There are a number of challenges associated with the use of cannabidiol (CBD) and hemp oils in pain management, including variations in the levels of CBD and tetrahydrocannabinol (THC), and a lack of thorough human clinical trials, according to a review article published in the Mayo Clinic Proceedings.
CBD and hemp oils have become a popular adjunctive option to conventional pharmacotherapy for pain management. However, research examining the therapeutic effects of CBD remains limited, as the majority of clinical studies focus on THC, which binds CB1 receptors, rather than on CBD itself. There is little research examining the use of CBD oils in pain management, and the majority of the studies focused on THC drugs that can be prescribed (eg, dronabinol, nabilone, and nabiximols). The most thorough research on CBD oil examined its effects in epilepsy and indicates that CBD oil may reduce the total frequency of seizures.
Preclinical trials indicate that CBD and hemp oils may be effective for chronic pain. If such results were replicated in patients with chronic pain, CBD and hemp oils may represent an effective option for reducing opioid consumption in this population. There is a lack of rigorous safety studies on full-spectrum phytocannabinoid oils, as these products are still recent, although existing data seem to indicate that they are not associated with serious safety concerns.
Variations in online product labeling have made access to high-quality CBD and hemp products challenging for consumers. The review authors recommend that CBD or hemp oil be extracted by carbon dioxide with no solvents and certified by the US Department of Agriculture as organic.
“We encourage physicians to not disregard patients’ interest in these therapies and instead to retain clinical curiosity as well as healthy skepticism when it comes to attempts to explore new options, especially in the context of curbing addiction and opioid overuse,” noted the review authors.
VanDolah HJ, Bauer BA, Mauck KF. Clinicians’ guide to cannabidiol and hemp oils. Mayo Clin Proc. 2019;94(9):1840-1851.