Understanding cannabidiol (CBD)

Cannabidiol (CBD) is a chemical compound made from cannabis. CBD isn’t psychoactive, unlike tetrahydrocannabinol (THC), the other byproduct of cannabis.

CBD is thought to activate serotonin receptors. It plays a role in:

According to recent studies, CBD also:

These benefits are what make CBD an appealing alternative treatment for pain disorders such as fibromyalgia.

Fibromyalgia is a chronic pain disorder that causes musculoskeletal pain in addition to:

It mostly affects women, and currently there’s no known cure for the condition. However, treatment options are available that focus on pain management.

CBD has been used to ease chronic pain symptoms and reduce inflammation. It’s presented as an alternative to taking opioid prescriptions which can be addictive.

However, the Food and Drug Administration (FDA) hasn’t approved CBD as a treatment option for fibromyalgia or most other conditions. The CBD-based prescription drug Epidiolex, an epilepsy treatment, is the only CBD product that’s FDA-approved and regulated.

There are currently no published studies on fibromyalgia that look at the effects of CBD on its own. However, some research does look at the effects of cannabis, which may contain multiple cannabinoids, on fibromyalgia.

The results have been mixed. More human studies are needed.

Earlier studies

A 2009 review found that CBD can be used to relieve neuropathic pain. The researchers concluded that cannabinoids such as CBD might be a useful adjunct to other pain medications.

A 2011 study looked at 56 people with fibromyalgia. Most of the participants were women.

Members of the study comprised two groups:

  • One group was comprised of 28 study participants who weren’t cannabis users.
  • The second group was comprised of 28 study participants who were cannabis users. The frequency of their cannabis use, or the amount of cannabis they used, varied.

Two hours after using cannabis, the cannabis users experienced benefits such as:

  • reduced pain and stiffness
  • an increase in sleepiness

They also had slightly higher mental health scores than the non-users.

2019 Dutch study

A 2019 Dutch study looked at the effect of cannabis on 20 women with fibromyalgia. Over the course of the study, each participant received four types of cannabis:

  • an unspecified amount of a placebo variety, which contained no CBD or THC
  • 200 milligrams (mg) of a variety with high amounts of both CBD and THC (Bediol)
  • 200 mg of a variety with high amounts of CBD and low amounts of THC (Bedrolite)
  • 100 mg of a variety with low amounts of CBD and high amounts of THC (Bedrocan)

The researchers found that the spontaneous pain scores of people using the placebo variety were similar to the spontaneous pain scores of people using some of the non-placebo varieties.

However, Bediol, which is high in CBD and THC, brought relief to a greater number of people than the placebo did. It caused a 30 percent reduction of spontaneous pain in 18 of the 20 participants. The placebo caused a 30 percent reduction of spontaneous pain in 11 participants.

Use of Bediol or Bedrocan, both high-THC varieties, significantly improved pressure pain thresholds when compared to the placebo.

Bedrolite, which is high in CBD and low in THC, didn’t show any evidence of being able to relieve spontaneous or evoked pain.

2019 Israeli study

In a 2019 Israeli study, hundreds of people with fibromyalgia were observed over a period of at least 6 months. Of the participants, 82 percent were women.

The study participants received guidance from nurses before taking medical cannabis. The nurses provided advice on:

All the participants started with a low dosage of cannabis, and dosages were increased gradually over the course of the study. The median approved dosage of cannabis started at 670 mg a day.

At 6 months, the median approved dosage of cannabis was 1,000 mg a day. The median approved dosage of THC was 140 mg, and the median approved dosage of CBD was 39 mg a day.

The researchers admitted that the study had limitations. For instance, they were only able to follow up with about 70 percent of participants. The use of so many different strains also made it difficult to compare the effects of CBD-rich and THC-rich strains.

However, they still concluded that medical cannabis was a safe and effective treatment for fibromyalgia.

At the beginning of the study, 52.5 percent of participants, or 193 people, described their pain level as high. At the 6-month follow-up, only 7.9 percent of those who responded, or 19 people, reported high levels of pain.

If you want to avoid the psychoactive effects of marijuana, you can find CBD products that contain only trace amounts of THC. If you live in a place where recreational or medical marijuana is legal, you can find CBD products that contain higher concentrations of THC.

Although they each have benefits separately, CBD and TCH likely work best when combined. Experts refer to this synergy, or interaction, as the “entourage effect.”

CBD also acts against THC-targeted receptors to reduce the negative effects of marijuana, such as paranoia and anxiety.

You can consume CBD in a number of ways, including:

  • Smoking or vaping. If you want to relieve immediate pain, smoking CBD-rich cannabis is the quickest way to reduce symptoms. Effects can last up to 3 hours. Smoking or vaping allows you to directly inhale CBD from the cannabis plant, absorbing the chemical into your bloodstream and lungs.
  • Edibles. Edibles are foods cooked with the cannabis plant, or cannabis-infused oil or butter. It’ll take longer to experience symptom relief, but the effects of edibles can last for up to 6 hours.
  • Oil extracts. Oils can be applied topically, taken orally, or dissolved under the tongue and absorbed in mouth tissues.
  • Topicals. CBD oils can be infused into topical creams or balms and applied directly to the skin. These CBD products can be an effective option for reducing inflammation and helping with external pain.

There may be respiratory risks to smoking or vaping marijuana. People with asthma or lung conditions shouldn’t use this method.

You should also follow dosage instructions carefully, especially with edibles, to avoid the negative side effects of taking too much.

Cannabidiol is thought to be safe and to have minimal side effects. However, some people have experienced the following side effects after using CBD:

  • fatigue
  • diarrhea
  • appetite changes
  • weight changes

A study on mice linked CBD intake to liver toxicity. However, some of the mice in that study had been force-fed large amounts of CBD in the form of CBD-rich cannabis extract.

Drug interactions are possible with CBD. Be aware of them if you’re currently taking other supplements or medications.

CBD, like grapefruit, also interferes with cytochromes P450 (CYPs). This group of enzymes is important to drug metabolism.

Researchers are still exploring whether CBD can effectively treat chronic pain disorders. Further studies are needed. There are some success stories, but CBD isn’t FDA-approved for fibromyalgia. Also, research has yet to show us the long-term effects of CBD on the body.

Until more is known, traditional fibromyalgia treatment is recommended.

If you decide to use CBD products for pain management, be sure to consult with a doctor first. They can help you avoid negative side effects or harmful interactions with your current medications and treatments.

Is CBD Legal? Hemp-derived CBD products (with less than 0.3 percent THC) are legal on the federal level, but are still illegal under some state laws. Marijuana-derived CBD products are illegal on the federal level, but are legal under some state laws. Check your state’s laws and those of anywhere you travel. Keep in mind that nonprescription CBD products are not FDA-approved, and may be inaccurately labeled.