Clinical Evidence: There are over 9 randomized controlled clinical trials and 2 open label clinical trials assessing CBD with or without THC for the management of pain and show varying levels of pain relief depending on the cause of pain, doses used, and type of cannabis product.
Scientific Evidence: CBD is known to have effects at the molecular level to decrease inflammation through multiple biological pathways, the primary method by which CBD may play a role in controlling pain is decreasing inflammation
Clinical and Scientific Evidence References:
Capano A et al. Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgraduate Medicine 2020 132:1, 56-61.
https://pubmed.ncbi.nlm.nih.gov/31711352/
Fine PG et al. The Endocannabinoid System, Cannabinoids, and Pain. Rambam Maimonides Med J 2013;4(4):e0022.
https://pubmed.ncbi.nlm.nih.gov/24228165/
Haroutounian S et al. The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes Chronic Pain – A Prospective Open-label Study. Clin J Pain 2016;32(12):1036-43.
https://pubmed.ncbi.nlm.nih.gov/26889611/
Hosking RD et al. Therapeutic potential of cannabis in pain medicine. Br J Anaesthes 2008;101(1):59–68.
https://pubmed.ncbi.nlm.nih.gov/18515270/
Johnson JR et al. Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain. J Pain Symp Manage 2010;39(2):167-79.
https://pubmed.ncbi.nlm.nih.gov/19896326/
Johnson JR et al. An Open-Label Extension Study to Investigate the Long-Term Safety and Tolerability of THC/CBD Oromucosal Spray and Oromucosal THC Spray in Patients With Terminal Cancer-Related Pain Refractory to Strong Opioid Analgesics. J Pain Symp Manage 2013;46(2):207-18.
https://pubmed.ncbi.nlm.nih.gov/23141881/
Ko GD et al. Medical cannabis – the Canadian perspective. J Pain Res 2016;9:735-44.
Lichtman AH et al. Results of a Double-Blind, Randomized, Placebo-Controlled Study of Nabiximols Oromucosal Spray as an Adjunctive Therapy in Advanced Cancer Patients with Chronic Uncontrolled Pain. J Pain Symp Manag 2018;55(2):179-88.
https://pubmed.ncbi.nlm.nih.gov/28923526/
Notcutt W et al. Initial experiences with medicinal extracts of cannabis for chronic pain: Results from 34 ‘N of 1’ studies. Anaesthesia 2004;59:440–52.
https://pubmed.ncbi.nlm.nih.gov/15096238/
O’Connell M et al. Medical Cannabis: Effects on Opioid and Benzodiazepine Requirements for Pain Control. Annals of Pharmacotherapy
2019
https://pubmed.ncbi.nlm.nih.gov/31129977/
Pertwee RG. Cannabinoid receptors and pain. Progress in Neurobiology 2001;63:569–611.
https://pubmed.ncbi.nlm.nih.gov/11164622/
Portenoy RK et al. Nabiximols for Opioid-Treated Cancer Patients With Poorly-Controlled Chronic Pain: A Randomized, Placebo- Controlled, Graded-Dose Trial. J Pain 2012;13(5).
https://pubmed.ncbi.nlm.nih.gov/22483680/
Urits I et al. Use of cannabidiol (CBD) for the treatment of chronic pain. Best Practice & Res Clin Anaesthesiol 2020;34:463-77.
https://pubmed.ncbi.nlm.nih.gov/33004159/
Vuckovic W et al. Cannabinoids and Pain: New insights from old Molecules. Frontiers in Pharmacology 2018;9:1259.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277878/
Ware MA et al. Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS) Supplementary materials.
https://pubmed.ncbi.nlm.nih.gov/26385201/
Ware MA, Wang T, Shapiro S, Collet JP, COMPASS study team. Cannabis for the management of pain: Assessment of safety study (COMPASS). J Pain 2015 Dec;16(12):1233-42.
https://pubmed.ncbi.nlm.nih.gov/26385201/
Whiting PF et al. Cannabinoids for Medical Use – A Systematic Review and Meta-analysis. JAMA. 2015;313(24):2456-2473.
https://pubmed.ncbi.nlm.nih.gov/26103030/
Clinical Evidence: There are over 9 randomized controlled clinical trials and 2 open label clinical trials assessing CBD with or without THC for the management of pain which show varying levels of pain relief depending on the cause of pain, doses used, and type of cannabis product.
Scientific Evidence: CBD has shown to have effects at the molecular level to decrease inflammation through FAAH inhibition and indirect modulation of CB2 receptors, decrease in pro-inflammatory cytokine release, inhibiting T cell proliferation, and reducing migration and adhesion of immune cells among other biological pathways. The primary reason by which CBD may play a role in controlling pain is decreasing underlying inflammation causative of pain.
Clinical and Scientific Evidence References:
Capano A et al. Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgraduate Medicine 2020 132:1, 56-61.
https://pubmed.ncbi.nlm.nih.gov/31711352/
Fine PG et al. The Endocannabinoid System, Cannabinoids, and Pain. Rambam Maimonides Med J 2013;4(4):e0022.
https://pubmed.ncbi.nlm.nih.gov/24228165/
Haroutounian S et al. The Effect of Medicinal Cannabis on Pain and Quality-of-Life Outcomes Chronic Pain – A Prospective Open-label Study. Clin J Pain 2016;32(12):1036-43.
https://pubmed.ncbi.nlm.nih.gov/26889611/Hosking RD et al. Therapeutic potential of cannabis in pain medicine. Br J Anaesthes 2008;101(1):59–68.
https://pubmed.ncbi.nlm.nih.gov/18515270/
Johnson JR et al. Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain. J Pain Symp Manage 2010;39(2):167-79.
https://pubmed.ncbi.nlm.nih.gov/19896326/
Johnson JR et al. An Open-Label Extension Study to Investigate the Long-Term Safety and Tolerability of THC/CBD Oromucosal Spray and Oromucosal THC Spray in Patients With Terminal Cancer-Related Pain Refractory to Strong Opioid Analgesics. J Pain Symp Manage 2013;46(2):207-18.
https://pubmed.ncbi.nlm.nih.gov/23141881/
Ko GD et al. Medical cannabis – the Canadian perspective. J Pain Res 2016;9:735-44.
https://pubmed.ncbi.nlm.nih.gov/27757048/
Lichtman AH et al. Results of a Double-Blind, Randomized, Placebo-Controlled Study of Nabiximols Oromucosal Spray as an Adjunctive Therapy in Advanced Cancer Patients with Chronic Uncontrolled Pain. J Pain Symp Manag 2018;55(2):179-88.
https://pubmed.ncbi.nlm.nih.gov/28923526/
Notcutt W et al. Initial experiences with medicinal extracts of cannabis for chronic pain: Results from 34 ‘N of 1’ studies. Anaesthesia 2004;59:440–52.
https://pubmed.ncbi.nlm.nih.gov/15096238/
O’Connell M et al. Medical Cannabis: Effects on Opioid and Benzodiazepine Requirements for Pain Control. Annals of Pharmacotherapy
2019
https://pubmed.ncbi.nlm.nih.gov/31129977/
Pertwee RG. Cannabinoid receptors and pain. Progress in Neurobiology 2001;63:569–611.
https://pubmed.ncbi.nlm.nih.gov/11164622/
Portenoy RK et al. Nabiximols for Opioid-Treated Cancer Patients With Poorly-Controlled Chronic Pain: A Randomized, Placebo- Controlled, Graded-Dose Trial. J Pain 2012;13(5).
https://pubmed.ncbi.nlm.nih.gov/22483680/
Urits I et al. Use of cannabidiol (CBD) for the treatment of chronic pain. Best Practice & Res Clin Anaesthesiol 2020;34:463-77.
https://pubmed.ncbi.nlm.nih.gov/33004159/
Vuckovic W et al. Cannabinoids and Pain: New insights from old Molecules. Frontiers in Pharmacology 2018;9:1259.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277878/
Ware MA et al. Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS) Supplementary materials.
https://pubmed.ncbi.nlm.nih.gov/26385201/
Ware MA, Wang T, Shapiro S, Collet JP, COMPASS study team. Cannabis for the management of pain: Assessment of safety study (COMPASS). J Pain 2015 Dec;16(12):1233-42.
https://pubmed.ncbi.nlm.nih.gov/26385201/
Whiting PF et al. Cannabinoids for Medical Use – A Systematic Review and Meta-analysis. JAMA. 2015;313(24):2456-2473.
https://pubmed.ncbi.nlm.nih.gov/26103030/
Recent Comments