Does CBD Oil Work For Pain And Anxiety

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Hearing a lot about CBD oil for pain management or anxiety? Many CBD products might not be the cure-all they claim to be. Learn more here. Despite some claims, there’s no scientific evidence that conclusively proves that CBD can help relieve anxiety.

CBD Oil — Are the Benefits Claimed Too Good To Be True?

These days, many of us could certainly go for a miracle cure-all, especially those of us who struggle with chronic pain, overwhelming anxiety, cancer-related symptoms and/or hard-to-treat neurological disorders. So, it’s no wonder that CBD oil is popping up in our search results. But can we really count on CBD oil to positively impact our symptoms in the ways we hope? Internal medicine specialist Paul Terpeluk, DO, explains why CBD oil may not be as effective as we’d like.

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What is CBD?

CBD, or cannabidiol, is just one of more than 100 chemical compounds found in the cannabis sativa plant. But it’s THC (tetrahydrocannabinol), not CBD, that’s the main psychoactive compound in cannabis that gives you a euphoric high.

CBD is pulled from hemp, a type of cannabis plant that contains very low levels of THC, so it doesn’t get you high. CBD oil is simply a product that contains CBD extract and an oil, like coconut oil, typically for topical use.

It’s important to know that since the implementation of the 2018 Farm Bill, the production and sale of CBD products in the U.S. has been legalized on the federal level as long as they contain less than .3% of THC. However, it’s still illegal under some state laws.

Plus, Dr. Terpeluk explains the market has been oversaturated with CBD products — from bath bombs to gummies, lotions, creams, tinctures and oil — none of which are Food and Drug Administration (FDA) approved and may not be 100% pure CBD. As of mid-December 2021, the FDA has only approved one cannabis-derived and three cannabis-related products, all of which you can safely get with a prescription from a licensed healthcare provider.

“There’s no oversight of the majority of CBD products from a regulatory authority,” says Dr. Terpeluk. “Most of the CBD that you’re buying, unless they have a rigorous marketing campaign and quality control that says it’s 100% CBD oil, more than likely, it’s contaminated with other cannabinoids, including THC.”

What are some of the benefits of CBD?

Several studies show the benefits of pure CBD may have wide-ranging positive effects, though. To understand those benefits, it’s important to consider our body’s endocannabinoid system, a complex system of enzymes, neurotransmitters and receptors that plays an important role in the development of our central nervous system. This system helps regulate a variety of functions, including pain, motor control, memory, appetite, inflammation and more. By further studying CBD’s effects in these specific areas, we may better understand how CBD impacts a variety of conditions and disorders.

Helps with neurological-related disorders

The FDA has approved Epidiolex as a treatment for several seizure disorders, including two rare disorders known as Duvet syndrome and Lennox-Gastaut syndrome. Several case studies suggest CBD may also be beneficial to patients who are resistant to anti-epileptic drugs. “With epilepsy, there’s a threshold in your brain that gets excitatory, and you go into a seizure,” says Dr. Terpeluk. “CBD increases that threshold.”

Other studies suggest CBD may also be useful in managing symptoms of multiple sclerosis, Parkinson’s disease and Alzheimer’s disease, as it has neuroprotective, anti-inflammatory properties. More studies are needed, however, as many suggest that it’s not just CBD alone, but a combination of CBD and other cannabinoids, that may help reduce many of these symptoms.

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It may assist with pain relief

By interacting with neurotransmitters in your central nervous system, CBD could potentially relieve pain related to inflammation, arthritis and nerve damage (peripheral neuropathy). In one four-week trial, people who had nerve damage in the lower half of their body reported a significant reduction of intense, sharp pain after using a topical CBD oil.

“All of our different anti-pain drugs affect some section of our pain system, whether it’s Tylenol®, Aspirin®, morphine or opioids,” explains Dr. Terpeluk. “No one wants to be addicted to opioids, so if there’s a cannabinoid you can take that’s not addictive but can repress the pain, that would be the Holy Grail with chronic pain.”

Still, he cautions, there’s a lot left to be studied, including whether there are significant adverse long-term effects of CBD when used for pain relief.

“If you’re taking it in an unregulated fashion, you don’t know how much is in there, and you’re not quite sure how it affects you outside of your particular pain,” says Dr. Terpeluk.

It may help with anxiety and mood disorders

Anxiety and mood disorders like depression or post-traumatic stress disorder can have a severe effect on your daily life and may often cause both physical and emotional stress that could lead to other underlying conditions like sleep disorders, high blood pressure, chronic pain and heart disease. It’s too early to understand the full gamut of effects that CBD may have on anxiety and mood disorders, but individual studies seem to suggest varying positive results. In one study of 57 men who received either oral CBD or a placebo 90 minutes before participating in a simulated public speaking test, researchers learned that a 300-mg dose of CBD significantly reduced social anxiety during the test.

And while there are a wide variety of treatments available for anxiety and mood disorders — ranging from talk therapy and counseling to prescribed medications — Dr. Terpeluk suggests the most important thing is to get at the root of the underlying causes of the anxiety you’re experiencing.

“Anxiety is better approached by looking at what’s causing it in your life rather than trying to figure out which drugs can reduce it,” says Dr. Terpeluk.

It might help with cancer-related symptoms

CBD may help with nausea, vomiting and weight loss caused by chemotherapy treatments. The FDA has approved three cannabis-related products to help alleviate these symptoms, as well as help increase the appetite for those who have AIDS. These drugs all contain some level of THC or synthetic THC and are not purely CBD alone.

But some studies seem to suggest that CBD can help decrease the size of tumors and help stop the spread of cancerous cells in skin cancer, breast cancer, prostate cancer and more. As with other areas of study, further human clinical trials are needed to understand the full effect CBD has on various kinds of cancer.

What are the side effects or risks of CBD?

If you’re purchasing CBD oil and other products online or from a local vendor, Dr. Terpeluk says there’s no real way of knowing the purity of the CBD you’re using, as it could be mixed with other cannabinoids, such as the dangerous delta-8, or THC.

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“It’s a little bit mysterious. It’s not as harmless as you think,” says Dr. Terpeluk. “If you take CBD oil because you buy it on the market, you have a very high likelihood that you could turn a drug test positive for THC because it could actually contain THC.”

CBD can also affect a variety of medications, including pain medications, antidepressants, antipsychotics and more. It could also cause several side effects that may include:

  • Issues with coordination. .
  • Drowsiness or fatigue. .

The best advice? Before considering CBD oil or other CBD products, make sure you talk to your healthcare provider to decide whether it’s safe for you and to ensure it doesn’t have harmful interactions with any medications you’re currently taking.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Does CBD Help With Anxiety?

It’s likely that in the last few years, you’ve come across a lot of discussion and anecdotes about cannabidiol, also known as CBD. Availability and sales of CBD have exploded across the U.S. since it became legalized on the federal level and is now legal in most states.

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You can find CBD on shelves in many stores, with various brands promoting benefits that range from alleviating pain to aiding sleep. It also comes in many forms like CBD gummies, CBD oils, CBD lotions and even CBD-infused sodas. And one big claim CBD supporters tout is its ability to relieve anxiety, a feeling many of us have experienced over the last few years thanks in part to the COVID-19 pandemic.

But not all CBD is created equally, and the truth about the benefits is kind of, well, complicated. To dig deeper into whether or not CBD actually curbs anxiety and what else you should know before trying it, we spoke to psychiatrist David Streem, MD.

What is CBD?

“CBD is one of the chemicals present in cannabis-containing plants,” explains Dr. Streem. CBD mostly comes from hemp and, notably, contains very small traces of tetrahydrocannabinol (THC), the psychoactive ingredient that causes the “high” in marijuana. In fact, the U.S. government limits hemp-derived products from having a THC content of more than 0.3%.

As far as proven health benefits, there has been some evidence that CBD might serve as a treatment for chronic pain, but data is still mixed. More substantially, though, Dr. Streem says, “CBD has particular health benefits that have been demonstrated in scientific studies and it’s the active ingredient in an FDA-approved medication for the treatment of particular childhood seizure disorders.”

Specifically, he notes that CBD has shown benefits for children experiencing Lennox-Gastaut and Dravet syndromes, both rare conditions. “In these cases, the more common seizure medications don’t work very well.” CBD is part of a treatment package that includes other medications and even brain surgery.

Does CBD really help curb anxiety?

In short, no. CBD probably doesn’t help curb anxiety the way advertisements or anecdotal evidence claim. “The science isn’t there yet,” says Dr. Streem, adding that while there are scientific studies backing the use of CBD for the previously mentioned seizure conditions, no such high-quality data exists for CBD and anxiety yet.

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And if you’re waiting on those studies to turn out evidence, get comfortable. As Dr. Streem notes, studies that yield the necessary data are difficult for researchers to conduct for two reasons.

A lack of oversight

The first is government oversight and federal laws that make research into cannabinoids, including marijuana, difficult. While the number of states that have legalized some form of marijuana — whether for medical or recreational use — has dramatically increased in recent years, cannabis containing THC remains illegal on a federal level.

The U.S. Food and Drug Administration (FDA) also has its hands full trying to regulate it. Many states allow selling CBD over-the-counter as a dietary supplement even though that’s, technically, against FDA regulations. The FDA has warned dozens of companies about this practice but, so far, little has been done to change these practices. Dr. Streem says, “The FDA has to have evidence that there’s a safety risk before they can intervene.”

That overlaps with the second issue with CBD, which is a troubling lack of quality control. You can buy CBD just about anywhere now, from boutiques that specialize in CBD to your corner convenience store. But not all CBD is created equally, and neither is the labeling.

A 2017 study published in the Journal of the American Medical Association (JAMA) tested 84 CBD products from 31 different companies and found that 26% had less CBD than claimed on their respective labels, while 43% had more CBD than claimed on their labels.

Just as troubling, Dr. Streem points out that a number of the tested products had what he calls “relevant amounts of THC.” In other words, enough THC to trigger a positive on a drug test even if the label said there wasn’t any THC in their oil. And if you ingest CBD with a certain amount of THC, you’re also subject to the side effects, including delusions and hallucinations. Plus, there’s a chance these effects won’t go away when the effects of the drug wear off.

Risks of taking CBD

If you’re thinking of trying CBD without consulting with your healthcare provider, Dr. Streem has a simple response: Don’t. It’s about the unknowns, including the unregulated nature of most products and the possible inclusion of enough THC to flag a drug test.

“Trying a CBD product with consultation from your doctor is less risky,” advises Dr. Streem, “but you should still be aware of how the product makes you feel. If it makes you feel strange at all, stop using that product immediately.”

He continues, “If you could confirm that a product had no THC and had a CBD percentage close to what the label claims, there’s little concern it would do any harm regardless of the benefits. But that’s not what we’re dealing with right now.”

The bottom line

While data shows there are some benefits of using CBD in certain medically approved settings, for now, the scientific evidence just isn’t there for using CBD to help with anxiety, concludes Dr. Streem. Trying over-the-counter products without more stringent regulation carries more risk than reward.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

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