Tag Archives: #CBD

AHRQ Review Evaluates Cannabis Products Containing THC and CBD for Pain Relief

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PainRelief.com Interview with:
Roger Chou, MD
Professor of Medical Informatics and Clinical Epidemiology, School of Medicine
Professor of Medicine, School of Medicine
2012-present Director, Pacific Northwest Evidence-based Practice Center
Medical Informatics and Clinical Epidemiology, School of Medicine
Oregon Health & Science University
Portland, Oregon

PainRelief.com: What is the background for this study?

Response: We started this review five years ago, it was funded by the Agency for Healthcare Research and Quality (part of the Department of Health and Human Services). Because there is a lot of interest in use of cannabis products for pain and because new research is coming out, we planned to do it as a “living” review, which means that instead of reviewing all the studies at one point of time and publishing the findings and then being done, we continually searched for new studies and updated our analyses as they became available. We conducted this review over 5 years and this article reports the final findings of the review.

An important thing to know is that cannabis products are complicated because cannabis contains different chemicals that are thought to have different properties, the most important being THC and CBD.  THC is considered the psychoactive component and CBD isn’t thought to have psychoactive properties but may have medical or therapeutic properties.  Different cannabis products (as well as the plants themselves) vary in how much THC or CBD is contained, ranging from “pure” THC or CBD to mixed products.  We separated cannabis products into different categories based on the amount of THC relative to CBD, which is important because the benefits or harms may vary according to how much THC or CBD is present.  We also looked at whether the products were taken from the plant or made in a lab (synthetic) as well as how the products were taken (e.g., a capsule or cream/oil or spray etc) which can all impact how the products work.

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Kidney Stones: Mayo Clinic Study Evaluates CBD Oil for Post-Procedure Kidney Stone Pain Relief

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PainRelief.com Interview with:
Karen L. Stern M.D.
Associate Professor of Urology
Mayo Clinic Arizona
Phoenix, AZ 85054

Dr. Stern

PainRelief.com: What is the background for this study? What are the main findings?

Response: Kidney stones are not rare and often require surgical intervention. One of the most popular and effective surgical interventions is ureteroscopy with laser lithotripsy. Essentially, the Urologist goes up to the kidney with a small scope and lasers the stone.

It is common after this procedure to leave a temporary stent – a small flexible tube that goes from the kidney to the bladder – which allows for urine to drain unobstructed during the healing process.

Unfortunately, that stent is associated with significant morbidity including urinary symptoms and pain.

There have been many studies looking at ways to alleviate this pain and discomfort, but this is the first to assess CBD in that capacity. We tested a low-dose FDA-approved CBD oil. We found it to be safe and well tolerated but we did not find any significant difference in postoperative pain.

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Study Finds Majority of Hemp Products Mislabeled for CBD and/or THC Content

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PainRelief.com Interview with:
Tory R. Spindle, Ph.D. 
Assistant Professor
Behavioral Pharmacology Research Unit
Department of Psychiatry and Behavioral Sciences 
Johns Hopkins University School of Medicine

PainRelief.com:  What is the background for this study?  What are the main findings?

Due to recent policy changes, hemp products and anything derived from hemp, including non-THC cannabis constituents such as CBD are now federally legal. As a result, CBD products are now available nation-wide, including in states where cannabis remains illegal. Some prior work had shown oral or vaporized cannabinoid products have poor labeling accuracy, but no one had examined the labeling accuracy of topical cannabinoid products, which are a product category growing in popularity. We purchased 105 topical cannabinoid products (e.g., lotions, creams, gels, patches) from national retailers and online. 

We found that the vast majority of the products were inaccurately labeled for CBD and/or THC and that many of the products had health claims on the label that are not recognized by the FDA, the most common of which was pain/inflammation.

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Study Evaluates Placebo Effect of CBD on Pain Relief

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PainRelief.com Interview with:
Martin De Vita, CPT, MS, USA
Doctoral Candidate
Clinical Psychology Department
Syracuse University

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Seemingly out of nowhere, cannabidiol (CBD) products became immensely popular. Cross-sectional studies showed widespread use among the public for various clinical conditions. Pain was by far the most commonly reason cited for using CBD. However, no human experimental pain studies had been conducted to evaluate the analgesic effects of CBD. A lot of people questioned whether CBD effects on pain were just a placebo.

To answer this question, we tested people’s baseline pain responding using sophisticated equipment capable of delivering safe, but painful stimulation that activates and evaluates human nervous system processes. Then we administered either CBD or a placebo and re-tested these pain outcomes to see how they changed. We took it a step further and manipulated the information that participants were given about which substance they received. So in some conditions, participants were told they got CBD, even though it was just a placebo. In other conditions, participants were told they got an inactive substance, despite actually receiving CBD. This way, we could test whether simply telling someone that they had received CBD would have an effect on their pain. These are called expectancy effects and there is a large body of literature that supports this phenomenon.

When we looked at the data, we found that CBD analgesia was actually driven by both expectancies (placebo analgesia) and pharmacological action. We also found that these manipulations affected different pain outcomes. We found that both CBD and expectancies reduced pain unpleasantness but not pain intensity. The results were complex in that CBD and expectancies for receiving CBD differentially affected various outcomes. This was exciting because we are left with even more questions to investigate in future research.

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