Fibromyalgia is one of many chronic pain conditions that are stubbornly difficult to treat.
With the ravages of the opioid epidemic causing many to avoid these powerful pain relievers, a significant number of people with fibromyalgia are finding effective replacements in products containing CBD, a new Michigan Medicine study finds.
CBD, short for cannabidiol, is the second most common cannabinoid in the cannabis plant and has been marketed for everything from mood stabilization to pain relief without the intoxicating effects of the most common cannabinoid, THC. THC, which stands for Delta-9-Tetrahydrocannabinol, is the ingredient in marijuana that makes people feel high.
The cannabis industry has exploded, aided by the legalization of medical and recreational marijuana in the United States and the removal of CBD from hemp from List 1 status – reserved for drugs with no currently accepted medical use and high potential for abuse Federal level.
Previous research has shown that some people replace opioids and other pain relievers with medicinal cannabis (often with high levels of THC), and reports that cannabis provides better pain relief and fewer side effects. However, there is far less data on the use of CBD.
“CBD is less harmful than THC because it is non-intoxicating and has less potential for abuse,” said Kevin Boehnke, Ph.D., a researcher in the Department of Anaesthesiology and the Chronic Pain and Fatigue Research Center. “If people can find the same relief without the side effects of THC, CBD can be a useful harm reduction strategy.”
Boehnke and his team asked people with fibromyalgia about their use of CBD to treat chronic pain.
“Fibromyalgia is not easy to treat and often involves multiple drugs with significant side effects and modest benefits,” said Boehnke. “In addition, many alternative therapies such as acupuncture and massage are not covered by the insurance.”
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For this study, the team focused on 878 people with fibromyalgia who reported using CBD to gain more insight into the use of CBD products.
The UM team found that more than 70% of people with fibromyalgia who used CBD replaced opioids or other pain relievers with CBD. Many of these participants reported that they either reduced their use or stopped taking opioids and other pain relievers as a result.
“I wasn’t expecting this rate of substitution,” said Boehnke, noting that the rate is quite similar to the rate of substitution reported in the medical cannabis literature. People who said they used CBD products that also contained THC had higher chances of substitution and reported greater symptom relief.
The finding that products containing only CBD also provide pain relief and replace pain relievers is encouraging and deserves future study, Boehnke noted.
The team found that much of the widespread use of CBD occurs without medical guidance and no relevant clinical studies. “Despite this lack of evidence, people are using CBD, replacing it for medication, and saying it is less harmful and more effective,” he said.
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Boehnke stressed the need for more controlled research on how CBD can provide these benefits and whether these benefits are due to the placebo effect.
Clinically, for reasons of drug safety and to “strengthen the therapeutic alliance and improve patient care,” it is essential to open discussions about the use of CBD for chronic pain, said Boehnke.
Other authors are Joel J. Gagnier, Lynne Matallana and David A. Williams.
quoted paper: “Substituting Cannabidiol for Opioids and Pain Relievers in People with Fibromyalgia: A Great Online Survey,” The Journal of Pain. DOI: 10.1016 / j.jpain.2021.04.011