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Did you know that many people use CBD instead of prescription meds like opioids to treat their intermittent and chronic pain symptoms?

Dr Zachar fielded some interesting questions regarding pain and CBD…

Question: What is pain?

Answer: The International Association for the Study of Pain defines as “an unpleasant sensory and/or emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. Pain is a symptom. All symptoms have a cause. If the cause is removed, the pain resolves. For example, a broken leg can cause pain. When the leg is casted and then repaired, the pain resolves. A gum infection can cause pain. When the infection is treated with antibiotics, gum infection is treated, and the pain resolves.
In the unfortunate case of chronic pain, even if the cause is treated (for example, performing surgery on multiple herniated discs), sometimes the pain remains because the long-lasting pain has already caused changes in pain receptors in the central nervous system resulting in permanent chronic pain. These unfortunate patients require safe long-term pain medication.

Question: What is the difference between opioids and CBD in the treatment of pain?

Answer: Opioids work in four places in the central nervous system.

  • They work in the dorsal root ganglion of the spinal cord where bind to the µ receptor and decrease pain perception.
  • They work in the midbrain in the nucleus accumbens where they stimulate dopamine release (the pleasure hormone)
  • They work in the locus ceruleus where they inhibit norepinephrine release which helps to decrease anxiety.
  • They work in the reticular activating system where they promote sedation.
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Prolonged opioid use produces biochemical changes in the central nervous system where it exerts its effects. The result of these biochemical changes is the need for the patient to require progressively higher doses to achieve the same pain control.
CBD works differently. It stimulates the inhibitory glycine receptor which results in decreased pain transmission from the source of the pain up to the brain where the pain is “felt”.

It stimulates the 5-HT1A receptors which results in decreased anxiety. It stimulates the TRPV1-2 vanilloid receptors which binds anandamide. This is known as the “bliss” hormone. The higher the anandamide in a person, the more peaceful and blissful he feels. It inhibits α-1adrenergic receptors which results is slight lowering of elevated blood pressure. It inhibits the reuptake of noradrenaline, dopamine, serotonin, GABA, and anandamide, therefore in helps alleviate anxiety, depression, pain, and increases “bliss”. It acts directly immune cells to decrease inflammation – the inflammation that is the source of the person’s pain. Thus, unlike opioids, it does not only decrease the person’s perception of pain, but it can decrease the cause of the pain.

As per your request, we are moving the weekly In-house doctor session from Thursday at 1 pm EST, to Thursday at 3 pm EST (That’s UK’s 20:00, NYC’s 15:00 and LA’s 12:00)

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If you liked these questions and answers and want more, why not check out the Q&A from – ‘Ask a Doctor – Obstructive Sleep Apnea And Sleep Hygiene

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