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Can CBD Alone Give Pain Relief or Do You Need THC?

Christine Kielhorn PHD

The answer for your pain relief depends on the source of the pain: inflammation or nerve?

Chronic pain makes even the simplest of tasks seem insurmountable. It can cause patients to become isolated and may even lead to mental health disorders. It is important that patients with pain quickly find the right treatment program to manage it and bring pain relief. Cannabis is the medicine of choice for more and more people and cannabidiol (CBD) products are touted to be the “miracle medicine” of the present and future. Certainly, CBD has an important role to play in the management of many conditions, but does it have what it takes to kill the pain?

Man sitting on bed with back pain

What is CBD?

Cannabidiol (CBD) is the second-most common cannabinoid cannabis produces. The first is delta-9-tetrahydrocannabinol (THC). Unlike THC, however, CBD does not have any psychotropic effects, making its therapeutic potential appealing to a wide base of patients. The most common medicinal uses for CBD include:  epilepsy, inflammation, and anxiety. And now patients are exploring the benefits of using CBD to treat chronic pain.

Most studies to date have observed that THC is the cannabinoid most responsible for the plant’s analgesic effects. It is known that THC strongly activates the CB1 receptor, which is involved in pain signalling pathways.  CBD, on the other hand, does not bind to the CB1 receptor, therefore much higher concentrations would be needed to obtain an effect on pain. This implies that CBD is not acting via the CB1 receptor.

Recent studies have hypothesized that CBD may work through a different receptor, the transient receptor potential cation channel, or vanilloid receptor (TRPV1), to reduce sensitivity to pain. Or perhaps the GPR55 receptor (otherwise known as CB3). CBD may also work by preventing the breakdown of endogenous cannabinoids like anandamide, which in turn would allow their concentrations to build up and help to subdue pain signalling.

How Do CBD and THC work together?

THC and CBD have an interesting relationship as CBD is effective at reducing the psychoactive effects of THC. Researchers agree that CBD antagonizes THC. Most clinical studies that use THC to relieve pain, use it in combination with CBD in order to mitigate this. Physicians, too, are prescribing 1:1 (CBD:THC) strains so that patients can get good pain relief without crossing the “too high” threshold.

When taken separately, CBD is excellent at reducing inflammation, which can result in a reduction in pain. THC is a known pain reliever, especially for neuropathy. The combination seems to be the most effective therapy.  You can try different strains depending on the root cause of your pain. If it’s nerve pain, start with a strain high that is 1:1 (CBD:THC). If you tolerate that well, you can continue to increase THC concentration until the pain disappears. But, if your paincomes from inflammation, like arthritis, high CBD strains are the place to start.

As with all cannabis medicine, pain relief from whole plant (full spectrum) products are medicinally superior to extracts.

Christine Kielhorn
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