CBD: An Innovation in Pain Management

Pain Management

Quality of life can be significantly impacted by acute, chronic or neuropathic pain. Pain may manifest as the result of disease, trauma injury, chronic inflammation, or even from medical treatments, such as chemotherapy, designed to make us well. Whatever the root cause of pain, there is no question that pain limits productivity and adversely affects well-being. For those suffering from long-term chronic pain, it becomes limiting at best, and debilitating at worst.

Pain is classified in one of three categories: nociceptive, neuropathic or psychogenic. Nociceptive pain is due to the ongoing activation of pain receptors, often associated with inflammation. This kind of chronic pain can be associated with fibromyalgia, rheumatoid arthritis, inflammatory bowel diseases, HIV or AIDS, and cancer. Neuropathic pain is attributed to changes that occur in the nervous system even after an injury has healed, which manifests as an ongoing painful sensation. Often, those who have undergone chemotherapy experience lingering pain sensations. Psychogenic pain is caused by a psychological disturbance such as anxiety or depression that results in pain.

Regardless of the type of pain one is suffering from, the typical treatments remain the same; strong regimens of opioid drugs. Traditional pharmaceutical drugs used to treat pain include codeine, morphine, hydrocodone and other strong narcotic drugs that act on the central nervous system to help alleviate the symptoms of pain, and allow some quality of life to return. But for many, these strong narcotic treatments come with a high price.

Serious Issues with Common Treatments

One need only read over the names of a few traditional pain medication drugs - OxyContin, Percocet, Dilaudid, and Demerol to name a few - to begin to understand some of the major health issues linked to the quest for pain relief.

A brief, and certainly not comprehensive, list of the side effects of opioid drugs includes:

The extreme side effects of these so-called treatments results in limited dosing. Higher doses, which could be more effective in limiting pain, are also avoided because of the fear of addiction. Even a lay person with no medical background is often familiar with the symptoms of prescription drug abuse from seeing stories on the evening news telling of the actions of those under the influence of prescription drugs.

Another big problem with the opioid line of defense is that the body becomes used to the doses over time, so increasingly larger and more dangerous doses are needed for the same pain-relieving effects. Higher doses increase the health risks and the dependence level. As a result, when the patient wishes to cease use of opioids, there are often severe withdrawal symptoms.

A Safer, Innovative Solution for Pain Sufferers

Those wishing to avoid the extreme risks of traditional opioids are now turning to safer alternatives. In the past, avoiding opioids was considered to be more of a homeopathic and less mainstream approach to pain management. But mounting evidence, particularly since the turn of the century, coupled with high-profile non-opioid advocates is bringing education on this topic to the forefront. More and more people are advocating for the benefits of selecting non-opioid solutions to pain management, no matter what the source of the pain.

Take a look at this high-profile example. Post-surgery pain is one common situation in which opioids are frequently prescribed. In an article appearing in a highly respected publication, U.S. News and World Report magazine, professional athlete Gabby Reece strongly advocates for non-opioid pain relief following her recent knee replacement surgery. The article writer describes it this way:

"Such [non-opioid] alternatives are especially important in light of a new survey finding that 1 in 10 orthopedic and soft tissue surgery patients in the U.S. report becoming addicted or dependent on opioids after their operations - a lot more than the 1 in 15 statistics historically quoted," says Dr. Scott Sigman, an orthopedic surgeon in North Chelmsford, Massachusetts, who's the team surgeon for the U.S. Ski Jumping Team. Sigman goes so far as to say surgery can be the inadvertent gateway to substance abuse.(1)

No matter what the root cause of pain, both homeopathic and traditional physicians are recognizing the effective use of alternative treatments, and specifically cannabidiol (CBD), for pain relief. It's a treatment option growing in popularity because it can be just as effective as opioid treatments, with none of the side effects.

Here is what one research publication said specifically about the use of CBD for pain relief:

Particular difficulties face the clinician managing intractable patients afflicted with cancer-associated pain, neuropathic pain, and central pain states (eg, pain associated with multiple sclerosis) that are often inadequately treated with available opiates, antidepressants and anticonvulsant drugs. Physicians are seeking new approaches to the treatment of these conditions...The entry of cannabinoid medicines to the pharmacopoeia offers a novel approach to the issue of chronic pain management, offering new hope to many.(2)

What Is CBD?

CBD is a plant-derived substance that works in the management of pain because it activates the two main cannabinoid receptors (CB1 and CB2) of the endocannabinoid system within the body. The CB1 receptors, found throughout the brain and central nervous system, regulate the release of neurotransmitter and central nervous system immune cells to manage pain levels (Russo, 2008).

CBD use is considered appropriate and effective in a number of situations. Categorized as a mild to moderate analgesic, CBD is a non-steroidal, non-opioid, anti-inflammatory drug exhibiting far fewer side effects that strong painkillers. Because CBD and opioids share a number of pharmacological properties, it synergistic effects in working alongside opioids can make it more efficient against inflammatory pain than conventional analgesics.(3)

How CBD Works

Cannabidiols and opioids share several interdependent, but not identical, medical properties that indicate using them together can be far more effective than using traditional opioids on their own. In one study, there was a decrease in pain level by 27% when patients were introduced to a CBD-opioid combination treatment, as measured against the use of opioids on their own.(4)

CBD is effective because it works within the spinal cord system of nerve endings, called glycine receptors. Several recent clinical studies have demonstrated that CBD can be an effective therapeutic option for patients with neuropathic pain and other types of chronic pain. Recent studies have shown that glycine receptors (GlyRs) are an important target for cannabinoids in the central nervous system.(5)

Because these glycine receptors have far-reaching impact on a number of body functions, finding an alternative treatment that is safe and effective in utilizing their properties is a breakthrough in pain management that has come about in the last decade.

In promising research, CBD and other cannabinoids have been shown to have analgesic properties for terminal cancer patients who have developed a strong resistance to opioid analgesics. This research indicates that in the case of patients whose bodies have become accustomed to high doses of traditional painkillers, CBD can provide a safe and effective alternative treatment.(6)

CBD As A Pain Reliever

The effects of CBD on the body reach deep into the inner workings of pain. Beyond quality of life issues, chronic pain can contribute to other adverse effects on the body for related issues; stress and anxiety, nausea, high blood pressure, and reduced immunity, to name a few.

A Tulane University study published the following list of symptoms that CBD can help to treat, many as the direct result of unmanaged chronic pain:

The collective effect of CBD on this host of symptoms, many of which are the result of unmanaged pain, is termed The Entourage Effect.(7)

Because of these interrelated effects, there is a broad spectrum of pain management that CBD use can help alleviate. In some of the most extreme examples, CBD is known to help cancer patients endure the wrenching nausea and pain associated with chemotherapy. Those suffering with multiple sclerosis can enjoy an afternoon in the park without a wheelchair, and CBD delivers significant seizure reductions to children with epilepsy.

Those suffering with painful diseases like fibromyalgia, rheumatoid arthritis, inflammatory bowel diseases, HIV or AIDS, epilepsy, muscular dystrophy, Parkinson's disease, stroke victims or even chronic inflammation may find relief in utilizing CBD as part of their pain management regimen. It has also proven effective with patients who desire to eliminate or lessen their exposure to opioids (as Gabby Reece did) for one of many reasons cited earlier in this article.

The first documented discovery of cannabinoids was in 1940 by Roger Adams in the United States. In 1964, Dr. Raphael Mechoulam at Hebrew University in Jerusalem began researching in more detail the chemical combinations present in CBD. He determined that these chemicals work synergistically within the human body, and specifically within the endocannabinoid system.(8) Since then, the study and use of CBD has grown, though not as rapidly as some hoped. It's applications to a number of chronic conditions, particularly those linked to intolerable pain, has broadened recently.

Dr. Mechoulam researched and documented 111 active chemicals in CBD. Now we know that CBD contains over 400 active chemicals, making it one of the pharmacologically active plants on the planet. That's why it benefits so many different illnesses, because it's unique combination of active chemicals make it one of the highly effective modalities for treating pain and inflammation of every varying degree.

The endocannabinoids in our body regulate balance in sleep, appetite the immune system, pain, and more. The pharmaceutically active components in CB mimic the functions of the endocannabinoids, so it helps the body manage crisis situations and restore itself after trauma.(9)

Solving the Pain Dilemma

For anyone suffering from chronic pain, whether due to injury, illness, or disease, CBD is viable alternative to opioids that should be taken into serious consideration within the treatment protocol. As more research is coming down the pipeline every year, pain sufferers owe it to themselves to explore safer treatment options that won't expose them to the risky side effects and addictive nature of traditional pharmaceutical treatments.

Those curious about the details of how and why CBD works can access a wealth of data that will prove CBD is a viable alternative in the world of pain management, and should be included in treatment protocols across a wide spectrum of pain-causing illnesses. Researchers continue to delve into this interesting topic, with the belief that for those suffering from chronic and debilitating pain, CBD holds the key to relief and a restored quality of life.

Footnotes

1 - Anna Medaris Miller, "Health Buzz: Volleyball Star Gabby Reece Champions for Non-Opioid Pain Relief, U.S. News and World Report (August 2, 2016).

2 - Ethan B. Russo, MD.,"Cannabinoids in the Management of Difficult to Treat Pain," Therapeutics and Clinical Risk Management (February 2008): 245-259.

3 - DI Abrams, P Couey, SB Shade, ME Kelly and NL Benowitz, "Cannabiniod-Opioid Interaction in Chronic Pain," Clinical Pharmacology & Therapeutics, (November 2011): 844.

4 - Abrams et al, pg. 844.

5 - W Xiong, T Cui, K Cheng, F Yang, S Chen, D Willenbring, Y Guan, H Pan, K Ren, Y Xu, L Zhang, "Cannabinoids Suppress Inflammaory and Neuropathic Pain by Targeting a3 Glycine Receptors," Journal of Experimental Medicine, (June 2012): 1121-1134.

6 - "Cannabidiol (CBD) Pain Relief Research," HempOilFacts.com (May 2016).

7 - Mary Ann Travis, "Researcher Explores Effects of Cannabinoids on Blood Pressure, Tulane News (June 2016).

8 - Gooey Rabinski, "What Are Cannabinoids," CBD Hemp Oil Facts.com (Nov. 2015).

9 -Nishi Whiteley, Chronic Relief: A Guide to Cannabis for the Terminally and Chronically Ill, (Avilio, Oct. 2016)