Dr. Cohen has found that chronic conditions including autoimmune diseases and pain syndromes can be helped with a 6-mg under-the-tongue tincture (the fastest delivery system) or a 25-mg capsule taken twice a day. Dosages for topical products like lotions are especially hard to determine—there’s no clarity on how much CBD gets into the system through the skin.
And we have a long way to go before we fully understand the relationship between CBD and pain regulation. But strong anecdotal evidence, combined with multiple lab tests and even some clinical trials, have established that CBD holds a lot of promise for pain relief. Or in science-speak, CBD “represents a novel class of therapeutic agents for the treatment of chronic pain.”
Although several clinical studies focused on the health effects of CBD, the results available so far were not enough to convince the FDA to approve it as a drug. The FDA does not agree with its use as a dietary supplement either, but as long as sellers publish the appropriate disclaimers (like those on the CBDPure website and labels), it’s not up to them.
Several weeks after a hysterectomy last spring, Bo Roth was suffering from exhaustion and pain that kept her on the couch much of the day. The 58-year-old Seattle speech coach didn’t want to take opioid pain-killers, but Tylenol wasn’t helping enough. Roth was intrigued when women in her online chat group enthused about a cannabis-derived oil called cannabidiol (CBD) that they said relieved pain without making them high. So Roth, who hadn’t smoked weed since college but lived in a state where cannabis was legal, walked into a dispensary and bought a CBD tincture.
Buying online is less reliable still because there’s no regulation or standardization. What you see on the label may not be what you are getting. A 2017 study in JAMA found that of the 84 CBD products researchers bought online, 43 percent had more CBD than indicated, while 26 percent had less, and some had unexpected THC.“There’s a 75 percent chance of getting a product where the CBD is mislabeled,” says Marcu, one of the study’s coauthors.
CBD derived from marijuana is a different story, and the law varies from state to state. But as long as you’re using CBD oil that contains less than 0.3 percent THC, you have nothing to be concerned about anywhere in the United States. On the other hand, if you want to take your CBD on a trip outside the country, definitely look into local laws to avoid getting into awkward situations while you’re away.
There’s a growing consensus that cannabis is a highly effective treatment for many kinds of neuropathic pain. A 2015 study published in Neurotherapeutics states, “Clinical studies largely affirm that neuropathic pain patients derive benefits from cannabinoid treatment.” But much of the human-based research (like this study) on CBD and nerve pain has centered around the efficacy of the FDA-approved medication Sativex, which includes both THC and CBD. Research on the best CBD for pain isolated from THC is still limited when it comes to neuropathic pain. There are exceptions, though:
In 2014, President Obama signed into law the Agricultural Act of 2014. Section 7606 of the act, Legitimacy of Industrial Hemp Research, defines industrial hemp as distinct from marijuana. This authorizes institutions of higher education or state department’s of agriculture in states that legalized hemp cultivation to regulate and conduct research and pilot programs. Basically, it’s up to the states to regulate the growth per their own State Departments.
This means that CBD oil products that are derived from these “not marihuana” parts of imported hemp plants are not federally banned, and the natural cannabinoids in hemp-derived products are exempt from DEA enforcement. While hemp cannot be legally cultivated in the U.S. except under state-regulated programs, hemp-derived oil has been a legal import in the U.S. for decades.