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cbd oil not working for pain

CBD Oil for Pain

Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman’s World, and Natural Health.

Lana Butner, ND, LAc, is a board-certified naturopathic doctor and licensed acupuncturist in New York City.

For many people experiencing chronic pain, cannabidiol (CBD) oil is steadily gaining popularity as a natural approach to pain relief. A compound found in the marijuana plant, cannabidiol is sometimes touted as an alternative to pain medication in the treatment of common conditions like arthritis and back pain.

The use of cannabis for pain relief dates back to ancient China.   It’s thought that CBD oil might help ease chronic pain in part by reducing inflammation. In addition, CBD oil is said to promote sounder sleep and, in turn, treat sleep disruption commonly experienced by people with chronic pain.  

It’s important to note that many CBD oil products do not contain tetrahydrocannabinol (THC), the compound responsible for producing the “high” associated with marijuana use. Unlike THC, cannabidiol is non-intoxicating and does not have psychoactive effects.

Potential Benefits and Side Effects of CBD Oil

Why People Use CBD Oil

According to the Institute of Medicine of The National Academies, 100 million Americans live with chronic pain. Along with drastically reducing quality of life, chronic pain can increase healthcare costs and have a negative impact on productivity at work.

Common types of chronic pain include:

  • Cancer pain
  • Fibromyalgia
  • Headaches
  • Irritable bowel syndrome (IBS)
  • Low back pain
  • Migraines
  • Multiple sclerosis pain
  • Neuropathic pain
  • Osteoarthritis
  • Temporomandibular joint disorder (TMJ)

Over-the-counter (OTC) and prescription pain medications are often recommended in the treatment of chronic pain, but many people seek out alternative forms of relief, such as herbs, nutritional supplements, and products like CBD oil.

Some of these people wish to avoid the side effects frequently associated with standard pain medication, such as damage to the liver and kidneys, while others have concerns about becoming dependent on such medications.

Some proponents suggest that CBD oil could provide a solution to opioid addiction as concerns over opioid overdoses continue to escalate.

Potential Benefits of CBD Oil

Scientists are still trying to determine how CBD oil might alleviate pain. However, there’s some evidence that cannabidiol may affect the body’s endocannabinoid system (a complex system of cell-to-cell communication). Along with contributing to brain functions like memory and mood, the endocannabinoid system influences how we experience pain.

When taken orally, CBD has poor bioavailability. Topical CBD application to localized areas of pain appears to provide more consistent levels of CBD with less systemic involvement.

Animal-Based Research

So far, much of the evidence for CBD oil’s effects on pain management comes from animal-based research. This research includes a study published in the journal Pain in 2017, in which scientists observed that treatment with topical CBD helped thwart the development of joint pain in rats with osteoarthritis.

Another study, published in the European Journal of Pain in 2016, found that topical CBD gel significantly reduced joint swelling and measures of pain and inflammation in rats with arthritis.  

Epidermolysis Bullosa

In a report published in Pediatric Dermatology in 2018, scientists reported three cases of topical CBD (applied as an oil, cream, and spray) use in children with a rare, blistering skin condition known as epidermolysis bullosa.  

Applied by their parents, all three people reported faster wound healing, fewer blisters, and improvement of pain. One person was able to completely wean off oral opioid analgesic pain medication. There were no adverse effects reported.

Chronic Neuropathic Pain

While very few clinical trials have explored the pain-relieving effects of CBD oil, a report published in the Cochrane Database of Systematic Reviews in 2018 examined the use of a variety of cannabis-based medicines and found they might be of some benefit in the treatment of chronic neuropathic pain.  

A type of pain triggered by damage to the somatosensory system (i.e., the system responsible for processing sensory stimuli), neuropathic pain often occurs in people with conditions like diabetes and multiple sclerosis.

In this report, researchers reviewed 16 previously published studies testing the use of various cannabis-based medicines in the treatment of chronic neuropathic pain and found some evidence that cannabis-based medicines may help with pain relief and reduce pain intensity, sleep difficulties, and psychological distress.

Side effects included sleepiness, dizziness, and mental confusion. The authors concluded that the potential harm of such medicines may outweigh their possible benefit.

However, it should be noted that the studies used a variety of cannabis-based medicines (e.g., inhaled cannabis, sprays, and oral tablets containing THC and/or CBD from plant sources or made synthetically), some of which are more likely to result in these side effects than products without THC.

Side Effects and Safety

The research on the side effects of CBD oil is extremely limited. CBD is the major non-psychoactive component of cannabis. Due to the lack of regulation, there is inconsistency in content and purity. The amount of CBD may not be consistent, and products can contain varying amounts of the psychoactive component THC.

In studies using varied doses, routes of administration, and combination or whole products with THC, a number of side effects have been reported. These include anxiety, changes in appetite and mood, diarrhea, dizziness, drowsiness, dry mouth, low blood pressure, mental confusion, nausea, and vomiting.  

There’s also some concern that taking high doses of cannabidiol may make muscle movement and tremors worse in people with Parkinson’s disease.

What’s more, CBD oil may interact with certain medicines, such as medications changed by the liver (including chlorzoxazone, theophylline, clozapine, and progesterone) and sedative medications (including benzodiazepines, phenobarbital, fentanyl, and morphine).

When smoked, cannabis has been found to contain Aspergillus (a type of fungus).   People with suppressed immune systems should be aware of the risk of fungal infection when using this form of cannabis. Topical CBD application may also cause skin irritation.

CBD oil should not be used as a substitute for standard care. In the case of chronic inflammatory conditions like arthritis, for instance, chronic inflammation can lead to joint damage (causing destruction and disability) if the condition is not effectively managed.

Availability of CBD Oil

As more and more states across the U.S. legalize the use of marijuana, CBD oil has become more widely available. CBD oil is now sold in a range of forms, including capsules, creams, tinctures, and under-the-tongue sprays.

While many companies now sell CBD oil online and in dispensaries, use of the oil isn’t legal in every state. Because state laws vary greatly when it comes to cannabis products, it’s crucial to confirm that use of CBD oil is legal in your state.

Considerations

Chronic pain is the most common reason for medicinal cannabis use, according to a recent survey.   If you have a chronic pain condition and have not been able to manage it with standard treatment (or wish to avoid the adverse effects of other medications), you may be considering CBD oil for pain relief.

Preclinical animal research suggests that CBD may have moderate pain-relieving effects for neuropathic pain without the cannabinoid-like side effects, however, there is currently a lack of large, well-designed clinical trials (the type of research you want to see to put full stock in a treatment) confirming these effects.

If you’re thinking of trying CBD oil for pain relief (and it is legal where you live), talk to your doctor to discuss whether it’s appropriate for you and the safest way to incorporate it into your pain management plan. Keep in mind that due to the lack of regulation, the purity and content of CBD oil products can vary.

A Word From Verywell

If you live with chronic pain, you may have experienced how it can disrupt sleep and, in some cases, can contribute to anxiety and depression. Natural and lifestyle therapies, such as exercising and taking up mind-body practices like meditation and yoga, as well as following an anti-inflammatory diet may help improve quality of life for some people who experience pain regularly.

As many as 100 million Americans experience chronic pain. Could the cannabis-based medicine CBD oil be the cure for pain?

How long does it take CBD to work?

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Contents

  1. How does CBD interact with the body?
  2. The method of consumption matters
  3. Dosage matters
  4. How long does it take CBD to get out of your system?

So, you’ve heard about cannabidiol (CBD) oil possibly working wonders for chronic pain relief, anxiety, and many other conditions. You finally sit down, unscrew the cap from the CBD oil bottle, and prepare to set out on a soothing journey guided by this non-intoxicating cannabinoid. After taking a few drops of CBD oil or applying a CBD-infused topical to the skin, you might start to ponder the following questions:

  • How long does it take for CBD to work?
  • How long will the effects of CBD oil last?

More clinical research is required to answer these questions with unwavering confidence, but we can still look at how CBD interacts with the body to come up with well-educated estimates.

How does CBD interact with the body?

CBD interacts with the brain and body through a number of different mechanisms, creating a complex relationship that still merits further research before we can fully understand how this cannabinoid might relieve certain ailments.

Upon entering the system CBD interacts with a wide range of proteins in the body and central nervous system. A key part of this interaction takes place within the endocannabinoid system (ECS), specifically the CB1 and CB2 cannabinoid receptors. Unlike THC, which is the intoxicating cannabinoid that binds to these receptors and creates the stoned effect, CBD actually has an inverse effect. When cannabidiol is introduced to the ECS, it inhibits the absorption of anandamide, a natural cannabinoid that regulates pain.

When cannabidiol is introduced to the endocannabinoid system, it inhibits the absorption of anandamide, a natural cannabinoid molecule that regulates pain. Photo by: Gina Coleman/Weedmaps

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CBD also interacts with other receptor proteins not directly related to the ECS, such as the serotonin receptor 5-HT1A and vanilloid receptor TRPV1. The widely perceived anti-inflammatory and pain relieving properties of CBD could stem from the activation of these additional biological pathways.

The relationship between CBD and the human body is rather complicated, but it’s a bit easier to understand how this cannabinoid moves through the body, as well as how long it takes CBD to leave your system. Even this answer, however, is contingent on several factors, including the method of consumption, the quality of the CBD product, and the person consuming CBD.

The method of consumption matters

Method of consumption plays a critical role in how long it will take to feel the effects of CBD. CBD is available in many different forms, and each has an influence on the onset time, among other factors.

Ingestion

The most common method for CBD consumption involves administering a couple of drops directly into the mouth. It is the quickest and easiest way to reap the potential benefits of this cannabinoid. But quickly swallowing the oil also prevents CBD from immediately entering the bloodstream, sending it instead through the digestive tract and eventually on to the liver, where it is broken down before finally reaching the bloodstream.

Studies show that when CBD compounds are metabolized by the liver, it undergoes what is called the “first pass effect,” where enzymes in the liver reduce CBD concentration before the remainder is finally sent to the bloodstream to be circulated throughout the body.

CBD oil dropper

Administering a couple of drops of CBD oil directly into the mouth is the quickest and easiest way to reap the benefits Photo by: Gina Coleman/Weedmaps

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CBD oil dropper

For ingestion of CBD edibles, the same principle applies. Let’s say, for example, you’re taking CBD gummies or adding a few drops of CBD oil into your favorite recipe. It will ultimately go through the same lengthy process and reduce the total CBD concentration found in your blood stream. With ingestion, it could be one to two hours before the effects of CBD finally set in.

Sublingual

CBD oil can be consumed sublingually by placing a few drops of CBD under the tongue before swallowing. By using this method, CBD is absorbed by the mucous membranes located in the mouth, bypassing the digestive system and liver. Compared with ingestion, this process allows the consumer to skip over the initial metabolization process, where CBD molecules are broken down in the liver, allowing it to enter the bloodstream more quickly.

Inhalation

Whether you’re smoking a high-CBD strain or taking a draw from a CBD vape pen, inhalation is often seen as an effective method of delivery for CBD because of how quickly it’s absorbed in the body. When CBD is smoked or vaped, cannabinoids are sent directly to the lungs, where they are rapidly absorbed into the bloodstream and put into circulation throughout the body. It reaches peak concentrations within three minutes after consumption, meaning the effects can be felt shortly after use.

Topical

Topical CBD is applied directly to the skin and can be absorbed through the surface of the skin to interact with localized cannabinoid receptors. In some cases, CBD-infused topicals should be applied liberally to overcome the low cannabinoid absorption rate of the skin. When CBD is applied topically, the effect peaks at about 90 minutes. This method of administration is often used for chronic pain in specific areas.

Topical CBD is applied directly to and can be absorbed through the surface of the skin. Photo by: Gina Coleman/Weedmaps

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Dosage matters

The way CBD operates throughout the body – and is inevitably excreted from the body – also depends on several factors that vary from person to person.

Body weight

The amount of body fat influences the amount of CBD needed to be effective. Someone with a larger body mass will require more CBD in order to feel the effects. Body weight and mass also affect how long CBD remains in the system. Like THC, CBD is stored in fat cells and gradually eliminated from the body through urine and feces. Does CBD have to build up in your system to work effectively? No, but it does get stored in the fat cells and can remain in the body well after the effects of CBD diminish.

Metabolism

The metabolic rate of the individual also has some sway over how long CBD stays in the system. The body’s metabolism determines how long it takes to break down and synthesize compounds, which affects how long it takes the body to process and metabolize the cannabinoid.

The body’s metabolism affects how long it takes to process and metabolize cannabinoids. Photo by: Gina Coleman/Weedmaps

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Frequency of use

It’s not just the human body that influences how long it takes CBD to work, but also the quality of the CBD product and how often it’s used. Once the CBD oil is acquired, the next step is to find the optimal dosing regimen, including frequency of use. Perhaps you’ve wondered to yourself:

  • Should I take CBD oil in the morning or at night?
  • What’s the right time of day to take CBD?

The answers will depend largely on the type of product, amount of CBD inside it, and the specific ailment you are targeting. Most reputable manufacturers will provide instructions on how to properly utilize the product, but experimentation may be required to find the optimal dose for you and your specific needs.

CBD dosage

Settling on the ideal CBD dosage is an important part of the treatment process, and will also impact how long CBD stays in your system.

Hemp-derived CBD products are not intended to give the user a stoned buzz or intoxicated feeling, so there’s no need to be conservative with the dosage amount. Still, it’s recommended to start with a lower dosage and gradually increase it until the ideal effects are discovered.

How long does it take CBD to get out of your system?

We’ve covered the factors that determine how long it takes for CBD to work, but what about how long it takes to get CBD out of your system? Again, it depends on many of the aforementioned factors that determine the effectiveness of the cannabinoid itself.

A 2007 study states that CBD can be detected up to 72 hours after smoking. Since the effects of CBD may be felt directly after inhalation, this method is appealing for those seeking immediate pain relief. In another study, volunteers were given soft-gelatin capsules of cannabis extract containing 2.5 milligrams of THC and 1.35 milligrams of CBD. The research team found that CBD was only detectable in the blood for up to six hours after ingestion.

woman smoking joint

CBD can be detected up to 72 hours after smoking. Photo by: Gina Coleman/Weedmaps

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woman smoking joint

Some people may be apprehensive to try CBD over concerns that it could cause them to fail a drug test. It’s highly unlikely that CBD would show up on most drug screenings, as most tests specifically look for the presence of THC and THC metabolites. But even hemp-derived CBD can contain trace amounts of THC, so there’s technically a chance, albeit extremely slim, of receiving a false positive test result from taking an unusually large dose (estimates range from 1,000 to 2,000 milligrams per day) of CBD oil.

For those worried about THC showing up in their system, look for broad-spectrum oil or products that contain pure CBD isolate. Broad-spectrum oil, as opposed to full spectrum oil, is refined to exclude the trace amounts of THC that may have been present in the hemp plant. Products with CBD isolate contain no THC or other plant-based cannabinoids. To find high-quality CBD, search for products that come with a certificate of analysis from a third-party testing lab to ensure that the information listed on the product label is accurate. Also, be on the lookout for products that claim to be hemp seed oil or hemp oil, which seldom contains any CBD at all.

How long does it take CBD to work? Copy article link to clipboard. Link copied to clipboard. Contents How does CBD interact with the body? The method of consumption matters