People with chronic pain often have difficulties trying to get relief. Doctors used to prescribe narcotics, but the opioid crisis has made many physicians reluctant to do so. NSAIDs, either prescription or OTC, can help alleviate acute pain. It isn’t clear, however, that they are especially helpful for chronic pain. In addition, NSAIDs can cause serious side effects if they are taken for long periods of time. As a result of these problems, many people have begun to wonder whether medical marijuana or the cannabis component cannabidiol (CBD) could relieve chronic pain.
CBD to Relieve Chronic Pain:
Q. My husband has an implanted morphine pump to treat chronic pain. He’s used it for ten years now.
Recently, his doctor suggested CBD. He has had the doctor turn his pump down 15 percent at every refill visit since then, and he has not been suffering with pain.
The pills are a bit pricey, but we’ve also had success with less expensive oil which he can take by the teaspoon. CBD does not make you high.
This is not the first time we have heard from a reader about using CBD to relieve chronic pain. One reader found that taking CBD oil triggered a positive drug test for marijuana.
Cannabinoids for Back Pain:
Q. The discs and vertebrae in my spine are degenerating and causing me severe pain. I started taking CBD oil for pain a few months ago.
Once it had time to build up in my system, the pain relief was miraculous. Sadly, I recently did a home drug test and it was positive for THC. I need to talk to my doctor because I have no idea how to address this. It’s legal to buy CBD oil OTC in my state, but there’s no way to prove it is the source of any THC in my test.
A. Cannabidiol (CBD) oil is legal in many states because it does not make people euphoric. It is not supposed to have any tetrahydrocannabinol (THC) in it. THC is the compound that produces a marijuana high. State by state regulation means that anyone who wishes to use this compound for pain relief will need to become familiar with the relevant laws of that state.
The FDA has approved one purified form of cannabidiol as a prescription anticonvulsant medication, Epidiolex. Research on CBD oil suggests some benefit against pain and inflammation (Molecules, online, Sept. 27, 2018).
Side Effects of Cannabidiol:
People using cannabidiol have reported fatigue, nausea, diarrhea and irritability. People on the anticoagulant warfarin (Coumadin) should avoid cannabidiol, as it may raise blood levels of warfarin. Like grapefruit, CBD can inhibit the intestinal enzyme CYP3A4, which the body uses to process a wide range of medications (Current Drug Metabolism, 2016).
But Will It Lead to a Positive Urine Test for Marijuana?
Unfortunately, certain CBD manufacturers are not able to remove all traces of THC. One study found that some people tested positive for THC after taking CBD oil (Journal of Pain Research, Feb. 12, 2016). ConsumerLab.com has written that people taking CBD oil aren’t likely to fail a marijuana drug test, but it is not impossible.
Other Readers Relate Their Experience:
J offered this explanation:
“I believe it depends on the source of the CBD as to whether you will test + for THC. My understanding is this: CBD from a marijuana source, for example Charlotte’s Web products, must have less than .03% THC per (federal?) guidelines. If ingested (drops, capsules, gummies), this will show + on a drug test. It did for me.
“CBD from hemp is not supposed to test positive. I haven’t tested this, yet.
“There are many products, with more arriving daily. Always check for quality-control certification.”
“I started taking CBD oil for alleviation of back pain, neck and knee pain and hoped it would help neuropathy. To my surprise, it helped and really stopped IBS. It’s not quite enough to fix the pain, but it does help. I hate being high and have never had a problem. Eventually, I believe the recreational use will come. Michigan is already working on it. If it does, there will have to be rules as there are with alcohol use. In my opinion, we haven’t scratched the surface of the medicinal uses for this plant.”
“CBD oil has been an effective alternative to taking NSAIDs for my rheumatoid arthritis. In the four months I’ve been using it, I’ve had to supplement it on only four occasions with acetaminophen. That’s a heck of a lot better than tearing up my gut with other drugs.”
Not everyone can give up on other drugs completely. George reported a downside from testing positive for THC:
“I test positive for pot in a urine test at my local VA Hospital when I’m using CBD oil. The VA will not prescribe pain meds if you have a positive test.”
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. Read Terry's Full Bio.
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Lossignol, "Cannabinoids: A new approach for pain control?" Current Opinion in Oncology, online Feb. 14, 2019. DOI: 10.1097/CCO.0000000000000523
Hande, "Cannabidiol: The need for more information about its potential benefits and side effects." Clinical Journal of Oncology Nursing, April 1, 2019. DOI: 10.1188/19.CJON.131-134
Bruni et al, "Cannabinoid delivery systems for pain and inflammation treatment." Molecules, Oct. 2018. doi: 10.3390/molecules23102478
Zendulka et al, "Cannabinoids and cytochrome P450 interactions." Current Drug Metabolism, 2016. DOI : 10.2174/1389200217666151210142051
Wertlake & Henson, "A urinary test procedure for identification of cannabidiol in patients undergoing medical therapy with marijuana." Journal of Pain Research, online Feb. 12, 2016. doi: 10.2147/JPR.S96856
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