How Can CBD Help With Pain?

    • Research on CBD and pain management has been promising. A study published in the journal Therapeutics and Clinical Risk Management found that cannabinoids, like CBD and THC, might help reduce pain (1). 
    • A 2012 study in The Journal of Experimental Medicine demonstrated the mechanism by which CBD alleviates inflammatory and neuropathic pain in a rodent model, which are challenging types of chronic pain to treat (2). 
    • Results from a 2017 study reported at the 3rd Congress of the European Academy of Neurology held in Amsterdam showed that CBD and THC could potentially lead to less acute pain and less intense pain for people with migraines (3).
    • A 2018 review in Frontiers in Pharmacology examined the studies on various types of pain, including neuropathic pain, cancer pain, and fibromyalgia. Researchers concluded that CBD may be effective based on the data that currently exist (4).
    • Researchers from the department of anesthesiology and the Michigan Medicine Chronic Pain and Fatigue Research Center noted that ongoing preclinical studies in animals have demonstrated CBD reduced pain and inflammation (5).

Why People Are Turning to CBD Oil for Pain

Kevin Boehnke, Ph.D., a research investigator in the department of anesthesiology and the Michigan Medicine Chronic Pain and Fatigue Research Center, noted that ongoing preclinical animal studies have demonstrated that CBD reduced pain and inflammation(6). 

Meanwhile, studies of CBD in humans show that it is well-tolerated and has few adverse side effects. 

There are also observational studies that ask why people use CBD and if it is useful, and the results tend to be quite positive. 

People report using CBD for anxiety, pain, and sleep —all things that go hand-in-hand with chronic pain, Boehnke added(7).

What makes CBD more appealing to most people is that this compound does not give the user a euphoric high, unlike its cannabinoid counterpart, THC (tetrahydrocannabinol) that is known for its psychoactive effects.

The research on CBD and pain management has been promising. One example is the study published in the journal Therapeutics and Clinical Risk Management that explored the efficacy of cannabinoids in pain management(8). 

The study showed that cannabinoids could reduce the pain of individuals with conditions or pain that is hard to manage. 

The participants in the study had cancer or multiple sclerosis, conditions that are associated with challenging-to-treat pain.

CBD for Chronic Pain

CBD may be feasible as an option for treating some types of chronic pain(9). 

Chronic pain, particularly neuropathic pain, is a primary clinical problem that is difficult to treat, according to the author of the study on neuronal mechanisms for neuropathic pain(10).

Chronic pain management continues to challenge some patients and their doctors. The investigation into potential therapies, such as CBD and hemp oils, continues for the future of clinical pain management(11).

As for CBD and hemp oils’ potential use in the treatment of chronic pain, a 2018 study noted that an overwhelming body of scientific evidence indicated cannabinoids might produce pain-relieving effects in inflammatory and neuropathic rodent pain models(12).

Also, studies showed that CBD might be able to treat addiction by reducing the activity of the amygdala and modulating dopamine and serotonin(13).

The amygdala is a set of neurons known for its role in fear processing, sending signals to areas of the brain to trigger a “fight-or-flight” response(14).

Serotonin influences levels of mood, anxiety, and happiness. Dopamine, meanwhile, regulates mood and muscle movement and plays a vital role in the brain’s pleasure and reward systems.

 With better regulation of serotonin and dopamine, CBD could help stabilize mood and reduce anxiety. 

Thus, CBD may represent an attractive option in chronic pain treatment, particularly in the context of opioid abuse. 

CBD is not only useful because of its potential efficacy but also because of its limited misuse and abuse safety profile(15).

However, more research is needed as the pilot human studies were conducted with small sample sizes. 

Nevertheless, the studies represent potential future areas of cannabinoid use in the clinical treatment of pain relief and opioid abuse. 

A 2018 review examined how well CBD works to help relieve chronic pain. The review analyzed the studies conducted between 1975 and March 2018(16).  

Researchers examined the studies on various types of pain, including cancer pain, neuropathic pain, and fibromyalgia. The researchers concluded that CBD was effective overall. However, the available data are not strong enough as of yet for CBD to become a mainstay treatment modality.

CBD for Arthritis Pain

A 2016 study from the European Journal of Pain showed, using rats as animal models, CBD applied on the skin might help lower pain and inflammation due to arthritis(17).

Researchers applied CBD gel to the rats for four consecutive days, with the animals receiving different doses per day. 

The researchers noted a reduction in inflammation and overall pain in the animals’ affected joints without noticeable side effects.

The rats that received low doses of CBD did not show improvement in their pain scores. Results found that 6.2 mg/day was a high-enough dose to reduce the rats’ pain and swelling symptoms.

Also, rats who received 62.3 mg/day had similar outcomes to the rats that received 6.2 mg/day. Receiving a substantially larger dosage did not result in them having reduced pain.

The pain-relieving and anti-inflammatory characteristics of CBD gel could potentially help individuals with arthritis. However, more human studies are needed(18).

A 2017 study from the journal Pain looked at the ability of CBD to prevent joint neuropathy and joint pain associated with osteoarthritis(19). 

Neuropathy is the damage or dysfunction of nerves that results in numbness, tingling, muscle weakness, and pain in the affected area(20). 

Osteoarthritis, a common form of arthritis, occurs when the protective cartilage that cushions the ends of the bones wears down over time. With osteoarthritis, the joints can get painful, swollen, and hard to move(21).

The researchers found scientific evidence to support both of the neuropathic and osteoarthritic functions of CBD. 

They concluded that these potential benefits of CBD were due to its nerve-protective properties and anti-inflammatory properties on the joints.

CBD for Neuropathic Pain

A study, which was conducted in 2012 and published in The Journal of Experimental Medicine, showed the mechanism by which CBD alleviates neuropathic and inflammatory pain, which are challenging types of chronic pain to treat(22). 

However, more studies with human subjects are needed in this area to substantiate the claims of CBD proponents about pain control.

Muscle spasms are typical symptoms of neuropathic damage which often leads to painful, uncontrolled muscle twitches(23). 

A study has demonstrated that Sativex, a medicine constituted by CBD and THC in a 1:1 ratio, might help with pain management in those with chronic neuropathic pain, pain due to nerve damage, peripheral neuropathy, advanced cancer pain, rheumatoid arthritis, and spasticity due to multiple sclerosis (MS)(24).

Similar results were obtained from another review, which was published in The Cochrane Database of Systematic Reviews in 2018(25). 

The said review of hundreds of studies examined marijuana-based pharmaceuticals on neuropathic pain in adults. 

While not all results were positive, there was evidence that cannabinoids could reduce the symptoms of neuropathy or nerve pain.

CBD for Migraine Pain

Migraine pain usually impacts both sides of the head and is often accompanied by light sensitivity and nausea. 

Studies on CBD and migraine are limited. Most of the studies, so far, have examined CBD’s effects when combined with THC, not when CBD is used alone(26).

Results from a 2017 study reported at the 3rd Congress of the European Academy of Neurology held in Amsterdam showed that CBD and THC may potentially lead to less acute pain and less intense pain for people with migraine(27).

The study, conducted in Italy, first set out to discover the most effective dosage of the cannabinoids for headaches. 

A starting dose of 10 mg was given orally to 48 chronic migraine patients, in a combination of two compounds. 

The first dose contained 19% THC, and the second contained 9% cannabidiol CBD but no THC. 

The researchers found that doses <100 mg were ineffective and that a 200 mg dose elicited a 55% drop in acute pain.

Results showed that those who took the THC-CBD drug reported fewer stomach aches and less muscle pain compared to those who took the prescription medication.  

The downside was that those taking the THC-CBD combination reported having some drowsiness and trouble with concentration.

CBD for Cancer Pain 

Cancer and its treatment can both lead to pain, and most people with cancer go through severe pain chronically. 

Seventy to ninety percent of patients with advanced cancer experience significant pain(28). Cancer often causes pain due to pressure or damage to internal organs, inflammation, or nerve injury.

In cancer patients, cannabinoids have primarily been used as a part of palliative care to alleviate pain, relieve nausea, and stimulate appetite(29).

While there are medications prescribed to ease the discomfort, they come with severe side effects, such as vomiting, extreme sleepiness, constipation, and addiction. 

When the pain is severe, it can become resistant to opioids, which are also excellent pain relievers. 

A study published in The Journal of Pain and Symptom Management showed that THC:CBD extract is efficacious for pain relief in individuals with advanced cancer pain not adequately relieved by potent opioids(30). Some patients may not respond well to opioids. 

The study found that the extract, when used in addition to the opioids, provided improved relief from pain compared to using opioids alone.

Results showed that THC:CBD extract is efficacious as an adjunct for relief of pain in patients with advanced cancer pain not adequately alleviated by potent opioids.

How CBD Oil Works for Pain

To understand how CBD works to help with pain, one must understand how the endocannabinoid system (ECS) works. 

The therapeutic effects of cannabinoids, like CBD, are realized by their active interaction with the body’s ECS and its cannabinoid receptors. 

The ECS is mainly responsible for regulating various body functions, including pain sensation, immune response, anxiety, sleep, mood, appetite, metabolism, and memory.

Receptors CB1 and CB2 are the two main types of receptors found in specific parts of the human body. These receptors each have specific roles in the ECS.

CB1 receptors are mostly situated in the brain and central nervous system. However, they are also found in the gastrointestinal and urinary tracts, reproductive organs, liver, lungs, and retina(31).

CB1 receptors influence motor regulation, memory processing,  appetite, pain sensation, mood, and sleep(32).

Various studies of the cannabinoid receptors have shown that endocannabinoids attenuate and suppress the perception of pain(33).

The activation of CB1 receptors has also been associated with neuroprotective responses. This activity suggests the cannabinoids with a higher affinity for CB1 receptors could help in the prevention and treatment of neurodegenerative conditions, such as  Parkinson’s disease, Alzheimer’s disease, and multiple sclerosis.

Meanwhile, CB2 receptors are mostly found on cells in the immune system and its associated structures.

When CB2 receptors are triggered, they trigger a response that fights inflammation, reducing pain, and minimizing damage to tissues.

These anti-inflammatory responses have been found useful in treating inflammation-related conditions, such as chronic inflammatory demyelinating polyneuropathy (CIDP), Crohn’s disease, arthritis, and inflammatory bowel syndrome(34).

CBD indirectly acts against cannabinoid agonists, which are substances that bind to a receptor and cause the same action as the elements that typically bind to the receptor.

Also, CBD interacts with several other receptors in the body, such as the 5-HT1A receptor, which is linked to serotonin, a neurotransmitter found to be a contributor to feelings of well-being. It is through this interaction that these cannabinoids promote healing and balance(35). 

The Pros and Cons of CBD Oil for Pain


  • Studies mentioned previously demonstrate CBD’s potential therapeutic benefits in helping with conditions and symptoms associated with chronic pain, arthritis pain, neuropathic pain, migraine pain, and cancer pain.  
  • CBD has been well-received by many distinguished health agencies, including the World Health Organization (WHO), stating that CBD “is generally well-tolerated with a good safety profile.”(36)
  • CBD does not give the users a euphoric high, unlike its psychoactive cannabinoid counterpart, THC (tetrahydrocannabinol).
  • CBD is non-addictive, says Nora Volkow, director of the National Institute on Drug Abuse (NIDA) in a 2015 article(37). This characteristic makes CBD safe for daily intake.
  • CBD oil may be purchased without a prescription in locations where they are legally available.


  • Cannabis has been a Schedule 1 drug, which has limited the type and scope of research needed to figure out how best to use it therapeutically. Under the U.S. Federal Controlled Substances Act, Schedule 1 drugs have no currently accepted medical use and a high potential for abuse(38).
  • Studies are not substantial enough to determine whether or not CBD is an effective treatment for conditions other than the ones approved by the U.S. Food and Drug Administration (FDA). To date, Epidiolex, a drug prescribed for epilepsy, is the only CBD product on the market that the FDA has approved(39).
  • As with the use of any natural chemical compound, there are risks involved in using CBD. According to the Mayo Clinic, possible side effects include drowsiness, dry mouth, diarrhea, fatigue, and reduced appetite(40).
  • CBD has been shown to interact with other drugs and alter how the body metabolizes certain medications, as a 2017 research revealed(41). Consult with a medical professional experienced in cannabis use before starting a CBD regimen or combining it with current prescription medications.
  • The lack of regulation on cannabis products in a dynamic CBD industry makes it difficult to determine whether the CBD gummies, tinctures, patches, balms, and gelcaps contain what the product label claims.

A 2017 review published in the Journal of the American Medical Association revealed labeling inaccuracies among CBD products. Some products had less CBD than stated, while others had more(42).

How CBD Oil Compares to Alternative Treatments as Natural Pain Relief

Alternative treatments for pain include the use of capsaicin, amino acids, and primrose oil(43).

Other herbs that are also used for natural pain relief are ginger and turmeric.

  • Capsaicin is a substance found in hot peppers. A study looked into the use of capsaicin 8% dermal patch and found that almost 71% of those who had cancer-associated nerve pain experienced 90% pain relief(44).
  • Theramine, an amino acid blend, could be useful in reducing pain and inflammation linked to chronic back pain, according to a 2016 study in the American Journal of Therapeutics(45). 
  • Primrose oil might help reduce neuropathy pain in people with diabetes, says Mayo Clinic, in an article on peripheral neuropathy diagnosis and treatment(46). 
  • Ginger and turmeric have potent anti-inflammatory properties, which could help decrease pain and protect against disease. Studies show that curcumin, the active ingredient in turmeric, and ginger are effective at decreasing chronic pain associated with arthritis(47). Meanwhile, CBD has been shown to possess characteristics that could be used for natural pain relief.
  • Some CBD products come in the form of creams and transdermal patches infused with capsaicin. The capsaicin in these CBD creams and patches combine with CBD’s natural pain-relieving benefits to target specific areas in the body.
  • Hemp oil produced from cannabis seed is an excellent source of essential amino acids and fatty acids(48).
  • CBD’s anti-inflammatory properties have been shown to potentially help with Type 1 Diabetes, according to a 2016 study published in Clinical Hemorheology and Microcirculation(49). Some CBD topicals also come infused with primrose oil. 
  • There are CBD tinctures available that are infused with ginger and turmeric. These tinctures may be taken orally, or used as massage oils for localized natural pain relief as needed.

How to Choose the Best CBD Oil for Pain

It is essential for patients and physicians who choose to try CBD and hemp oils for pain to know how to choose high-quality CBD oil.

This issue becomes all the more remarkable when considering some of the problems noted previously. 

There are three types of CBD oil: full-spectrum, broad-spectrum, and CBD isolate.

The full-spectrum variety contains a complete range of cannabinoids, terpenes, flavonoids, and other compounds naturally present in cannabis, including other compounds and minerals, such as a variety of fatty acids and beneficial fiber. 

Terpenes are the compounds in cannabis plants that give it distinctive aromas and flavors, while flavonoids are responsible for the vivid colors in most plants.

The combination of all these components creates a synergy known as “entourage effect,” where all of the constituents working together are more efficient than their isolated elements(50).

Studies cited previously showed that CBD is not the only cannabinoid found in cannabis that can help alleviate pain. Hence, when choosing a CBD product, opt for one that contains full-spectrum CBD oil.

However, it is up to the discretion of the physician whether to suggest trying full-spectrum formulations. 

No research is available on their efficacy and safety outside of specific components in separate contexts(51).

Meanwhile, those with allergies to THC may opt to use broad-spectrum CBD oil, which is like full-spectrum CBD but THC-free or contains trace amounts (less than 0.3%) of THC. 

CBD isolates, on the other hand, carry only pure CBD. For people who are allergic to specific components of the hemp plant and do not want any THC in their system, CBD isolates are an option.

Regardless of the form of CBD oil products, careful consideration must be employed in selecting the best CBD oil for pain that is suitable for one’s lifestyle and preferences.

The following factors are essential to ensure the safety and reliability of the CBD products purchased:

  1. Research on the exact legal stipulations applicable to CBD in the area where it would be bought and used.
  2. Purchase only non-GMO, organic hemp-derived CBD oil products from legitimate and reliable CBD brands known for their high-quality CBD oil products. The majority of CBD companies that manufacture the best CBD oil products grow their hemp from their own farm, or they purchase from licensed hemp producers.
  3. Research product reviews before buying from an online store. When purchasing from a physical store or dispensary, check whether the store is authorized by the government to sell CBD.
  4. Knowing the extraction methods used in making the CBD oil is also essential. Researchers of a study indicate that the Supercritical-CO2 extraction process is recognized as safe by the U.S. Food and Drug Administration (FDA) in pharmaceutical manufacturing(52). The supercritical CO2 extraction method allows for the highest purity and potency because the process does not extract any unwanted ingredients and impurities. NuLeaf Naturals is only one of several companies that use the supercritical CO2 extraction method to extract CBD oil for their tinctures. The most natural carrier oils that may be used include MCT oil (medium-chain triglycerides from coconut oil), hemp seed oil, and extra-virgin olive oil. Nuleaf extracts their CBD from hemp plants of the highest quality, grown on licensed farms in Colorado, USA. NuLeaf uses organic hemp oil as its carrier oil, for the most natural connection to the body’s endocannabinoid system and the most compatible oil for CBD.
  5. One important thing to look for in CBD products is certification codes. Several certification authorities approve certain products only after some thorough screening tests. A certificate of analysis (COA) is a laboratory report regarding the contents of a product. In the case of CBD, a COA includes cannabinoid content and other tested compounds, such as pesticides, mold, and heavy metals. COAs ensure the customer knows what is in the product they are purchasing. This piece of information does not only promote transparency, but it also ensures that the product contains what it claims. A reputable CBD company always ensures its products have passed lab testing and offers the most recent COAs of the products they provide. After all, a COA is as much for the customer as it is for the manufacturer to make sure that consumers get only high-quality products. COAs ensure that consumers get only products of the highest quality with every purchase. Apart from the COA, another certificate that is worth checking is the U.S. Hemp Authority Certification, which is the CBD industry’s initiative to provide high standards, best practices, and self-regulation.
  6. Compare company claims about their products’ potency with that of the third-party lab testing reports. Look for a certificate of analysis for every product purchased.
  7. Consulting with a trusted medical professional experienced in the use of CBD is ideal before using any CBD product.

Additional Tips on Shopping for the Best CBD Oil Products

  • Consider CBD-rich, high-quality products derived from high-resin cannabis grown sustainably following with certified regenerative organic standards.
  • Be wary of CBD brands that claim their CBD is derived from the seed and stalk of hemp plants. CBD is not present in hemp seed, and there is barely any CBD in the stalk of the hemp plant.
  • Avoid CBD hemp oil vape cartridges containing flavor additives, toxic thinning agents (such as propylene glycol and polyethylene glycol), and other harmful ingredients.
  • Avoid poor quality CBD-infused gummies made with artificial colors and corn syrup. 
  • Reach out to CBD companies directly to ask questions. Try another brand if they do not communicate.

CBD Dosage for Pain

There is no conclusive research about how much CBD a person needs to take in order to experience the benefits of CBD oil, such as pain relief.

There are very few studies on CBD conducted with humans, and those that have been done include doses that vary considerably. 

To further add to the confusion, CBD is available in different forms, like oils and tinctures, creams and lotions, pills, vape juice, and edibles. 

Each form is different in terms of bioavailability, the percentage of active ingredients that gets into the bloodstream.

However, in the context of treating pain, one study reported the safety of oral CBD administration (400-800 mg of CBD) alongside fentanyl (a synthetic opioid pain reliever) administration(53). 

There was also a review on the use of Sativex for treating neuropathic pains of different origin(54). 

According to the U.S. National Library of Medicine, through its website, Sativex may be used in both cases as pain medication(55):

  1. For palliative care (an approach that improves the quality of life of individuals with a life-threatening illness, such as cancer), Sativex may be administered at low doses, with a range of 1 to 4 sprays per day. Each actuation of the spray delivers 2.7mg delta-9-tetrahydrocannabinol (THC) and 2.5mg CBD. The maximum daily dose is 10.8mg THC and 10mg CBD.
  2. For pain, Sativex may be administered at medium doses, with a range of 6 to 10 sprays per day. 

Each actuation of the spray delivers 2.7mg delta-9-tetrahydrocannabinol (THC) and 2.5mg CBD. The maximum daily dose is 27mg THC and 25mg CBD.

Ultimately, it takes some experimentation or trial and error when using CBD for pain. Note that a consultation with a doctor experienced in cannabis use is essential before deciding to use any CBD product.

How to Take CBD Oil for Pain

A topical CBD cream, CBD transdermal patch, or CBD massage oil is ideal when dealing with inflammation or pain in a specific area of the body. 

When applied in this way, the CBD can target localized clusters of cannabinoid receptors, rather than interacting with the ECS as a whole.

The CBD in topicals goes to work instantly after rubbing the product onto the affected area, and relief can be felt in about 15 minutes. 

One option is to take CBD oil topically alone or combined with lotion or cream(56). 

Research published in the European Journal of Pain studied the advantage of this approach and found that topical CBD application has therapeutic potential for relief of arthritis pain-related behaviors and inflammation without evident side-effects(57).

For topical products, look for keywords on the product labels that indicate that the product uses nanotechnology, encapsulation, or micellization of CBD. 

These words indicate that their solution can carry CBD through the dermal layers, rather than just staying on the skin.

Many CBD creams, salves, patches, and massage oils are also infused with other elements, such as essential oils, that may supplement CBD’s health benefits for pain relief.

Meanwhile, CBD oil capsules and edibles, such as brownies, gummies, and lozenges, are a convenient and straightforward way to take CBD oil, especially for beginners.

CBD oil tinctures or drops may be a practical option for those who seek fast results and maximum dosage control. 

A syringe, marked dropper, or easily-calculated number of drops is used for consistent and accurate dosing. 

Sublingual application of CBD tincture allows for results to be experienced within 30 to 60 minutes after its use, and the effects can be felt for 4 to 6 hours.

CBD oil vapes are one of the quickest ways to get CBD into the body since it enters the bloodstream through the lungs, without going through the digestive system. 

When vaping CBD oil, effects can be felt in minutes. However, the effects last only for 30 minutes to an hour or two. Also, with CBD vapes, it is difficult to determine precisely how much CBD is in each draw. 

As a 2018 study published in Molecules indicated, the primary limitations of inhaling are the variability in individuals’ inhalation techniques and respiratory tract irritation during inhalation(58).

Although labels for CBD oil vape products usually indicate the amount per inhale, the amount may vary in individuals. Thus, getting the dose right requires a bit of experimentation at first. 

Vaping is not for everyone. Experts are not sure whether or not vaping causes lung problems. However, they believe that the most likely culprit is a contaminant, not an infectious agent. 

Possibilities may also include chemical irritation or allergic or immune reactions to various chemicals or other substances in the inhaled vapors(59).

Thus, individuals contemplating vaping CBD for the first time must proceed with caution and first consult with a doctor experienced in cannabis use.

CBD and Hemp Oil

Given the variation in the legislation concerning Cannabis sativa plants, as well as the increase of new products being marketed in the CBD industry, there has been a lack of clarity about the types of hemp extract and CBD oils. 

There can be various components present in the extract, depending on what part of the plant is extracted.  

Phytocannabinoids, such as CBD and THC, and terpenoids, like beta-caryophyllene and limonene, collect in the flowers and leaves(60).

Conversely, the seeds of the C Sativa plant contain zero to little phytocannabinoids. However, they are rich in Omega-6 and Omega-3 essential fatty acids and other nutritious antioxidants(61). 

Also, there are cannabis oil products. These oils, derived from the marijuana plant, have high levels of THC(62).

To obtain the benefits of cannabidiol, ensure that the CBD oil contained in the product is not merely hemp seed oil.

Note that hemp seed oil, although containing nutritious Omega-3 fatty acids, does not contain any of the cannabinoids or terpenes(63). 

CBD products may be marketed as full-spectrum hemp extract, hemp oils, dietary supplements, or CBD-enriched products, coming in the forms of oils, sprays, capsules, soft gels, balms, and foodstuffs, such as gummy bears, horse pellets, and pet treats. 

Some CBD products are infused with other extracts, such as clove, lavender, Boswellia, arnica, curcumin, ashwagandha, and turmeric. These products are being marketed for a wide range of uses such as sleep aids, pain relief, or stress reduction. 

Given the inconsistency in ingredient choices, as well as amounts and method of administration, it is difficult to know which ingredient accounts for specific symptom relief(64). 

Thus, always consult with a doctor experienced in cannabis use when contemplating trying CBD products.

CBD Side Effects

Most people tolerate CBD oil well. However, there are some possible side effects.

 According to a 2017 review in Cannabis and Cannabinoid Research, the most common side effects include diarrhea, tiredness, and changes in appetite and body weight(65).

In addition, using CBD oil with certain medications can make those medications more or less effective. This interaction is brought about by some medications that are metabolized, or broken down, in the body after ingestion.

The CYP450 liver enzymes are primarily responsible for breaking down toxic compounds, including over 60% of any over-the-counter or prescription drugs consumed.

Certain substances can affect processing times within this system, making drugs metabolize faster or slower than they would on their own.

Cannabidiol can inhibit the cytochrome P450 system’s ability to metabolize certain drugs, leading to an overall increase in processing times(66). 

In theory, using CBD along with medications that are broken down by the liver may increase the effects and side effects of certain medications. 

CBD might also affect the liver’s ability to break down toxins, increasing the risk of liver toxicity.

Meanwhile, the patient information leaflet for Epidiolex cautions that there is a danger of liver damage, lethargy, and possibly depression and suicidal thoughts(67). However, these are also true of other treatments for epilepsy.

Nevertheless, CBD and other cannabinoids may also put the user at risk for lung problems.

A 2016 study in Frontiers in Pharmacology, suggested cannabinoids’ anti-inflammatory effect may reduce inflammation too much(68). 

A significant reduction in inflammation could diminish the lungs’ defense system, increasing the risk of infection.

Scientists still have to study some aspects of CBD, such as its long-term effects on hormones. Further long-term studies are needed to understand and determine any side effects CBD has on the body over time. 

Those who are considering using CBD oil should be well-informed of all the side effects that may be induced by CBD use and discuss their concerns with their doctors. 

The Legality of CBD

CBD is readily obtainable in many parts of the United States, although its exact legal status continually changes. 

In December 2015, the FDA eased the regulatory stipulations to allow researchers to conduct CBD investigations and trials. 

Currently, many people are able to get CBD online without a medical cannabis license(69).

The government’s position on CBD is confusing, and it depends in part on whether the CBD comes from hemp or marijuana(70). 

There is a consensus in Congress to legalize hemp, which would make CBD difficult to prohibit, says Dr. Peter Grinspoon, in a 2019 article published by Harvard Health. Grinspoon is the author of Free Refills: A Doctor Confronts His Addiction(71). 

Many states and Washington, D.C., have passed cannabis-related laws, making medical marijuana with high levels of THC legal(72). Still, marijuana may require a prescription from a licensed physician.

Also, several states have made the recreational use of marijuana and THC legal. One should be able to buy CBD products in states where marijuana is legal for medical or recreational purposes.

For more information on state laws and penalties, click here(73).

Individuals who possess cannabis products in a state where these are illegal or do not have a medical prescription in states where these are legal for medical treatment could be penalized.

For a complete list of legal medical marijuana states and D.C., including the corresponding laws, fees, and possession limits, click here(74).


Studies conducted with human and animal models have shown that CBD might be useful in helping with pain conditions and symptoms associated with chronic pain, arthritis pain, neuropathic pain, migraine pain, and cancer pain.  

While there is no conclusive data to support CBD or CBD oil as the preferred method of pain management, researchers agree that these types of products have much potential.

CBD is non-addictive and non-psychoactive, making it beneficial for individuals with pain, without causing drug intoxication and dependence.

Still, further research needs to be conducted to study the long-term side effects of CBD use. 

Before taking CBD or any CBD products to help with pain relief, do research and consult with a doctor experienced in cannabis use for advice and guidance.

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  2. Xiong W, Cui T, Cheng K, et al. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. J Exp Med. 2012;209(6):1121–1134. DOI:10.1084/jem.20120242.
  3. EMJ. (2017, Aug). Review of the 3rd European Academy of Neurology Congress 2017. EMJ Neurol. 2017;5[1]:12-29. Congress Review. Retrieved from
  4. Vučković S, Srebro D, Vujović KS, Vučetić Č, Prostran M. Cannabinoids and Pain: New Insights From Old Molecules. Front Pharmacol. 2018;9:1259. Published 2018 Nov 13.
  5. Malcom K. (2019, Oct 30). Should You Take CBD for Pain? Retrieved from
  6. ibid.
  7. ibid.
  8. Russo EB. op. cit.
  9. Grinspoon, P. (2019, Aug 27). Cannabidiol (CBD) — what we know and what we don’t. Retrieved from
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  11. VanDolah HJ, Bauer BA, Mauck KF. Clinicians’ Guide to Cannabidiol and Hemp Oils. Mayo Clin Proc. 2019;94(9):1840–1851. DOI:10.1016/j.mayocp.2019.01.003.
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