Approval by the US Food and Drug Administration has, so far, been limited to synthetic or pharmaceutical-grade components of cannabis. In June 2018, the agency approved Epidiolex (GW Pharmaceuticals) — a high CBD, low THC whole-plant alcohol extract — for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome in patients age 2 and older. FDA has also approved Marinol (AbbVie) and Syndros (Insys Therapeutics), which both contain dronabinol, or synthetic THC. Both are indicated for weight loss associated with anorexia and HIV. Marinol is also indicated for severe nausea associated with cancer chemotherapy, as is FDA-approved Cesamet (Meda Pharmaceuticals). Cesamet contains the active ingredient nabilone, which has a chemical structure similar to THC.
Herbs, Oils, and Edibles, Oh My!
“There is little consistency in plant constituents between products’ strain names,” said David Bearman, MD, a physician in private practice who specializes in pain management and has more than 40 years of experience in managing substance abuse. “These names are mainly marketing tools and tell little about the constituents of the product. The best advice is to read the label and understand it.”
A growing body of clinical research and a history of anecdotal evidence support the use of cannabis for the relief of some types of chronic pain, including neuropathic pain, and spasticity (ie, stiffness or tightness) associated with multiple sclerosis. 1 In a recent comprehensive review of existing data on the health effects of cannabis and cannabinoids, the National Academies of Science concluded that adult patients with chronic pain who were treated with cannabis/cannabinoids were more likely to experience a clinically significant reduction in pain symptoms. 2 They rated these effects as “modest.”
Cannabis oil and edibles
OK, so we know that taking it won’t get you high, but taking enough (often based on your weight), can have a calming effect. And the side effects are minimal, with some people experiencing drowsiness, nausea, or tiredness. It is unlikely to negatively impact your mood or cognitive ability, making it a seemingly safer and preferred product for many.
Although CBD is generally well tolerated, THC may decrease potential side effects of CBD. THC may also play an important role in CBD’s pain-relieving effects, by aiding its influence on the endocannabinoid system.
Clear? You likely still have questions. Read on for specific products and which symptoms they aid.
WHAT ELSE TO EXPECT WHEN TAKING CBD
14. Bruni N, Della Pepa C, Oliaro-Bosso S, et al. Cannabinoid delivery systems for pain and inflammation treatment. Molecules. 2018;23(10):2478.
7. De Gregorio D, McLaughlin R, Posa L, et al.Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain. 2019;160(1):136-150.
You can vape a full spectrum CBD, which may get you a bit high, even when using a strain with trace amounts of THC.
There is no one best CBD oil for pain. The type will depend on your pain condition, how you consume the CBD, and your body chemistry. An important consideration will be whether the oil is a CBD isolate, a full spectrum extract, or a broad spectrum extract. It is also important to know you are buying a trustworthy product, especially because the CBD market is not regulated.
You can also use cannabis oil like you would an edible or a capsule by adding it to food and drinks. While this method is effective, the bioavailability of anything you ingest is generally lower, meaning you won’t absorb the cannabinoids as thoroughly because they must pass through the stomach and the liver. Ingesting cannabis oil can take anywhere from 30 to 90 minutes to kick in depending on things like what you’ve eaten and the speed of your metabolism.
Choosing a method of cannabis consumption is about personal preference. While cannabis oil doesn’t work as fast as inhalation methods like vaping or smoking, it can work more quickly than ingesting edibles. It also comes in a variety of potency options, from oils that contain only CBD to those with a wide range of THC concentrations.
The most effective way to take cannabis oil is sublingually, where the oil is placed under the tongue with a dropper and absorbed by the mucous membranes that lead directly to the bloodstream. This method allows it to bypass the stomach, which raises the bioavailability (the number of cannabinoids that make it to your bloodstream when your body absorbs the medicine) and takes about 15 to 30 minutes to kick in.
How to Use Cannabis Oil
Start with a few drops and wait at least an hour to see how you feel. Slowly increase the dose until you experience the effects you desire. Keep in mind that more isn’t always better and there could be a tiny dosage window or “sweet spot” that works best for you. You might need to adjust your dosage over time, but many people find that a consistent dose can work for their needs over the long term.
Just like with any cannabis product, dosing depends on the individual. It will take a bit of experimentation to find the right dose for you, but the general rule of thumb is “start low and go slow.” You want to find the lowest dose that provides the effects you are looking for, and that might be lower than what is recommended on the product label.
Cannabis oils are concentrates that are created by extracting cannabinoids like THC and CBD from cannabis plants. Most oils you find at a dispensary are created by a process called “chemical extraction.” These methods use a solvent to extract cannabinoids along with other beneficial compounds like terpenes and flavonoids and add them to carriers like hemp oil or MCT oil.
While there are many methods of extracting oil from a cannabis plant, some are safer and more effective than others. CO2 extraction is quickly becoming the gold standard because it produces a safe and potent product that is free from chlorophyll, waxes, and any toxic residues that other solvents can sometimes leave behind.