CBD Products Don't Relieve Chronic Pain After All

Wolfgang Claussen from Pixabay

Chronic pain adversely affects the quality of life of millions of people, and current pharmaceutical treatment options for it remain limited. Acetaminophen can damage liver function and is largely ineffective for arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, carry the risk of significant gastrointestinal effects, and opioid pain medications have fueled an epidemic of addiction.

Against this backdrop, CDB (cannabidiol) has been broadly and increasingly promoted as effective in relieving a wide range of pain-related ailments without any psychotropic or addictive effects. CBD products in the forms of oils, vapes, creams, gummies, drinks, and more are widely advertised in retail stores as well as online as a therapy for pain relief. Their claims fuel a massive and expanding market in the United States, expected to exceed $60 billion by 2030.[1]

CDB is one of the two primary ingredients in cannabis—the other being tetrahydrocannabinol (THC), which is responsible for the predominant mind and mood-altering effects. Some CBD formulations contain very small quantities of THC, while others purport to contain none.[2]

According to the U.S. Substance Abuse and Mental Health Services Administration (SAMSHA), as of 2020, approximately 1 in 3 U.S. adults have used CBD products in the form of oils, capsules, gummies, and creams.[3] While many people use CBD products hoping for relief from chronic pain, a study just published in the Journal of Pain shows minimal—if any—benefit for this purpose.[4]

Researchers from the U.K. and Canada made this finding in a meta-analysis of the results of 16 randomized control trials (RCTs) evaluating the pain-relieving properties of CBD published in scientific journals between 2021 and 2023. This new study found a lack of evidence that CBD in a variety of forms, including topical, oral, and sublingual (under the tongue), reduces pain. No significant difference in perceived pain between CBD and placebo was found in 15 RCTs involving 899 participants, and one trial showing some positive benefit related to CBD had only 18 participants.

This study adds to the results of a 2021 systematic review of 36 different RCTs that also found no benefits on chronic pain from CDB, cannabis, and cannabis-based medicines.[5] The new research further determined that most commercially available CBD products contain varying amounts of cannabidiol—if any at all. They may, however, contain traces of other chemical substances, some of which may be illegal and/or harmful to health, such as THC. The researchers also noted that CBD is not without adverse side effects, citing worsening liver function and increasing rates of cannabis use disorder in some individuals.

The vast majority of CBD use in the United States comes from over-the-counter (OTC) CBD products, and the composition of OTC CBD products is not always verified. The current research found evidence from other studies and reviews that CBD products are frequently mislabeled, containing less or more CBD than advertised. A 2022 study found that only a quarter of the 105 products tested were accurately labeled for CDB, with some containing more than was claimed and others less.[6]

Pain is an extremely subjective phenomenon, and pain levels, as well as the degree of distress/suffering linked with them, vary dramatically from person to person. Similarly, the methods people with chronic pain find helpful are also often highly individualized. As someone with a chronic pain condition myself, I utilize a range of mind-body-spirit modalities that combine professionally administered and self-directed approaches, and I’m always open to new and potentially beneficial resources.

Several years ago, a friend in my 12-step fellowship told me about the noticeable pain relief he experienced from taking CDB oil sublingually and suggested that I try it. It was not inexpensive, and upon using it for four weeks, I found no positive difference in my pain levels, so I discontinued it.

Chronic pain can be nightmarish. As a result, people are often highly motivated to find relief by any means available. This makes them vulnerable to the generally too-good-to-be-true promises made about CBD (along with other products). Over-the-counter CBD has become a multibillion-dollar business whose products are advertised as therapies for numerous health conditions, even though many of these claims are unproven and the health effects of the products are unknown. Anyone choosing these products to treat chronic pain should be aware that companies can and do make unsubstantiated promises about the effectiveness of their products.

As clearly indicated through scientific research, CDB simply does not have the pain-relieving properties it promotes, and those who suffer with chronic pain are well advised to use CBD cautiously, if at all.

Copyright 2024 Dan Mager, MSW