Science on cannabis
The Ultimate Remedy for Chronic Pain: Is CBD Actually Helpful?
A recent conclusion from a meta-analysis
The attention on cannabis for treating various conditions, including pain and anxiety, is quite high (pun intended).
As an apprentice epidemiologist studying the determinants of non-problematic cannabis use, CBD always appeared to me as a perfect justification for the legalization of cannabis. Without having delved deep into the CBD scientific literature, I had recommended to friends and family to use CBD products for their well-known benefits.
I was convinced of the benefits of CBD, especially after long runs when I would take it in capsule form. I always felt great afterward. Although it was quite expensive, I believed it was good for my health, so I continued to use it for a while.
In recent years, a shift in perspective among the population and lawmakers has led to the decriminalization and legalization of cannabis use across many countries and states. Nine countries and 24 states have legalized recreational use, and 49 countries have legalized medical use []. One of the reasons for this legal restructuring was the advertised benefits of cannabis for mental and physical health.
While many investors lost money in publicly traded cannabis companies (Canadian investors have collectively lost — ouch), the CBD market alone (excluding THC) is forecasted to reach 60 billion U.S. dollars by 2030. This revenue is propelled by multiple claims from the industry about the benefits of CBD. Here’s just one example:
I always have been an advocate of CBD. In our health-optimizing era, where everything should be sharpened and improved, I always thought that CBD products were a safe and powerful tool to help people improve their daily lives.
Plus, it is very easy to use. There are CBD oils, CBD lotions, CBD isolate, CBD gummies, CBD capsules, and even CBD water. It’s everywhere.
It is fair to say that the marketing of all these miracle CBD products is responsible for the blind trust I had in the benefits of cannabis.
The choice of the words ‘blind trust’ is not innocuous. A few days ago, an alarming was published in warning consumers about the therapeutic claims of CBD.
I have never read a scientific article that is this clear-cut. They have dotted their i’s and crossed their t’s. Here are two segments of the first page:
“There is no good reason for thinking that CBD relieves pain, but there are good reasons for doubting the contents of CBD products in terms of CBD content and purity.”
And
“Consumers and health care providers should rely on evidence-based sources of information on CBD, not just advertisements. Current evidence is that CBD for pain is expensive, inefffective, and possibly harmful.”
Detailed summary of the article
The article examines 16 rigorous randomized, double-blind trials — all conducted since 2019 — that compare pharmaceutical-grade CBD with a placebo for pain relief. In epidemiology, these types of studies are considered the gold standard.
In total, 917 patients were involved in these direct comparisons between CBD and placebo. Notably, among all the studies, only one demonstrated a significant difference in favor of CBD after two weeks of treatment. This particular study involved only 18 patients.
In addition to the examination of the real therapeutic effect of CBD on chronic pain, the study expanded their search on the purity and safety of CBD products. They found an article that reported an analysis of 105 topical CBD products in the US. In 35% of those products, THC was detected, with a total content of up to 100mg (considered a very high dose, even for experienced users). It’s like expecting a relaxing cup of tea only to discover it has the power of an energy drink.
Moreover, only one-quarter of the CBD products were correctly labeled. The other three-quarters had either less or more CBD than advertised. We would never tolerate that for ibuprofen or acetaminophen.
My critique of the article
I quite appreciated the arrogant tone of the article. The amount of money spent by people on CBD to reduce pain (cited 50% of the time as a reason for use) is significant.
I find it unacceptable that a multi-billion-dollar industry profits from the vulnerability and helplessness of people who suffer daily. To be frank, I also condemn big pharma for over-prescribing opioids to manage pain. Instead of debating who is worse, let’s agree that both practices are harmful.
As a side note, I found one paragraph in the results section to be irrelevant. It states that traffic injuries associated with cannabis have increased by 500% in Canada since its legalization. I find that it is a very compelling statistic, but it didn’t have a place in a study on CBD. The main point of the author is that some CBD products were mislabeled and contained higher amounts of THC than advertised. While it’s a significant statistic, it isn’t relevant here, so let’s focus on CBD.
Confusion in the scientific literature
I was so surprised by this reading that I dove into the current knowledge of CBD. I found a publication in the Harvard Health Publishing released on April 4, 2024:
“Animal studies, and self-reports or research in humans, suggest CBD may also help with:
- : Studies and clinical trials are exploring the common report that CBD can reduce anxiety.
- Insomnia: Studies suggest that CBD may help with both falling asleep and staying asleep, in part by helping address chronic pain and anxiety.
- : Increasingly, human studies are substantiating the claims that CBD helps control pain. One animal study from the European Journal of Pain suggests CBD could help lower pain and due to when applied to skin. Other research identifies how CBD may inhibit inflammatory and neuropathic pain, which are difficult to treat.
- : CBD can help lower cravings for tobacco and heroin under certain conditions, according to some research in humans. Animal models of addiction suggest it may also help lessen cravings for other addictive substances such as alcohol, cannabis, opiates, and stimulants.”
On one hand, I’ve got a high-quality study saying that CBD is expensive and useless. On the other, I’ve got Harvard telling me that “human studies are substantiating the claims that CBD helps control pain.”
Even me, studying full-time cannabis use, I’m lost. Welcome into the beautiful and complex world of Science.
Reconsideration of my take on cannabis
For the time being, I will cease recommending the use of CBD. Despite my previous confidence in this product, I’ve come to realize that we don’t fully understand its effects or mechanisms. I will wait for more conclusive research before forming a new opinion.
Adopting this stance is challenging and makes me feel vulnerable. Admitting uncertainty about CBD’s reliability while studying cannabis in depth is difficult. Scientists strive to uncover the truth; our identity is deeply rooted on knowledge. However, acknowledging our limitations is crucial for deeper understanding.
Yet, I will continue to advocate for the legalization of cannabis. I find it very silly (to say the least) that we, as a society, incarcerate individuals for using cannabis, especially when compared to the more socially accepted alcohol consumption.
There is beauty in cannabis, although I recognize it can be harmful. We should allow adults to use it for the right reasons and in the appropriate contexts. There’s no need to make false claims to achieve this.
Let’s embrace our vulnerability in acknowledging what we don’t know. In our constant pursuit of the magic pill or the absolute truth, we must remember that the human brain is inherently biased and that it’s perfectly acceptable to be wrong.
By recognizing these biases, we can engage in less divisive discussions and nurture greater trust among us. Ultimately, confronting our “blinded trust” will lead us toward more honest and loving relationships.
About me
Thank you for reading and commenting!
I’m a master’s student in epidemiology at the Université de Montréal and a part-time counselor at a suicide hotline. My research focuses on suicide, mental health, and cannabis.
Here’s another of my story:
