Jonathan Kost, MD
Harford HealthCare Pain Treatment Center
Spine & Pain Institute at MidState Medical Center
As a physician who treats patients with a range of chronic-pain conditions, I am interested in emerging treatments that offer relief without a list of troubling side effects. There is a component of marijuana and hemp plants called cannabidiol, or CBD, that is being increasingly seen as a promising pain-relief compound. While it’s already being used by patients in various over-the-counter products, it’s also the subject of ongoing scientific research.
But, let’s back up. Marijuana itself is not an “emerging treatment.” Although the legal use of marijuana as medicine dates from 2012 in Connecticut, it has been used medicinally for centuries. We still have a lot to learn about both its benefits and downsides, but we know that patients using it have found relief from dozens of conditions and illnesses for which it is currently approved. As a member of the Medical Marijuana Program Board of Physicians for the Department of Consumer Protection, I have been part of the advisory team that has expanded the appropriate use of medical marijuana for more conditions.
Unless the legislature makes a change this year, non-medicinal marijuana will remain illegal in Connecticut for the foreseeable future. Marijuana contains both CBD and tetrahydrocannabinol (THC). It’s THC that creates the marijuana “high.” But CBD can be obtained from legal hemp, and 100-percent CBD from hemp can bring pain relief without the buzz.
Research has begun to indicate that CBD may have strong antioxidant, anti-inflammatory, anticonvulsant, antidepressant, antipsychotic, antitumoral and neuroprotective qualities. CBD-containing products can be used topically, sublingually (under the tongue), inhaled through vaporization or eaten. These products may turn out to be helpful for a number of conditions, including: chronic pain; cancer; Crohn’s disease and ulcerative colitis; diabetes; rheumatoid arthritis and osteoarthritis, anxiety, post-traumatic stress disorder, multiple sclerosis and other illness. Research is underway to evaluate CBD to delay the onset of schizophrenia or to combat Alzheimer’s disease.
It’s a fascinating molecule that may turn out to be a “wonder drug,” but more research is needed. One very hopeful fact is that CBD appears to have few serious side effects and it has no adverse effects on physiological parameters, including heart rate, blood pressure, body temperature, psychological and psychomotor functions, gastrointestinal transit or food intake. Indeed, the federal Food and Drug Administration (FDA) has approved CBD for treatment of a severe seizure disorder in children age 2 and older.
My advice to patients is to use safe, well-established pain-relief treatments in consultation with a doctor. If these are not effective – or if side effects are intolerable – CBD may be an option. The CBD products found in pharmacies and health-food stores are, technically, nutritional supplements. They have not undergone rigorous FDA testing, so it’s a “buyer-beware” situation. Potency of the CBD may vary. Products derived from hemp have extremely low quantities of THC and are not likely to have psychoactive effects. Patients with access to medical marijuana will find more cannabis strains with high percentages of CBD – although most also contain significant THC.
Until recently, federal drug laws made it difficult for a large number of researchers to study the workings of marijuana, its component properties and possible medical applications. Today, there is a great deal of research being done here and around the world. It’s unusual that a substance with the potential of CBD is available in retail settings ahead of the science. So, let’s hope that its promise is fulfilled, especially for those suffering with chronic pain.