CBD Flops Big Time For Pain

CBD Flops Big Time For Pain


What Pain Patients Didn’t Need: Another Useless Substitute for Real Pain Medication. This time, it’s the much-hyped CBD (cannabidiol) oil that’s taking the hit, courtesy of a new paper in the Journal of Pain in which Andrew Moore and his colleagues at the University of Alberta conducted a meta-analysis of 16 randomized controlled clinical trials where the drug was tested against various pain-related conditions. Unsurprisingly, it almost bombed with one possible exception. The title alone, Cannabidiol (CBD) Pain Products: Ineffective, Expensive, and Potentially Harmful, speaks volumes.

No one should be surprised that CBD hasn’t made the cut as a pain therapy. The pseudo-drug has been claimed to have utility for almost every disease afflicting humans and other animal life. In his article, Moore comments on the ubiquity of unsubstantiated claims (1) fact about CBD. (There are claims of at least 10 different conditions that can only be found on Twitter.)

[Online] Outlets are often unmonitored and unbalanced and appear to be aimed at promoting revenue rather than safe practices. Consumers (people living with pain), their careers and their professional advisers need more balanced and evidence-based consumer advice. This can now be provided.

Moore, et. al., The Journal of Pain

In addition, the authors expressed skepticism about the contents of the bottle, a concern I have addressed several times regarding dietary supplements.”

The US analysis of 105 products found that only 1 in 4 products was accurately labeled for CBD, 1 in 5 had less than 90% of the advertised CBD, and 1 in 2 had more than 110%. The range indicated that the CBD content varied from almost nothing to very large amounts.

beautiful

Meta-analysis of RCTs

The group searched PubMed and ClinicalTrials.gov for randomized, double-blind trials conducted since 2019 that compared CBD (at any dose and by any means of administration) to a placebo for any painful condition. Sixteen trials met these criteria.

Results: CBD has little or no effect on pain

Below is a brief summary (Table 1) of the trials included in the meta-analysis and their results.

We can graphically visualize these results in Table 1: a forest diagram.

Source: Moore et al., The Journal of Pain, Vol 25, no. 4 (April), 2024: pp. 833–842.

Figure 1. A forest diagram of the 16 trials that met the meta-analysis criteria. The area to the left of the zero vertical line indicates trials where CBD outperformed placebo (one). The area on the right indicates trials where placebo outperformed CBD (none). When a hatch mark touches (or crosses) the zero vertical line, the results are not significant. Only one (green oval) of 16 trials (topical CBD oil for arthritic thumb pain) showed a significant advantage of CBD over placebo, but it should be noted that this trial only had 18 participants.

Summary

Not only did Moore and his colleagues demonstrate CBD’s lack of utility, they also opined that the drug is essentially being given a free pass, and that this will ultimately harm people suffering from pain.

[It is unclear] why is there tolerance for the marketing and use of a product without proven benefit but at risk of harm to a large population of people suffering from debilitating pain. This may be due to aa false perception of security [or] the desire of governments to create markets in what is perceived as a new area of ​​national gross domestic product (GDP) growth… What we do know is that if we collude by pretending we have treatmentyes we are not faced with the need to invest in the discovery and innovation of pain relievers. It is encouraging to reflect that changes to state medical cannabis laws in the United States to allow greater use have had no major impact on the rate of opioid or non-opioid prescriptions or procedures. [emphasis added]

In other words, CBD joins the growing list of drugs that are ineffective at treating pain, potentially dangerous, or both. But as long as no opioids are used, I guess it’s fine.

NOTE:

(1) There is a pharmaceutical grade CBD (brand name Epidiolex), which is only approved for seizures.

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