Cannabidiol and arthritis – a consultant’s view

If you are thinking about trying cannabidiol, or CBD, it's important to find out exactly what the potential benefits and risks are first. Dr Martin Lee advises

Cannabidiol (CBD) is one of many chemicals found in the cannabis plant (Marijuana). It is not classed as a controlled drug under the Misuse of Drugs Act in the UK and CBD oil has become widely available in pharmacies, high street shops and on-line.

CBD won’t get you high because it doesn’t contain THC (tetrahydrocannabinol). THC is the psychoactive component of cannabis and is also the component of cannabis that is thought to be associated with addiction and potentially psychosis.

In my opinion, there is no scientific evidence that suggests that CBD is useful for controlling inflammation and preventing joint damage in arthritis and therefore should not be used for these reasons.

It has been claimed that CBD oil has a number of medicinal properties and could be useful in treating conditions such as arthritis. In my opinion, there is no scientific evidence that suggests that CBD is useful for controlling inflammation and preventing joint damage in arthritis and therefore should not be used for these reasons.

There is some evidence suggesting that CBD could potentially be beneficial for certain types of pain, termed neuropathic pain (Mücke et al. 2018). Neuropathic pain is pain caused by either nerve damage or abnormalities in the area of the brain involved in pain perception. Neuropathic pain is the sort of pain that people with conditions like fibromyalgia may experience. However, CBD has not got a medical licence for pain in the UK and therefore cannot be prescribed by your doctor.

There are also some other issues you need to be aware of. The CBD you can buy from shops or online is not regulated. That means that there is lack of consistency in what you get. During the purification process in which CBD is produced, it is very difficult to get rid of all the THC and therefore you can’t be sure how much THC the CBD oil that you are buying contains.

Companies that produce unlicensed CBD oil (that is freely available) aren’t properly regulated (or even regulated at all!) in how much THC their CBD oil contains. It could even contain enough THC to be illegal! Essentially this means that there is a lack of consistency between brands that you can purchase and even between batches of the same brand. Even buying products that are marketed as ‘pure CBD’ does not guarantee that they will be of good quality or safe.

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There is one pharmaceutical company that produces a ‘pure’ CBD product (Epidiolex) that is going through the licensing process in the UK. However, this will only potentially be licensed for a few conditions, such as rare forms of severe childhood epilepsy, and currently is extremely expensive so your doctor will not be able to prescribe it for pain.

In summary, most CBD products will contain some THC. The main risks of THC include psychosis and addiction. Generally, the more THC the product contains, the greater the risks are. Cannabis bought illegally off the street, where the quality, ingredients and strength are not known, is the most risky form to use.

Mücke M et al. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Databases Syst Rev. Mar 7, 2018.

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