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To CBD or To Not CBD?

CBD:

- Does not give a high

- Has anti-inflammatory and anti- anxiety potential

- It comes in oils, tinctures, topically, lattes and cocktails

- US Hemp Authority– Certification program to guide consumers

- Very limited scientific research for side effects and efficacy

- Interaction with NSAID, Coumadin, and Cortisone

- Topical may be effective in Arthritis of the knee (recent research)

The arthritis foundation says:

“Cannabidiol (CBD) is a plant based compound that has grown in popularity over the past several years, especially among individuals seeking relief from chronic pain. However there is a lack of scientific data regarding the safety and efficacy of CBD- based products, as well as uncertainty about their legality.”

““While CBD is controversial and its effectiveness inconclusive, people with arthritis aren’t waiting to try to treat their pain’” Cindy McDaniel, MBA, Senior Vice President, Consumer health and Impact, Arthritis Foundation, Atlanta, GA, said in a press release. “To help gain a deeper understanding about how people with arthritis feel about using CBD, we conducted a national survey in July. Our survey results confirmed they need to push for more regulation and provide useful CBD guidance.””

1.CBD may help patients with arthritis alleviate their pain, anxiety, and insomnia; however, it is important to remember that no rigorous clinical trials have been conducted among this population to confirm the efficacy of these products

2. Although no major safety issues have been discovered regarding the use of moderate doses of CBD, potential drug interactions have been identified

3. CBD should never be used in place of disease-modifying anti-rheumatic drugs that may prevent permanent joint damage in inflammatory types of arthritis.

4. Patients should discuss the use of CBD with their physicians beforehand, and should schedule follow –up visits every 3 months, as they would the start of any new treatment.

5. Patients using CBD should start with a low dose and only increase the amount as needed on a weekly basis.

6. CBD should only be purchased from reputable companies that test each batch for purity, potency, and safety, using an independent laboratory and providing a certificate of analysis.

CBD is in a grey zone. We are intrigued by the potential of CBD. Right now, it appears to be fairly safe and might help certain types of pain. It’s far better to give this guidance, even preliminary, because otherwise people will have no guidance whatsoever.

-Rheumatology practice management vol. 1, number 1, October 2019