The cannabis-derived substance provides fewer side effects, with less potential for abuse.
“Fibromyalgia is not easy to treat, often involving several medications with significant side effects and modest benefits,” Boehnke explained. “Further, many alternative therapies, like acupuncture and massage, are not covered by insurance.”
Boehnke and his team surveyed people with fibromyalgia about their use of CBD for treatment of chronic pain.
In states where marijuana and/or CBD is legal, there's no longer a clash between state and federal law. That's a win for those wanting to take CBD products medicinally.
Technically, federal law overrules state law. That doesn't mean that those states will stop arresting and trying people on CBD charges, though, especially if they want to challenge the new federal law. If you're in one of those states, be safe and talk to an expert about any possible trouble you could get into for using CBD products.
The website ProCon.org has information about which states have laws specific to CBD oil. A site called Governing maintains a map of where marijuana is legal in some form.
The substance responsible for the high associated with marijuana comes from a different substance, which is called THC (tetrahydrocannabinol.) Growers who want to maximize the plant's high use breeds and techniques that focus on higher THC levels. Meanwhile, cannabis that's grown for hemp is generally richer in CBD than THC, and that's where CBD is derived from.
Is CBD Oil Legal?
CBD that's extracted from cannabis is being used for a lot of medical purposes, and you can find a lot of impressive-sounding claims online. Are they true? From a scientific standpoint, the answers are more like "possibly" and "some of them appear to be" than a firm "yes," and it depends on which claims you're looking at.
People are using CBD oil for a lot of different medical purposes, including:
A 2016 review published in Cannabis and Cannabinoid Research found evidence that CBD is effective in migraine and irritable bowel syndrome, which are related to fibromyalgia. It also stated that some cannabis-based treatments appeared effective for fibromyalgia. The authors stated that CBD is often preferable to patients due to the high and other effects associated with THC.
As of mid-2018, CBD oil is not FDA-approved for any conditions. Research in the United States is in the early stages, though, since for decades, legal restrictions made it extremely difficult to study the medical benefits of marijuana or any of its components. We may see applications submitted to the agency as research continues to move forward.
A 2017 paper published in Expert Opinion on Therapeutic Targets suggested CBD as a possible way to diminish the activity of brain cells called glia, which leads to central sensitization. That’s a major feature of fibromyalgia and other central sensitivity syndromes such as chronic fatigue syndrome, irritable bowel syndrome, and migraine.
Widely understood to be a safer alternative, recent studies suggest that vaporization of the cannabis flower may provide distinct therapeutic advantages as compared to other ROAs (Aston et al. 2019; Lanz et al. 2016; Russo 2016). Vaporization of the botanical cannabis flower should not be confused with the use of the e-cigarette (vaping), which heats a concentrated form of cannabis oil to a high temperature and has recently been implicated in vaping-related acute lung injury (VpRALI) and adverse effects on the cardiovascular system (Fonseca Fuentes et al. 2019; Qasim et al. 2017). Only one of the studies selected for this review utilized vaporization in 100% of study participants (Van de Donk et al. 2019).
While 100% of the selected studies focused on participants with a fibromyalgia diagnosis, only two studies (Van de Donk et al. 2019; Habib and Artul 2018) used established criteria to determine the diagnosis. Both studies reported using diagnostic criteria established by the American College of Rheumatology (Wolfe et al. 2010). In addition to a lack of continuity within and across studies regarding the operationalization of diagnostic parameters, one study (Habib and Avisar 2018) did not establish confirmation of a fibromyalgia diagnosis in study participants. A broader literature review indicated that precise parameters for establishing a fibromyalgia diagnosis are operationalized in widely different manners across patients, clinicians, official medical bodies, and even cultures. Diagnostic consistency was not widely established across the selected studies.
Route of administration
For example, the prevalence of depression in the fibromyalgia population is 25–60%, and research has shown that fibromyalgia patients with comorbid long-term or preexisting depression are less responsive to certain pain medications than fibromyalgia patients with short-term depression (Silverman et al. 2017). While two of the selected studies asked participants about comorbidities as part of the demographic questionnaire, none of the studies controlled for comorbidities or considered them during analyses. Establishing a baseline across fibromyalgia patients with diverse comorbidities is another critical aspect of methodological design, which is essential for assessing the efficacy, safety, and tolerance of cannabis for pain management. Additionally, comorbidities should be taken into consideration when establishing baselines, control groups, and reference groups.
Minimal recent research has examined the use of cannabis for pain reduction in patients with fibromyalgia, with existing studies offering limited evidence for safety, efficacy, and tolerability. Moreover, there is a lack of methodological rigor among existing studies in this area. Additionally, comparative analysis of systematic data across relevant studies is challenging due to the low number of overall studies and the significant limitations, vast differences in methodology, and inconsistent results. Recent systematic reviews regarding the use of cannabis for fibromyalgia pain have been limited in scope, with only one identified study focusing solely on fibromyalgia patients (Walitt et al. 2016). Further, limitations include a lack of investigation of herbal preparations, with a majority of studies focusing on synthetic preparations. Also, few studies covered a broad range of study designs, focusing mainly on randomized clinical trials (RCTs). This review briefly summarizes the role of the endocannabinoid system in pain management with fibromyalgia patients and provides a critical review of selected studies from 2015 to 2019.
Studies have indicated that ROA appears to have a distinct influence on health outcomes from cannabis use, with some ROAs having a higher instance of adverse health effects than others (Aston et al. 2019; Russo 2016). The most common ROAs include smoking, inhalation via vaporization, oral administration, and transdermal (Bridgeman and Abazia 2017). As revealed in multiple systematic reviews, respiratory problems such as coughing and wheezing, increased phlegm production, reduced pulmonary function, bronchodilation, and chronic bronchitis have been associated with smoking cannabis (Gates et al. 2014; Ghasemiesfe et al. 2018; Martinasek et al. 2016; Tashkin 2014). Additionally, researchers have noted that daily cannabis use via inhalation may cause adverse pulmonary effects over an extended period (Nugent et al. 2017). Habib and Artul (2018) noted that patients whose primary ROA was smoking were more likely to report transient adverse side effects of dry mouth and redness of the eye. Russo (2016) noted that smoking is undesirable for therapeutic application of cannabis, particularly with patients who have chronic conditions.