The Cannabis sativa plant has more than 100 chemicals that can affect your body and mind. The two that scientists know the most about are THC and CBD.
News release, The National Academies of Sciences, Engineering, and Medicine: “The Health Effects of Cannabis and Cannabinoids.”
Benefits for RA
Mayo Clinic: “Mayo Clinic Q and A: Treatment with medical cannabis,” “Marijuana,” “What are the benefits of CBD — and is it safe to use?” “Rheumatoid arthritis.”
Cannabis and Cannabinoid Research: “Cannabis and Pain: A Clinical Review.”
Medical marijuana has similar side effects, that may include:
If CBD alone doesn’t work and you are in a state where medical or recreational marijuana is legal, you could consider talking to your doctor about taking CBD with a very low-dose THC product. Be aware that even at low levels, THC may make you feel high, resulting in cognitive, motor, and balance impairment.
Studies have found moderate interactions between CBD and medications commonly prescribed for treating RA.
As cannabidiol (CBD) has grown in popularity over the years, major organizations like the Arthritis Foundation have released guidelines pertaining to its use in the treatment of rheumatoid arthritis (RA). CBD is a non-psychoactive component of cannabis. The CBD in most products is extracted from hemp, a variety of cannabis that only has traces (up to 0.3%) of THC, the active compound that gets people high. Studies have shown CBD can help reduce chronic pain by impacting endocannabinoid receptor activity, which may also reduce inflammation.
Preparation and Dosage
Given the lack of strong scientific evidence supporting the use of CBD, it is not recommended as the first choice for pain relief in RA.
Currently, the U.S. Food and Drug Administration (FDA) does not regulate the safety and purity of CBD products, so you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. The product may contain other unknown elements. The most effective therapeutic dose of CBD for any particular medical condition has not been established.
Interactions can occur with these medications:
Pregnant people and children should consult a doctor before using CBD since there isn’t enough research on the effects of CBD on these populations. There has been concern about a possible link between inhaled cannabis and lower-birthweight babies, but it’s not clear if this applies to CBD.
Footnote: In the US, the FDA (Food and Drug Administration) has taken action against some CBD manufacturers making specific condition-related health claims; however, many companies are still unabashedly marketing products as curatives. In short, this is big business, and it will take some time to bring in proper regulation to ensure safety.
Dr Alexander in an interview with the Congress News said “We know there’s a broader story, and that it’s not just pain itself – it’s all the ancillary things that go alongside it, such as anxiety, depression, comorbidities, and so on. I think, therefore, that the message is one of tentative hope.”
Cannabis and cannabis-based derivatives such as CBD cannabidiol are often used or enquired about for pain management in RA, but is there evidence that they are effective as painkillers?
By Clare Jacklin, CEO
The question is, can medical cannabis be recommended as a new analgesic option in musculoskeletal conditions? The answer is not simple or clear-cut according to Professor Serge Perrot, Professor of Clinical Pharmacology at Paris Descartes University and a rheumatologist and Head of the Pain Centre at Cochin-Hotel Dieu Hospital, Paris. “All the meta-analyses (examination of data from a number of independent studies of the same subject, in order to determine overall trends) and literature reviews have demonstrated that, for example in fibromyalgia, in back pain, in neuropathic pain, “it was not very different from placebo.” That said there are “specific clinical cases” where cannabis-based treatments may be useful on an individual basis, which “speaks in favour of authorising the products”, said Prof. Perrot. He went on to say that emerging data suggests that cannabis-derived medicines may prove to be more effective for conditions such as anxiety, sleep disorders, and loss of appetite, rather than specifically for pain.
According to Dr Alexander, there was in the order of 85 registered clinical trials for cannabinoids in a variety of conditions being conducted, and if only a modest proportion of these trials prove to be successful, he suggests “that’s quite a major advance”.
While the lectures from both Prof. Perrot and Dr Alexander were quite complex and scientific, my big take-home message was that there is still a huge amount of research required and it is not as simple as some messaging on social media would have you think. I feel that far more clarification is required when talking about cannabis as there are many different varieties of cannabis plants and products out there. There is a massive difference between medicinal cannabis and what some chap in the pub may offer you in a little plastic bag! In a recent Time magazine article, I also read that only 31% of CBD products that were tested actually had the amount of CBD in them that they claimed on their labels!
Dr Steve Alexander, Associate Professor in molecular pharmacology at the University of Nottingham Medical School, said that some of the effects – or side effects – of these medicines might be relevant to rheumatology patients. For example, the drowsiness that has been associated with some cannabis preparations could be beneficial, since improved sleep does affect people’s subjective scores of pain.