Does CBD Oil Work For Pain And Anxiety

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Hearing a lot about CBD oil for pain management or anxiety? Many CBD products might not be the cure-all they claim to be. Learn more here. CBD products claim to help with anxiety, insomnia, muscle pain and more. It almost sounds too good to be true. So I conducted my own experiment. Despite some claims, there’s no scientific evidence that conclusively proves that CBD can help relieve anxiety.

CBD Oil — Are the Benefits Claimed Too Good To Be True?

These days, many of us could certainly go for a miracle cure-all, especially those of us who struggle with chronic pain, overwhelming anxiety, cancer-related symptoms and/or hard-to-treat neurological disorders. So, it’s no wonder that CBD oil is popping up in our search results. But can we really count on CBD oil to positively impact our symptoms in the ways we hope? Internal medicine specialist Paul Terpeluk, DO, explains why CBD oil may not be as effective as we’d like.

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What is CBD?

CBD, or cannabidiol, is just one of more than 100 chemical compounds found in the cannabis sativa plant. But it’s THC (tetrahydrocannabinol), not CBD, that’s the main psychoactive compound in cannabis that gives you a euphoric high.

CBD is pulled from hemp, a type of cannabis plant that contains very low levels of THC, so it doesn’t get you high. CBD oil is simply a product that contains CBD extract and an oil, like coconut oil, typically for topical use.

It’s important to know that since the implementation of the 2018 Farm Bill, the production and sale of CBD products in the U.S. has been legalized on the federal level as long as they contain less than .3% of THC. However, it’s still illegal under some state laws.

Plus, Dr. Terpeluk explains the market has been oversaturated with CBD products — from bath bombs to gummies, lotions, creams, tinctures and oil — none of which are Food and Drug Administration (FDA) approved and may not be 100% pure CBD. As of mid-December 2021, the FDA has only approved one cannabis-derived and three cannabis-related products, all of which you can safely get with a prescription from a licensed healthcare provider.

“There’s no oversight of the majority of CBD products from a regulatory authority,” says Dr. Terpeluk. “Most of the CBD that you’re buying, unless they have a rigorous marketing campaign and quality control that says it’s 100% CBD oil, more than likely, it’s contaminated with other cannabinoids, including THC.”

What are some of the benefits of CBD?

Several studies show the benefits of pure CBD may have wide-ranging positive effects, though. To understand those benefits, it’s important to consider our body’s endocannabinoid system, a complex system of enzymes, neurotransmitters and receptors that plays an important role in the development of our central nervous system. This system helps regulate a variety of functions, including pain, motor control, memory, appetite, inflammation and more. By further studying CBD’s effects in these specific areas, we may better understand how CBD impacts a variety of conditions and disorders.

Helps with neurological-related disorders

The FDA has approved Epidiolex as a treatment for several seizure disorders, including two rare disorders known as Duvet syndrome and Lennox-Gastaut syndrome. Several case studies suggest CBD may also be beneficial to patients who are resistant to anti-epileptic drugs. “With epilepsy, there’s a threshold in your brain that gets excitatory, and you go into a seizure,” says Dr. Terpeluk. “CBD increases that threshold.”

Other studies suggest CBD may also be useful in managing symptoms of multiple sclerosis, Parkinson’s disease and Alzheimer’s disease, as it has neuroprotective, anti-inflammatory properties. More studies are needed, however, as many suggest that it’s not just CBD alone, but a combination of CBD and other cannabinoids, that may help reduce many of these symptoms.

It may assist with pain relief

By interacting with neurotransmitters in your central nervous system, CBD could potentially relieve pain related to inflammation, arthritis and nerve damage (peripheral neuropathy). In one four-week trial, people who had nerve damage in the lower half of their body reported a significant reduction of intense, sharp pain after using a topical CBD oil.

“All of our different anti-pain drugs affect some section of our pain system, whether it’s Tylenol®, Aspirin®, morphine or opioids,” explains Dr. Terpeluk. “No one wants to be addicted to opioids, so if there’s a cannabinoid you can take that’s not addictive but can repress the pain, that would be the Holy Grail with chronic pain.”

Still, he cautions, there’s a lot left to be studied, including whether there are significant adverse long-term effects of CBD when used for pain relief.

“If you’re taking it in an unregulated fashion, you don’t know how much is in there, and you’re not quite sure how it affects you outside of your particular pain,” says Dr. Terpeluk.

It may help with anxiety and mood disorders

Anxiety and mood disorders like depression or post-traumatic stress disorder can have a severe effect on your daily life and may often cause both physical and emotional stress that could lead to other underlying conditions like sleep disorders, high blood pressure, chronic pain and heart disease. It’s too early to understand the full gamut of effects that CBD may have on anxiety and mood disorders, but individual studies seem to suggest varying positive results. In one study of 57 men who received either oral CBD or a placebo 90 minutes before participating in a simulated public speaking test, researchers learned that a 300-mg dose of CBD significantly reduced social anxiety during the test.

And while there are a wide variety of treatments available for anxiety and mood disorders — ranging from talk therapy and counseling to prescribed medications — Dr. Terpeluk suggests the most important thing is to get at the root of the underlying causes of the anxiety you’re experiencing.

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“Anxiety is better approached by looking at what’s causing it in your life rather than trying to figure out which drugs can reduce it,” says Dr. Terpeluk.

It might help with cancer-related symptoms

CBD may help with nausea, vomiting and weight loss caused by chemotherapy treatments. The FDA has approved three cannabis-related products to help alleviate these symptoms, as well as help increase the appetite for those who have AIDS. These drugs all contain some level of THC or synthetic THC and are not purely CBD alone.

But some studies seem to suggest that CBD can help decrease the size of tumors and help stop the spread of cancerous cells in skin cancer, breast cancer, prostate cancer and more. As with other areas of study, further human clinical trials are needed to understand the full effect CBD has on various kinds of cancer.

What are the side effects or risks of CBD?

If you’re purchasing CBD oil and other products online or from a local vendor, Dr. Terpeluk says there’s no real way of knowing the purity of the CBD you’re using, as it could be mixed with other cannabinoids, such as the dangerous delta-8, or THC.

“It’s a little bit mysterious. It’s not as harmless as you think,” says Dr. Terpeluk. “If you take CBD oil because you buy it on the market, you have a very high likelihood that you could turn a drug test positive for THC because it could actually contain THC.”

CBD can also affect a variety of medications, including pain medications, antidepressants, antipsychotics and more. It could also cause several side effects that may include:

  • Issues with coordination. .
  • Drowsiness or fatigue. .

The best advice? Before considering CBD oil or other CBD products, make sure you talk to your healthcare provider to decide whether it’s safe for you and to ensure it doesn’t have harmful interactions with any medications you’re currently taking.

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What happened when I took CBD for a week to help with my anxiety

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  • CBD products claim to help with everything from anxiety to insomnia to muscle pain.
  • The hype almost sounds too good to be true, so Business Insider’s Benji Jones conducted an experiment to find out how it might help him with his anxiety.
  • Jones took 250 milligrams of CBD oil per day for one week. Mostly, he felt tired after taking the doses, but he did notice a relief from anxiety, particularly during stressful moments of his week.

Following is a transcript of the video.

Steven Phan: You gotta lean back. No, tongue back!

Benji Jones: That’s me, trying CBD at a shop in New York City. Lately, I’ve seen this stuff everywhere: At the local health food store, but also at Urban Outfitters, Sephora, and CBD shops like this one. And if you look at some of the branding, it kind of makes sense.

CBD products claim to help with everything from anxiety to insomnia to muscle pain. It almost sounds too good to be true. And maybe it is. To find out, I set up a little experiment. For one week, I took CBD three times a day, while tracking my anxiety with a scorecard. I also chatted with an expert before and after to sort through the results. Here’s what I learned.

CBD is a distant cousin of THC, the psychoactive chemical in marijuana. They both come from the cannabis plant, but CBD isn’t psychoactive. Meaning it doesn’t get you high. Now, of course, getting high isn’t the only reason why cannabis is popular. People also use it to relieve pain, control seizures, and lessen anxiety. But as researchers like Dr. Yasmin Hurd are discovering, it’s likely CBD, not THC, that’s behind these benefits.

Dr. Hurd: “It can activate some serotonin receptors, and the serotonin system is associated with alleviating anxiety.”

Jones: Hurd has been studying the effects of CBD for over 10 years. And she’s found that it can reduce anxiety in people with a history of heroin addiction. Now, fortunately, I don’t have a history of addiction, but I do see a therapist for chronic anxiety. And CBD could still help.

Dr. Hurd: “Both under normal conditions and in people who have anxiety disorders, enough research has started to show that it does have an anti-anxiety effect.”

Jones: So, back at the shop, I tried all kinds of product. From sweets to lotions and sprays. And while Hurd couldn’t recommend a specific dose for me, she did say that 300 milligrams a day should be enough to feel something. Because participants in clinical trials typically take anywhere from 300 to 600 milligrams. So, those chocolates and sprays? They weren’t going to cut it. Instead, I went for something else.

Phan: The tinctures, right? This is where you really get into the higher-strength things.”

Jones: I decided to err on the side of caution and take 250 milligrams each day, broken out into three doses: 50 milligrams in the morning, 100 milligrams at midday, and another 100 milligrams at night. That way, it wouldn’t hit me all at once.

Jones: All right, today is the day! I have my CBD here. I’m kind of nervous. All right, here we go.

Now, mind you, this was a Wednesday. A workday. Side note: The reason I’m taking CBD this way is that there are tons of capillaries under your tongue. So, anything you put there can be absorbed directly into your bloodstream. Whereas when you ingest CBD, like with that chocolate, a lot of it is broken down by your stomach. Which means you probably won’t feel much.

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Anyway, several hours later, I took my last dose of the day.

If anything, I just feel extremely tired.

That was the first thing I noticed: that CBD was making me drowsy. Really drowsy. Which Hurd said is a pretty normal side effect at high doses. Though we’re not exactly sure why. But as I discovered the next night, it’s also great for hangovers.

I had some alcohol, and I’m certainly not going to have trouble sleeping. I think I’m going to eat a slice of pizza.

The next morning, I felt…great. And according to Hurd, that’s because CBD also has some anti-inflammatory effects. But what about anxiety, what I was really in this for? Each morning, I filled out the anxiety scorecard that Hurd gave me. It was a rough estimate of my daily emotional state, based on numbered responses to statements like, “I feel at ease.” But day to day, it was harder to figure out whether CBD was helping.

Just walking home on Friday night after three days of CBD, and I’m reporting that I’m mostly just tired and feeling lethargic. Not in a bad way; it kind of feels like I have a warm blanket around me, so I don’t hate it.

But over the weekend, I finally got the relief I was looking for, even more quickly than I had expected.

So, I happened to take CBD right before I had to do something stressful. It’s Sunday, but I had a task that I was not looking forward to. And I took 100 milligrams, and I pretty quickly felt my nerves calming down. And I was like, OMG, this is totally working, which is really great because I’m looking for that quick relief like everyone is.

Now, of course, this could have been a placebo. I mean, all of this could have been placebo. So, a few days later, I tried it again in a similar high-stress situation.

Not going to lie, I actually feel a little bit more calm. It kind of puts me into a dissociative state, where I’m slowing down a little bit. I actually get physical pain in my heart region when I’m anxious, which I know sounds terrible. But just 30 minutes after taking my 100-milligram dose for the evening, I feel an absence of that. I will say that I’ve also been listening to the “Lion King” soundtrack, so there are confounding variables. But yeah, I feel a lot better right now.

At that point, I had just one day left.

All right, I’m about to take my last dose of CBD! I must say, I’m kind of excited to stop having to take this three times a day. I think part of it is scheduling and remembering. But also, yeah, I’ve also just been so much more tired. I don’t feel like my anxiety was just washed away. I felt like there were a few times where it really helped in certain instances. And, overall, kind of lowered the intensity of how I was feeling because I felt lethargic. But yeah, I don’t want to be tired anymore.

Afterward, I looked over my anxiety scorecards. And sure enough, it showed that I was feeling slightly less anxious on my last day, compared to my first. Especially when I looked at statements like this. Yeah, that’s a big one for me. I wanted to run these results by Hurd.

Dr. Hurd: “How do you feel?”

Jones: Um, to be honest, I don’t feel that different. I think that the biggest change that I noticed is…I was just tired all the time. I feel this kind of slo-mo lethargia that makes me feel, like, a little bit disassociated with reality. And I think that is what made me feel a little less anxious at times.

Dr. Hurd: So, perhaps…taking it at night only might be best because it can make you a bit sleepy, and everyone has a different sensitivity. If you take it at night you get past the initial sedative effects… and then you don’t have to worry about taking other things like caffeine to try to stay awake.

Jones: And what about those moments of instant relief? Was that in my head, or could CBD act that fast?

Dr. Hurd: “Yeah, absolutely. It can act that quickly. For us, in our studies, people did — shortly after getting CBD — report reduced anxiety.”

Jones: But if there was one takeaway from our conversations, it was this:

Dr. Yasmin Hurd: Ironically, even though it’s now this huge fad in our society, we still don’t have a very good handle on how it’s working.

Jones: In other words, we don’t know: what size dose you should take, how, exactly, it changes your brain, or how it impacts different people in different ways. That’s because until late 2018, nearly all CBD was classified as an illegal substance. Which made it really difficult for scientists to study. And while research is starting to catch up… in some ways, it’s too late.

Dr. Hurd: It’s one of the first times in history that the public is determining whether something is medicine, not scientists and physicians.

Jones: As for me, will I continue using CBD? Yes — but likely only for those moments when I need instant relief. Because, while it seems to benefit a lot of people … I’m not yet fully convinced. But also because, this bottle? It costs more than $130! And if I’m going to spend that much, I want to be absolutely sure it works.

EDITOR’S NOTE: This video was originally published on August 20, 2019.

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.

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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