What You Need to Know About CBD Oil for Rheumatoid Arthritis

Patient Expert
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As the opioid crisis has led to restrictions on narcotic painkillers, many people with rheumatoid arthritis (RA), and others who live with chronic pain, are looking for alternatives. Increasingly, the conversation is turning to CBD oil, created from the cannabis plant. The Washington Post has called it the new “it” drug, due to its reputation for being beneficial for anything from pain to anxiety, cancer, diabetes, and more.

What is it and can it actually be effective for RA pain?

What is CBD oil?

The full name of the cannabis plant is cannabis sativa. It contains hundreds of different chemicals, about 100 of which are cannabinoids. These are substances that can change the way brain cells communicate with each other.

Two cannabinoids are particularly relevant to this discussion. One is THC or Delta-9-tetrahydrocannabinol. This is the substance that can make you high. Cannabidiol (CBD) is the second-most-active ingredient in cannabis, but it does not have the intoxicating effects of THC — it is not psychoactive. In fact, there is some evidence that CBD actually blocks the effects of THC. CBD is derived from the hemp plant and is an essential component of medical marijuana.

The hemp plant is in the same family as marijuana but has very low THC. Hempseed oil can be used as a substitute for olive and other cooking oils. The CBD oil that is used as an alternative remedy to treat a variety of medical conditions is created from the oil of the flowers on the hemp plant. This type of oil may also contain small amounts of THC. It is available in capsules or tinctures.

Benefits of CBD oil for RA

A number of studies have indicated that CBD has beneficial effects in the treatment of pain. Many of these studies particularly investigate the efficacy of Sativex, a sublingual (under-the-tongue) spray containing both CBD and THC available in many countries, but not currently in the United States.

Randomized studies have shown that it can be effective for pain caused by RA, neuropathy, and cancer. This medication can be effective for cancer pain that does not respond sufficiently to other medications. CBD has also been shown to have a remarkable impact on  sleep quality. A study specifically investigating its effect on RA found a significant impact on pain caused by this condition.

Is it legal?

The general understanding of CBD oil is it that it is legal in all 50 states. This is not exactly true.

The 2014 Farm Bill allowed for cultivation of hemp in certain circumstances and some states require licenses to grow it. Some CBD may be cultivated in ways that do not adhere to those circumstances. Currently, the Drug Enforcement Administration (DEA) classify CBD as a schedule 1 drug, in the same category as LSD and heroin. During the summer of 2018, Sen. Mitch McConnell, R-Kentucky, announced his intention to introduce a bill that would legalize hemp on a national level.

That said, a DEA spokesperson has indicated that the agency takes a lenient attitude toward the use of CBD for medicinal purposes. The law regarding CBD and the enforcement of this law continues to be somewhat in flux. In the meantime, CBD oil continues to be widely available and used.

Is it safe?

CBD is considered to be quite safe. The World Health Organization stated in a 2017 report that “In humans, CBD exhibits no effects indicative of any abuse or dependence potential… To date, there is no evidence of public health related problems associated with the use of pure CBD.”

As with most substances, there is a possibility of interactions with other medications and side effects. Most medications are processed in the liver by an enzyme system called cytochrome P–450. Cannabidiol can inhibit this process, therefore affecting the time it takes for a wide variety of medications to metabolize. This problem can potentially be solved by adjusting the doses and timing of the drugs. In terms of side effects, a 2017 study found these to include “tiredness, diarrhea, changes in appetite/weight.” However, the study also concluded that CBD is safer than many other drugs.

My take

Marijuana has been used for its medicinal properties for almost 5,000 years. There is a long history of anecdotes in chronic illness communities about people using it for pain and other symptoms. Research shows very clearly that it can be an effective adjunct to other treatment. This evidence indicates that CBD oil could be a valuable tool to treat your pain.

However, as with any alternative remedy, there are many factors to consider and discuss with your doctor. These include side effects, dosing, and interactions with other medications, as well as the legal status. A thorough conversation with your doctor, plus some additional research, will enable you to make an informed decision on whether you will include CBD in your pain-management toolkit.