says, “CBD has particular health benefits that have been demonstrated in scientific studies and it’s the active ingredient in an FDA-approved medication for the treatment of particular childhood seizure disorders.”

Specifically, he notes that CBD has shown benefits for children experiencing Lennox-Gastaut and Dravet syndromes, both rare conditions. “In these cases, the more common seizure medications don’t work very well.” CBD is part of a treatment package that includes other medications and even brain surgery.

Does CBD really help curb anxiety?

In short, no. CBD probably doesn’t help curb anxiety the way advertisements or anecdotal evidence claim. “The science isn’t there yet,” says Dr. Streem, adding that while there are scientific studies backing the use of CBD for the previously mentioned seizure conditions, no such high-quality data exists for CBD and anxiety yet.

And if you’re waiting on those studies to turn out evidence, get comfortable. As Dr. Streem notes, studies that yield the necessary data are difficult for researchers to conduct for two reasons.

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A lack of oversight

The first is government oversight and federal laws that make research into cannabinoids, including marijuana, difficult. While the number of states that have legalized some form of marijuana — whether for medical or recreational use — has dramatically increased in recent years, cannabis containing THC remains illegal on a federal level.

The U.S. Food and Drug Administration (FDA) also has its hands full trying to regulate it. Many states allow selling CBD over-the-counter as a dietary supplement even though that’s, technically, against FDA regulations. The FDA has warned dozens of companies about this practice but, so far, little has been done to change these practices. Dr. Streem says, “The FDA has to have evidence that there’s a safety risk before they can intervene.”

That overlaps with the second issue with CBD, which is a troubling lack of quality control. You can buy CBD just about anywhere now, from boutiques that specialize in CBD to your corner convenience store. But not all CBD is created equally, and neither is the labeling.

A 2017 study published in the Journal of the American Medical Association (JAMA) tested 84 CBD products from 31 different companies and found that 26% had less CBD than claimed on their respective labels, while 43% had more CBD than claimed on their labels.

Just as troubling, Dr. Streem points out that a number of the tested products had what he calls “relevant amounts of THC.” In other words, enough THC to trigger a positive on a drug test even if the label said there wasn’t any THC in their oil. And if you ingest CBD with a certain amount of THC, you’re also subject to the side effects, including delusions and hallucinations. Plus, there’s a chance these effects won’t go away when the effects of the drug wear off.

Risks of taking CBD

If you’re thinking of trying CBD without consulting with your healthcare provider, Dr. Streem has a simple response: Don’t. It’s about the unknowns, including the unregulated nature of most products and the possible inclusion of enough THC to flag a drug test.

“Trying a CBD product with consultation from your doctor is less risky,” advises Dr. Streem, “but you should still be aware of how the product makes you feel. If it makes you feel strange at all, stop using that product immediately.”

He continues, “If you could confirm that a product had no THC and had a CBD percentage close to what the label claims, there’s little concern it would do any harm regardless of the benefits. But that’s not what we’re dealing with right now.”

The bottom line

While data shows there are some benefits of using CBD in certain medically approved settings, for now, the scientific evidence just isn’t there for using CBD to help with anxiety, concludes Dr. Streem. Trying over-the-counter products without more stringent regulation carries more risk than reward.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

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