CBD for Chronic Pain – Evidence-Based Occupational Therapy Practice 2021

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  • Human use of cannabis-derived products, including for medicinal use dates back many millennia.((Kalant, H. (2001). Medicinal Use of Cannabis: History and Current Status. Pain Res. Manag. 6 (2), 80–91. doi: 10.1155/2001/469629))
  • Clinical evidence suggests that CBD (cannabidiol) provides therapeutic benefits including analgesia in certain conditions.
  • These therapeutic benefits can improve one’s quality of life (QoL).((Argueta, D. A., Ventura, C. M., Kiven, S., Sagi, V., & Gupta, K. (2020). A balanced approach for cannabidiol use in chronic pain. Frontiers in pharmacology, 11, 561.))
  • Chronic pain affects 50-100+ million American adults.((Committee on Advancing Pain Research Care and Education, B. O. H. S. P., I. Stitute of Medicine (2011). a Call for Cultural Transformation of Attitudes Toward Pain and Its Prevention and Management. J. Pain Palliat Care Pharmacother. 25 (4), 365–369. doi: 10.3109/15360288.2011.621516))
  • Many people may develop tolerance to conventional medical treatments suffer adverse effects from widely used medications and interventions. Many of these medications can be highly addictive.((Labianca, R., Sarzi-Puttini, P., Zuccaro, S. M., Cherubino, P., Vellucci, R., Fornasari, D. (2012). Adverse Effects Associated With Non-Opioid and Opioid Treatment in Patients With Chronic Pain. Clin. Drug Invest. 32 Suppl 1, 53–63. doi: 10.2165/11630080-000000000-00000))
  • In a mixed cohort of patients suffering from intractable pain due to multiple sclerosis, spinal cord injury, brachial plexus injury, and limb amputation, CBD treatment significantly reduced pain on a visual analog scale (VAS).((Wade, D. T., Robson, P., House, H., Makela, P., Aram, J. (2003). A Preliminary Controlled Study to Determine Whether Whole-Plant Cannabis Extracts Can Improve Intractable Neurogenic Symptoms. Clin. Rehabil. 17 (1), 21–29. doi: 10.1191/0269215503cr581oa))
  • In patients with fibromyalgia, CBD treatment decreased pain by more than 30% in significantly more patients than placebo.((Van De Donk, T., Niesters, M., Kowal, M. A., Olofsen, E., Dahan, A., Van Velzen, M. (2019). An Experimental Randomized Study on the Analgesic Effects of Pharmaceutical-Grade Cannabis in Chronic Pain Patients With Fibromyalgia. Pain 160 (4), 860–869. doi: 10.1097/J.Pain.0000000000001464))
  • CBD has been indicated to be safe for prolonged use and accompanied by self-reported improvements in pain and QoL.((Gulbransen, G., Xu, W., Arroll, B. (2020). Cannabidiol Prescription in Clinical Practice: an Audit on the First 400 Patients in New Zealand. BJGP Open. doi: 10.3399/Bjgpopen20x101010))
  • More than half of patients in one study were able to reduce their opioid dependency after adding CBD extract to their regime. 94% of CBD users reported QoL improvements. Therefore, CBD could significantly reduce opioid use and improve chronic pain and sleep quality among patients who are currently using opioids for pain management.((Capano, A., Weaver, R., & Burkman, E. (2020). Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgraduate medicine, 132(1), 56-61.))

Occupational Therapy Practice

  • As occupational therapists aim to provide a holistic approach to treatment of various conditions, CBD can be an alternative form of therapy if legal in the state that you practice in.
  • Measures and tools such as the COPM, visual analog scale, pain scale, pain diary, quality of life scales, and specific scales for occupations (e.g., AMPAC 6 Clicks, Barthel Index) can be used for various conditions in conjunction with CBD as an intervention for pain, sleep, and mood.
  • CBD (without THC) can be purchased in many retail stores and online legally (as of this post’s writing).
  • CBD can work alongside many other therapies and medications, e.g., OT, PT, chiropractic, bodywork, massage, yoga, etc.
  • The therapeutic effects of CBD can promote sleep and rest, a vital occupation.
  • Check with your team and facilities guidelines and regulations if your patient or client can take CBD as an intervention.

My Story with CBD

As an occupational therapist who suffers from chronic pain, I looked to many options in the beginning. I went to outpatient physical therapy, regular chiropractic adjustments, massage, over-the-counter pain medications…none seemed to work – at least over a long period without an extinction effect. My wife’s midwife suffered a similar condition as me and introduced me to the world of CBD. I tried several brands: Wana, Nuleaf, and CBDistillery. All of these 3 US-based brands are lab tested (with results you can see for your batch). But the one that worked the best in terms of potency and therapeutic effect was CBDistillery.

Currently, I regularly use CBDistillery’s CBD tinctures to not only help with my chronic pain, but also to promote sleep, relaxation, and to overall wellness for my endocannabinoid receptor system. I personally recommend trying this product if you are in a similar situation. Of course, everyone’s body reacts differently, but if you are exploring CBD for your clients or even your own health, I suggest* you try this brand first.

If you have any questions, such as taking CBD while you are pregnant or breastfeeding, consult with your physician or pediatrician for input.

Stay well and have a nice day!

*This is not medical advice.