Posted on

cbd oil for fibromyalgia

Cbd oil for fibromyalgia

People are using CBD oil for a lot of different medical purposes, including:

What Is CBD Oil?

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.

Research for Fibromyalgia

Still, a lot of people don't really understand what CBD oil is or how it works, and it tends to be wrapped up in the controversy over medical marijuana. That can make people hesitant to try it. There's also a lot of confusion over whether it's legal—but there are also some positive changes on that subject.

Cbd oil for fibromyalgia

CBD, short for cannabidiol, is the second most common cannabinoid in the cannabis plant, and has been marketed for everything from mood stabilization to pain relief, without the intoxicating effects produced by the most common cannabinoid, THC. THC, which stands for delta-9-tetrahydrocannabinol, is the ingredient in marijuana that causes people to feel high.

The cannabis industry has exploded, aided by the legalization of medical and recreational marijuana in states around the United States and the removal of hemp-derived CBD from Schedule 1 status—reserved for drugs with no currently accepted medical use and a high potential for abuse—at the federal level.

The cannabis-derived substance provides fewer side effects, with less potential for abuse.

Cbd oil for fibromyalgia

In addition, the selected studies generally failed to clearly record participant symptoms at the start of each study protocol. Symptoms such as constipation, dizziness, dry mouth, and dry eyes consistent with symptoms of fibromyalgia may also be attributable to cannabis use (Van de Donk et al. 2019). Future studies should establish a baseline for symptoms that are commonly associated with fibromyalgia so as to distinguish them from the adverse effects of cannabis. Future studies should also control for cannabis use patterns when assessing adverse side effects, establishing a control group for each category of cannabis user (past uses, current user, naïve user, and non-user).

Fibromyalgia is a chronic health condition characterized by widespread, severe musculoskeletal pain that affects an estimated 5–7% of the global population. Due to the highly comorbid nature of fibromyalgia, patients with the disorder often respond poorly to traditional pain treatments. Recent studies suggest that patient response may be more favorable to alternative analgesics, such as cannabis. However, the therapeutic potential of cannabis-based pain treatment for fibromyalgia remains unclear. The present study examined the most recent cannabis literature (2015–2019) and provides a critical review of current research on the safety and efficacy of medical cannabis treatments for fibromyalgia.

Additional weaknesses in methodological design occurred in varying configurations across all selected studies. These weaknesses affected the overall generalizability of outcomes and included problems with inclusion and recruitment criteria, lack of control groups or appropriate reference groups, short treatment duration, and small sample sizes. Randomized clinical trials with proven methodological design are a critical need in the field of cannabis research as it pertains to assessing chronic pain management in fibromyalgia patients. The growing legalization and increasing use of cannabis across all populations indicates that cannabis use, for any reason, is a significant public health concern, and empirically-based information is urgently needed.

As previously noted, the majority of participants across the selected studies were female; 85% (Habib and Avisar 2018; Habib and Artul 2018), 82% (Sagy et al. 2019), 90% (Yassin et al. 2019), and 100% (Van de Donk et al. 2019). The high rate of female participants across studies might be expected due to an overall higher prevalence of fibromyalgia diagnosis in females. However, the three studies that included both males and females failed to take into consideration the differences in cannabis use patterns, propensity for addiction, and the biological mechanisms of cannabis interaction between sexes. Further, four of the five studies did not consider controlling for gender when analyzing and reporting results. Additionally, there is little research highlighting the differences in efficacy and safety of agent, strain, and ROA across genders. More research is needed in order to assess the generalizability of cannabis efficacy results across genders. Of the selected studies, the results of Van de Donk et al. (2019) (100% female) are the most generalizable across diverse female populations.

Diagnostic continuity

We followed Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in searching the PubMed and Medline databases using the search terms “cannabis + fibromyalgia” and then “cannabinoids + fibromyalgia.” Inclusion criteria were a) English language, b) published in peer review journals, c) published from 2015 to 2019, d) all study designs except for systematic reviews and meta-analyses, and e) all cannabis preparations.

Literature search process

Research has indicated an extensive endocannabinoid system in animals, comprised of systemic endogenous ligands and receptors with critical localization to nervous tissue in both the central nervous system and the immune system (Donvito et al. 2017; Fitzcharles et al. 2016; Silver 2019; Walker et al. 2019). The primary function of the endocannabinoid system in humans is to maintain homeostasis, which includes regulation of pain and inflammation (Fitzcharles et al. 2016; Guindon and Hohmann 2009; Silver 2019). The endocannabinoid system is integral to normal physiological functioning in humans and has been associated with the pathology of several neurological conditions (Russo 2016). In addition to endogenous endocannabinoids, exogenous molecules with cannabinoid properties, such as botanical cannabinoids, engage the endocannabinoid system (Silver 2019). Traditionally utilized as a plant preparation derived from Cannabis sativa, cannabinoids have been widely used throughout history for medicinal effects (Bridgeman and Abazia 2017).

Methods

Evidence highlighting the efficacy of cannabis in the treatment of chronic pain for fibromyalgia patients will not have acceptable validity if the type, strain, and dosage is not carefully tracked. Further, correlations between assessed outcomes and specific types of cannabis cannot be accurately determined if dosage and strain are not carefully tracked alongside outcomes. In the selected studies, Sagy et al. (2019) utilized 14 unspecified strains of cannabis that had been approved by the Israeli Ministry of Health with unverified self-reported dosages. Yassin et al. (2019) assessed the effects of unspecified strains of medical cannabis (1:4 THC: CBD) with a set dosage of 20 g from producers that had also been approved by the Israeli Ministry of Health.

While there was little continuity across selected studies regarding ROA, all but one study (Van de Donk et al. 2019) utilized ROAs for which safety and efficacy are not well-supported in the extant literature. Sagy et al. (2019) reported using smoked joints, oil, or a combination of the two methods, noting that the choice was made by the study participant and was not tracked by the researchers. Habib and Avisar (2018), relying on self-report data only, reported that 80% of participants smoked cannabis in some form, 15% used vaporization, and 5% used oil. Habib and Artul (2018), also through self-report measures, noted that 58% of participants smoked, 23% vaporized, 14% combined vaporization and smoking, and 8% combined smoking and oil. Yassin et al. (2019) reported that study participants either smoked joints or used vaporization, but that information was not tracked across participants. Van de Donk et al. (2019) utilized vaporization in 100% of study participants, which is currently the ROA with the most supporting empirical evidence for safety. The utilization of ROAs for which safety and efficacy are not supported by empirical evidence is highly concerning, especially given the 60% increase in worldwide cannabis use over the past decade (United Nations Office of Drugs and Crime (UNODC) 2019).