Why Do Britons Take CBD for Pain Management?

Over eight million Britons suffer from chronic pain. People with arthritis, osteoarthritis, fibromyalgia, joint and back pain, and other chronic pain problems are consistently looking for ways to alleviate their pain and improve their quality of life.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can be purchased over the counter but can prove less than efficient. Additionally, many people complain of side effects that put them off these medicines. That is true of most mainstream pain medicine: they often come with side effects or diminishing returns, hence people’s desire to find an alternative.

With the legalization of CBD and the increasing public awareness that came with it, consumers have become more willing to try CBD for their well-being and a better lifestyle. Nowadays, more than 70% of Britons who take CBD do so for pain management.

But why do Britons think that taking CBD can alleviate their pain? And, most importantly, does it work?

CBD and the Endocannabinoid System

CBD works hand-in-hand with the human endocannabinoid system.

All mammals have an endocannabinoid system (ECS). This system is responsible for regulating many bodily functions, including appetite, memory, learning, reproduction, temperature perception, motor perception, inflammation, and pain perception.

What does the ECS do?

The ECS strives to maintain the body’s homeostasis—its natural state of balance. All body functions should be working in perfect harmony, keeping the body healthy. It is the ECS that accomplishes that.

An example is the feeling of thirst, which describes the signals the body sends when its cells are dehydrated. The ECS is immediately alerted that something is out of sync and releases endocannabinoids—cannabinoids created by the body—to alert the relevant neurotransmitters. These send the message to the brain that creates a feeling of thirst, and you head for the kitchen to get a glass of water. Once you have drunk it, the ECS is alerted that everything is balanced again and all bodily functions are under control.

To achieve all this, the ECS works with two human cannabinoids called anandamide and 2-AG. These cannabinoids bind to their respective receptors, which are located all across the body, including the immune system. The receptors bind with the cannabinoids and start the process of alerting the cells.

How does CBD work with the ECS?

CBD is a phytocannabinoid—i.e. produced in cannabis—that has a close affinity to one of the endocannabinoids, 2-AG. CBD appears to interact with the ECS in an indirect way, by making it work more efficiently. While it was initially thought that CBD works by binding directly to the cannabinoid receptors, it is now theorized that CBD nudges instead the ECS to work better and make better use of the existing human cannabinoids.

What do CBD, the ECS, and pain have in common?

The body has several ways of protecting itself. The immune system has developed over millions of years to fight intruders. As part of the immune system, the body creates inflammation around any point of entry such as a cut on your finger, to stop germs from spreading and reaching any vital organs.

But what happens if the body is falsely alerted? Chronic stress, for example, creates the conditions for false alerts, whereby the body mistakenly perceives the presence of intruders when there are, in fact, none. In this case, the body creates unnecessary inflammations, which is how auto-immune disorders like arthritis, Crohn’s, and asthma are created. The body’s false initial reaction leads to a painful result that can lead to decreased quality of life and chronic pain. In this case, the ECS is out of sync and may struggle to regain its balance.

It is hoped that CBD may help in the future with such conditions. By gently nudging the ECS to use its cannabinoids efficiently, it is theorized that CBD may help decrease inflammation and improve pain perception and management.

Research on CBD and pain management

Intrigued by this possibility, researchers have focused on CBD and its effect on pain management. Since the legalisation of CBD in many countries, a lot of research has been directed towards a better understanding of how CBD works. Scientists and researchers have studied CBD for pain management because most current pain-relieving medicines have significant potential side effects. Also, the body builds tolerance to analgesics and requires larger doses to achieve pain relief.

CBD, the immune system, and inflammation

Since inflammation causes pain, reducing inflammation is a critical step for people experiencing chronic pain.

Preliminary evidence suggests that CBD interacts with the immune system through the ECS. CBD, and cannabinoids in general, seem to reduce inflammation by regulating the release of cytokines—proteins that cause inflammation.

Cannabinoids also appear to help cells die (apoptosis) instead of lingering on. Cells that hang on instead of following their natural course produce inflammation.

Additional research has found other paths, namely the glycine receptor, through which CBD interacts with the body and acts as an analgesic.

CBD for pain management

All of the above suggest that CBD may someday be used to manage pain and reduce inflammation. Such hopes are strengthened by recent studies, including a recent clinical trial with Sativex—one of two cannabis-based medications currently available on the market—on people suffering from chronic pain. The trial concluded that those who took Sativex experienced “significant improvements in pain on movement, pain at rest, [and] quality of sleep.”

This gives sufferers of auto-immune disorders hope, as auto-immune conditions are linked to inflammation. Arthritis, for example, is a major cause of pain and discomfort for people. Whether it’s rheumatoid arthritis or osteoarthritis, people experience painful joints that are inflamed and swollen. They can’t bend or walk without feeling pain, which takes away from the pleasure of life—not to mention the consistent pain. Research on osteoarthritic rats showed CBD managed to relieve inflammation and pain. If this is true of humans as well, then CBD may prove in the future a useful ally in the fight against arthritis and other auto-immune disorders.

Are people choosing CBD for pain management?

Already, a lot of people are choosing CBD to manage their pain and achieve a better quality of life. Researchers decided to interview people with fibromyalgia about their pain management techniques. Through interviews with more than 800 fibromyalgia patients, the researchers made some fascinating findings:

• Over 70% had switched from their conventional pain management medication to CBD.
• 53.3% decided to switch from opioids to CBD.
• 21% switched from benzodiazepines to CBD.
• The main reason respondents gave was that they wanted fewer side effects and better pain management.
• The majority of patients substituting CBD mentioned they experienced less pain, a better quality of life, better sleep, and significant health improvements.

The most interesting finding of this report is that the fibromyalgia patients interviewed had decided to switch to CBD without any concrete medical findings that would prove that CBD actually works for pain management. This shows the dearth of beneficial pain medication that has no side effects or addictions.

CBD instead of opioids: less addiction?

Britain may not have an opioid problem comparable to the United States, but opioid prescriptions have been on the rise, and patients with chronic pain risk addiction.

A 2018 study from the British Medical Journal found that at least a quarter of the patients prescribed opioids were overprescribed. Each patient was prescribed 8 opioid prescriptions on average.

It is estimated there are over 20 million Britons suffering from musculoskeletal problems like arthritis, back pain, fibromyalgia, and osteoarthritis. Of these, it is believed that 1.5 million people are prescribed opioids to manage their pain and lead better lives.

Unfortunately, opioid medications have important side effects such as drowsiness, constipation, and nausea. The most worrisome problem, however, is that people can develop an addiction to opioids, especially if opioid medication is taken long-term. Research confirms that opioid prescriptions can lead to tolerance, dependence, and eventually addiction.

Unsurprisingly, many patients with chronic pain are looking into ways to move from opioids to CBD for better pain management and far fewer side effects.

A 2018 study showed that 53% of people who were given the opportunity to add CBD to their health routine reduced their opioid intake.  More than 90% reported noticing improvement in their life quality. This study shows that CBD may someday be an alternative to conventional medication for pain management and chronic pain.

CBD for pain management

There appears to be a sweeping tide of people who demand better quality of life and efficient pain management solutions. Some of these people are experimenting with CBD as an alternative. Anecdotal evidence is showing promising results. These findings, however, need to be backed by scientific evidence.

Specifically, there needs to be a systematic study regarding the potential effectiveness of CBD in regard to pain management. Various types of pain sources should be analysed (arthritis, back pain, fibromyalgia, etc.) and different CBD potencies must be tested to observe the effectiveness of CBD in pain management. Only then can a proper protocol that includes dosology and counter-indications be developed.

A further issue is the quality of CBD products in the market. Until recently, CBD products were sold without much regulation and CBD manufacturers could make claims and develop CBD products without much oversight.

With the novel food definition attributed to CBD, the British CBD market could get better regulated and CBD products could have proper labelling. They would also display the exact CBD potency, according to compulsory third-party lab tests.

Better information and oversight could lead to a better quality of CBD products. These would be the first steps towards a safer CBD market, giving more confidence to people who wish to try CBD for pain management purposes.