CBD – Pain

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CBD – Pain

According to a recent Piplsay poll of 12,075 Brits, the popularity of CBD is continuing to rise across the UK, with over 61% saying that they have found it to be an effective solution for their needs. But what are those needs?


Still topping the charts is a desire to quell anxiety and depression which, unsurprisingly, has been a serious problem for many during the rollercoaster ride that is 2020. But following very closely behind this is an attempt to soothe chronic pain, which current data suggests affects around half the adult population (approx 28 million people) in the UK alone – higher still in the population over the age of 75.


The most common, pharmaceutical treatment of chronic pain conditions, such as arthritis, back pain, fibromyalgia, persistent headaches and MS often falls short of what patients need. As it stands, most people who visit their GP with these sorts of issues will be offered opioid painkillers (prescriptions have risen 22% over the last decade, now amount to around 40 million a year), which health experts have warned are ineffective for 90% of patients, addictive and potentially very dangerous.


What’s the alternative?


Medical cannabis is an alternative treatment that has been available from private clinics in the UK since 2018. This has proven to be very effective in US states where cannabis is legal for medicinal use, indicated by an enormous 30% drop in prescriptions for opioids and anti-depressants. This is a number not only of vital importance to help reduce the shocking 31% of deaths linked to opioid addiction each year, but also to our environment, marine life and waterways, which have become saturated with prescription medication thanks to the alarming levels present in sewage that gets flushed out to sea.


However, as medical cannabis is not yet easily accessed on the NHS, people have started to look elsewhere for answers. For around 1.4 million patients, this means turning to the illegal cannabis market for relief. For others, high-quality, organic CBD oil offers access to some of the cannabinoids and terpenes also found in medical cannabis (albeit, at lower potency and without THC).


While there is still plenty of room for further clinical research into how CBD and over 100 other cannabinoids and terpenes impact pain responses, here’s what the science is currently saying…


Pain & the Endocannabinoid System

The Endocannabinoid system (ECS) is a complex network that spans the entire body. It interacts with our naturally produced endocannabinoids (namely the ‘bliss molecule’anandamide and 2-AG) to keep the body working as it should.


There are two, fundamental cannabinoid receptors these endocannabinoids work with: CB1 and CB2. For the most part, CB1 receptors (largely found in the brain and central nervous system) controls perception, mood, sleep, memory, and appetite. The CB2 receptors are found in abundance in the tissues of the peripheral nervous system, the digestive system, and specialized immune cells and therefore have the potential to control inflammation, which is an immune response.


Since its discovery in the early 90s, researchers have gone on to find that the ECS plays an integral role in almost every bodily process, acting as a sort of dimmer switch to modulate neuronal activity, inflammatory responses and much more.


This is a key point when it comes to chronic pain conditions because (alongside inflammation causing aggravation) the manifestation of pain and control of it is communicated around the body via neuronal pathways. When all is functioning as it should, the pain response serves a protective role for the body. However, when something goes awry, nerve cells can misfire sending pain signals to the brain without reason.


A balanced ECS helps to keep the nervous system, brain and neurotransmitters interacting as they should (see more about this below). But, it has been theorised that when the body is subjected to stress, chronic pain, sleep deprivation or unhealthy lifestyle choices, our all-important endocannabinoids become depleted. This is referred to as an ‘endocannabinoid deficiency’. As a result, the ECS falls out of balance – and so does everything else.


Fortunately, the discovery of the ECS only came about when scientists found that phytocannabinoids found within the cannabis plant (such as CBD) also interact with the ECS. In fact, CBD is now known to inhibit the FAAH enzyme which breaks down anandamide, therefore elevating levels of this endocannabinoid in the bloodstream, strengthening the ECS and helping maintain global homeostasis.


Vanilloid (capsaicin) receptors, opioid receptors, adenosine receptors

 & serotonin receptors


As mentioned above, neurotransmitters are essential for pain modulation. They are essentially the chemical messengers which travel to a range of receptors to inform the body that pain has been detected and prompt it to act accordingly. When a problem occurs, these can misfire, preventing them from traveling to and activating receptors as and when appropriate.


However, CBD has also been shown to mimic certain neurotransmitters by directly activating vanilloid (capsaicin)receptors, opioid receptors, adenosine receptors and serotonin receptors (among others) as well as well as interacting with the ECS. All of these are involved in a range of inflammatory pathways responsible for inflammation and, when activated, help to control the response of nociceptors (a type of receptor that exists to feel all and any pain), contributing to analgesic, anti-inflammatory, antiepileptic, and antiemetic effects.