Category Archives: Cannabidiol (CBD) Oil

Cannabidiol (CBD) – ‘Cannabis With the Fun Bit Taken Out’ – For Severe Chronic Pain

Feature Image sourced from:  https://www.cannadish.net/cbd-oil-benefits

Dear Pain Matters blog readers,

Today’s blog post will focus on a particular cannibinoid molecule called cannabidiol (CBD).

Cannabidiol offers many medicinal benefits including pain relieving, mild anti-inflammatory, antioxidant and neuroprotective benefits.

Contrary to widespread belief, cannabidiol (CBD) treatment results in NIL psychoactive effects.  Hence it is impossible to get ‘high’ on cannabidiol (CBD) alone.  Some people even jokingly refer to cannabidiol (CBD) as ‘cannabis with the fun bit taken out’.

Introduction

The cannabis plant species (that includes marijuana and hemp plants) comprise up to 144 different phytocannabinoids (ie cannabinoids).  Different plant strains contain different combinations of cannabinoids.  These cannabinoids act on cannabinoid receptors throughout the body and brain.  These cannabinoids include a non-psychoactive molecule, cannabidiol (CBD), as well as a psychoactive component, tetrahydrocannabinol (THC).  

Different cannabis plant species (ie marijuana and hemp plant strains) offer different CBD:THC ratios.  For example, industrial hemp contains less than 0.3% THC levels.

It is important to note that when isolated, the CBD molecule is the same, regardless whether it is isolated from marijuana or female hemp.  As such, CBD (in its purest molecular form) does not exert any hallucinogenic effects, regardless of its source.   

Quoting Franjo Grotenhermen, International Association of Cannabinoid Medicines:

“CBD is CBD. The human body does not care where the molecule comes from.

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Diagram of the CBD molecule is sourced from:

https://www.thecbdistillery.com/hemp-cbd-versus-marijuana-cbd/

Cannibidiol use does not lead to addiction and there is virtually nil toxicity (hence minimal side effects).  Cannabidiol is well tolerated and can be taken alone or with other medications (with nil CBD-attributable side effects).  Inclusion of CBD in pain management can lead to reduced intake or complete cessation of other pain medications (hence reducing or eliminating all of their adverse effects).

Cannabidiol can reduce ongoing pain in arthritis, rheumatoid arthritis, nerve pain, cancer pain, back pain, knee pain, fibromyalgia and other debilitating chronic pain conditions via its strong anti-inflammatory and other biological effects.  

Not only does cannabidiol promote relaxation and calmness, but it may also alleviate certain symptoms of insomnia, menstrual pain, depression, mood problems, anxiety, fear, post traumatic stress syndrome (PTSD) and Parkinson’s disease (including significant reduction of tremors as well as improved swallowing and talking) (Barton, 2017).  Cannabidiol may ameliorate chemotherapy-induced nausea and vomiting, spasticity, epileptic seizures as well as certain symptoms of multiple sclerosis (MS) and Alzheimer’s.  Cannabidiol may be a useful adjunct to palliative care.  

Cannabidiol’s neuroprotective and other biological effects are invaluable following a stroke (Hayakawa et al, 2010), bone fracture (Kogan et al, 2015) or against Paclitaxel-induced neurotoxicity (Likar and Nahler, 2017).  A CBD-based study is currently underway to investigate CBD’s potential effects on malignant brain tumours in children.  This study was inspired by a 4-year old boy whose potentially fatal brain tumour shrunk by 66% after being given CBD and going on a low carbohydrate (ketogenic) diet (Grundy, 2017; Marsh, 2017; Waugh, 2017).   

Hops-Derived CBD (vs Cannabis- or Hemp-Derived CBD)

Researchers are now able to isolate CBD from hops.  Given that hops is not associated with the same stigma that cannabis- or hemp-derived CBD may still have, doctors may be more willing to prescribe hops-derived CBD for pain (in countries where CBD is legal).

https://isodiol.com/isodiol-news/civilized-life-reports-scientists-develop-non-cannabis-cbd-hops/

https://www.civilized.life/articles/scientists-have-developed-a-non-cannabis-cbd-product-made-out-of-hops/

Given that CBD in its purest form is ‘only’ a molecule , it is irrelevant whether CBD is derived from hemp, cannabis, hops or otherwise.  As stated above,  

“CBD is CBD. The human body does not care where the molecule comes from.” 

Nano-Amplified Cannabidiol (CBD)

Researchers are now able to reduce the size of CBD molecules by 100 times (down from their original size of 2,000 nanometers) via a process called ‘Nano-Amplification’ (ie nano-emulsification of CBD).  Being as small as 16-20 nanometers across, these Nano-Amplified CBD particles may be more easily be absorbed by human cells than unaltered large, fat-soluble CBD molecules, leading to greater bio-availability of CBD.  

https://isodiol.com/isodiol-news/cbd-isolate/

Adult-Onset Still’s Disease (AOSD)

Excess levels of the pro-inflammatory cytokine IL-1β play a major role in Adult-Onset Still’s Disease (AOSD), a systemic autoimmune disease that often presents with persistent high spiking fevers, joint pain and salmon-colored bumpy skin rashes.  Recent treatments of AOSD include Canakinumab and Rilonacept (ie IL-1β blockers) (Giampietro and Fautrel, 2012).  

A study showed that when mice with MS-like symptoms were treated with CBD, they had decreased IL-1β and other pro-inflammatories (compared to mice who did not receive CBD treatment) (Mecha et al, 2013).

A question: Would CBD treatment that strongly inhibits IL-1β and other pro-inflammatory cytokines in mice similarly benefit AOSD patients (where excess IL-1β levels also appear to be a problem)?  If yes, what CBD dosage would be effective?  Investigation may be warranted.    

How to Use Cannabidiol (CBD)

Cannabidiol products are available as capsules, tinctures, infused edibles, syrups, teas, chewing gum, extracts, isolate and topical creams and ointments (that allow CBD to be directly absorbed through the skin).  Each product has its own method of dispensing (eg. via ingestion, inhalation via vapourizer or e-cigarette).  To obtain the full benefits of CBD, one should always read the instructions.  

Cannabidiol is also available as CBD oil that can be sublingually applied.  Sublingual application of CBD involves the placement of multiple drops of CBD oil under the tongue.  This allows CBD to be quickly absorbed into the bloodstream via the mucous membrane in the mouth, thus bypassing the digestive system and liver.

Some CBD products are more effective than others, depending on CBD purity (see next section involving the Austrian study for a discussion on CBD purity).  Extraction methods, plant strains and application methods may also influence CBD’s effectiveness.  

Correct dosages are important.  Dosages may have to be titrated until therapeutic benefits including pain relief are achieved.    

The application of CBD oil is somewhat similar to that of cannabis-derived Sativex (Nabiximols), although the latter is sublingually applied via mouth spray.  There is one crucial difference between CBD and Sativex, being that Sativex comprises both CBD and THC, roughly on a 1:1 ratio, while CBD oil comprises negligible amounts of THC.

Note: Sativex was also discussed in 2 earlier blog posts: 

https://painmatters.wordpress.com/2017/04/10/lets-talk-to-an-inspirational-young-woman-paula-orecklin-about-crps-sativex-physiotherapy-and-neuroplasticity

and here:

https://painmatters.wordpress.com/2016/09/22/medical-cannabis-medical-marijuana-and-nerve-pain

A CBD-Based Medical Study in Austria

The Study

Prof Dr Rudolf Likar, MSC, performed a study involving 9 severe pain patients in Austria.  Four patients were unable to complete this study for various reasons, while the remaining 5 patients completed the study. 

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Prof Dr Rudolf Likar, MSC

Head of Anaesthesiology and Intensive Medicine, Klinikum Klagenfurt, Austria

General Secretary of Österreichischen Schmerzgesellschaft (ÖSG; Austrian Pain Society)

Photo sourced from:   https://www.facebook.com/Dr.Likar/

The severe pain patients in Dr Likar’s study were offered 2 ‘200 mg CBD’ capsules, twice a day after meals (one in the morning and one at night, totalling 400 mg CBD daily), in addition to their usual medications.  

Made by a pharmacist in Velden, Austria, the CBD capsules contain CBD in its purest form (purity exceeding 99.5%) that has been isolated from industry hemp grown in the UK.  Pure CBD, in its crystalline (powder) form, is dissolved in hemp oil and heated up to temperatures not exceeding 50 degrees C (to preserve CBD’s bioactivity) (Likar, 2016; also see the excellent video in German, below, from 2:30 minutes on).    

The 5 patients including 3 males were aged 49 to 79.  Three patients had cancer (multiple myeloma, urothelial carcinoma and breast cancer), one patient (49) had fibromyalgia and one patient (52) suffered various painful conditions including brachialgia, cervico-cephalgia, thalamic pain and dental pain.

After 1 month of CBD treatment, the urothelial carcinoma patient (53) no longer suffered any pain.  Post-CBD, he stopped taking Fentanyl patches, Neodolpasse, Vendal and Lidocaine infusions.  His pain was completely managed via CBD and 150 mg Lyrica/day (down from 300 mg Lyrica/day).

After 4 months of CBD treatment, the fibromyalgia patient (49) enjoyed significantly less pain (from VAS = 8 to VAS = 3).  She was able to reduce her Oxygerolan medication by 33% as well as stop all her other pain medications.  

After 6 weeks of CBD treatment, the breast cancer patient (74) no longer had nausea and was, for the most part, pain-free.  Her Hydal intake was reduced by 33% daily and all her other pain medications were stopped.

After only 1 week of CBD treatment, the multiple myeloma patient (79) enjoyed pain reduction from 9 to 6 (VAS) and was consequently able to reduce his Lyrica intake.  His quality of sleep also improved.

After 2 months of CBD treatment, the patient with several painful conditions (52) had reduced pain levels and better quality of sleep.  She was able to reduce some of her medications. 

In summary, there were no psychoactive effects nor side effects resulting from the CBD treatment.  There was no risk of addiction and the CBD treatment was well tolerated as a co-medication (Likar, 2016).     

Dosing

In order to derive optimal medicinal benefits from CBD treatment, it is perimount that CBD (in its purest form) be offered on a 20:1 ratio (or greater) with THC.  Otherwise, there is a risk that CBD’s unique effects including pain relief may not occur (due to ‘CBD underdosage’) (Likar, 2016).

In comparison (as noted in the Introduction), Sativex comprises relatively equal amounts of CBD and THC on a ~1:1 ratio.  Precisely, each 100 microlitre spray contains 2.5 mg CBD and 2.7 mg THC (ie CBD and THC on a 1.00:1.08 ratio) (plus up to 0.04 g alcohol).

Dr Likar noted that in the presence of an equal amount of THC, CBD underdosing may result – that may lead to reduced and/or nil CBD-induced pain relief.  Thus, a significantly higher CBD to THC ratio (for eg, 20:1, or greater) is a prerequisite before CBD’s unique medicinal benefits can be optimally achieved (Likar, 2016).

The following YouTube (in German) includes interviews with Prof Dr Rudolf Likar and several pain patients:

Here in this video, Dr Likar noted that some pain patients may require daily CBD dosages up to 400 mg – 600 mg (half in morning and half at night) to derive optimal pain relief (refer to 2:25 minutes), while others may not benefit from CBD treatment.

Anecdotal Case Studies   

(1) Laura Bryant of Australia – Cannabidiol (CBD) Oil for Severe Arthritis Pain Including Ankylosing Spondylitis 

Laura Bryant (20) from Canberra, Australia, suffers from severe arthritis including painful ankylosing spondylitis.  Stress (eg due to university studies) and cold weather are enough to bring on flares, painful joints, aching hands and feet as well as skin blotches.  At times her pain is so bad that she relies on an elbow crutch for mobility.  

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Laura Bryant (20) at home in Canberra, Australia (2015) 

Credit: Jay Cronan, Fairfax Media/The Canberra Times

Prior to discovering the pain-relieving benefits of CBD oil for her painful ankylosing spondylitis, Laura used to ingest a fistful of pills, crawl into the bathroom and soak in a hot bath for 2 hours while waiting for the stabbing, knife-like, pain in her back and hips to finally ease up just a bit.  On a good day, she would finally be able to leave her room just in time for a 20-30 minute lunch (assuming that she could eat in the first place due to all the pain pills that messed with her appetite).  After lunch, her mother had to help her back into bed where she had to lie horizontal due to excessive pain.  Laura spent entire days and weeks watching television.  It was simply too difficult to read given all the pills that she was taking.  This routine continued for 3 years as her ankylosing spondylitis worsened.

One day, she counted 28 daily pills including Oxycontin!  ‘Wow, 28 pills every day?’, she thought to herself.  There were pills for breakfast, lunch and dinner.  In fact, there were so many pills that they made her sweat turn orange.  Her appetite suffered drastically.  The worst part of this story was that her daily cocktail of 28 pills did not even effectively manage her severe pain!

Laura endured more than 10 hospitalizations due to excessive pain.  Laura even fainted on the hospital floor due to excessive painful stabbing in her vertebra.  Despite this, she would rate her pain as ‘only a 7’.  This is because she feared that if she rated her pain levels any higher, they might accidentally overdose her on morphine again.  She feared being in a wheelchair again with tubes coming out of her nose.

Laura tried many pain treatments including a treatment involving a 30 cm-long spinal needle with a 45 degree bend.

One day, her specialist said to her (after discussing her ongoing cortisone and biological injection treatment protocol):

“If this doesn’t work, I’m afraid this is pretty much it … You’re on everything we can give you.  There are no more treatment options … I’m afraid, I’ve run out of options … This is going to be your life.”

Laura sobbed after hearing her hopelessly grim, long-term prognosis from her specialist while her dedicated parents looked on helplessly.

Depression soon set in.  She would stare at her Oxycontin pills and think:

“Why not just take a couple of extra and be done with it?”

One sad day, Laura begged her mother, Bernadette, to ‘put her out of her misery’ and ‘help her end it all’.

On another day while driving to Sydney with her family, doubled up in pain in the back seat of the SUV, Laura wailed out in pain,

“I don’t want to do this anymore.  I can’t do this.  I can’t do this!”

Laura’s 16-year old brother tried to comfort her in the back of the SUV by saying, “It’s going to be OK.”  But even he could not stop his own tears from streaming down his face.  Bernadette quickly stopped the vehicle to a safe side of the road.  It was pouring rain and dark outside.  Regardless, Bernadette hurried outside to the back of the SUV to locate the Valium that would sedate Laura as quickly as possible, all the while listening to her daughter scream out, “Just give them to me!”  

Seeing her daughter in so much pain, suffering and agony was almost too much for Bernadette to handle…

Warning:  Under-treatment of severe chronic pain often leads to thoughts of suicide, and Laura was certainly no exception.  Sadly, many who despair due to excess pain actually do go through with suicide.  Clearly, timely access to effective pain treatment options (whether this is CBD or another pain treatment option) is paramount.   

Finally, A Trickle of Hope Turns Into A Tsunami of Pain Relief

One day while lying in bed, a television show appeared about a Colorado-based company called Charlotte’s Web.  This company offered a strain of cannabis that promised low-psychoactive effects.  The show added that some arthritis sufferers were now obtaining relief from this strain of cannabis.

Wasting no time, Laura immediately emailed the company, Charlotte’s Web:

“… I’m in Australia … can you give me any advice or put me in touch with people here? I’m desperate.”

Several weeks later, Laura received her first supply of CBD oil.  Laura’s daily pill intake was reduced shortly afterward, as was her time spent in bed and in the hot bath.  Within 2 weeks, her pelvis became less stiff.  Consequently, she no longer needed her long, hot baths and she removed her shower chair and toilet aids from the bathroom.  She also started eating breakfast at a normal time.

Laura started working out with a personal trainer each week.  One day, she started playing Oztag.  Another day, she was finally strong enough to take her nephew to the park to play … and her sister was so overwhelmed that she cried with joy.  Laura even started dreaming about her life goals and travel plans again.

Laura now uses several drops of CBD oil under her tongue every morning to manage her painful ankylosing spondylitis.  Laura states,

“[Medicinal cannabis] has given me my life back [after years of severe pain] and doctors aren’t recognising it” (Hannaford, 2015; Brown, 2016).

For more details, please read:

http://www.canberratimes.com.au/interactive/2015/cannabis-and-pain/

This article also includes an excellent 4-minute video called ‘Forbidden Healing’ (Credit: Jay Cronan, Fairfax Media, 2015).

(2) Hope Bobowski of Canada – Cannabidiol (CBD) Oil for Severe Osteoarthritis Pain in Back  

Hope Bobowski (79) of Keremeos, BC, Canada, is spreading her own very special message of hope and joy around.  Until June 2016, Hope suffered from severe osteoarthritis pain in her back.  Her pain was so severe that her husband had to assist her to and from bed, dress her and take over the cooking.  In her words,

“I was going downhill fast.”

Hope was taking 4 – 6 ‘Tylenol 3’ codeine-containing pills daily for her intense osteoarthritis pain.  When her GP suggested trying opioid painkillers, she was worried about becoming addicted.

In June 2016, after her husband located CBD oil from an unlicensed producer, Hope tried her very first spoonful of CBD oil.  Guess what happened next??  Only one day after taking 10 drops of CBD oil, she had nil pain in her back!  In her own words,

“There was no pain.”

Since taking her daily spoon of CBD oil just before going to sleep, Hope was able to cease taking all pharmaceutical painkillers.  Hope has nil psychotic effects from the CBD oil due to its virtual absence of THC.  Best of all, Hope no longer suffers from back pain and is now able to sleep without leg cramps.   

Thanks to her daily dose of CBD, Hope was able to return to gardening, card games and cooking for her beloved great-grandchildren.  Life could not be better for Hope (Barton, 2017)!   

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Image of Hope Bobowski with her beloved grandchildren

Credit: Jeff Bassett, The Globe and Mail

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Image of Hope Bobowski at home in Keremeos, BC, Canada, on April 2017

Credit: Jeff Bassett, The Globe and Mail

(3) Deryn Blackwell of the UK – Cannabis Tincture for Severe Cancer Pain 

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Image of Deryn Blackwell with his devoted mother, Callie  

Credit: This Morning/Youtube  

Deryn Blackwell underwent chemo- and radiation therapy following his diagnosis of leukemia in 2010 (when he was only 10).

Two years later, Deryn (by then, aged 12) was also diagnosed with Langerhans cell sarcoma, a very rare form of cancer with very poor prognosis.  Deryn’s treatment for Langerhans cell sarcoma included countless additional chemo- and radiation therapies, 3 failed bone marrow transplants plus a 4th (and final) bone marrow transplant. 

On Day 46, post-4th transplant, and believing that he was terminally ill anyway, Deryn decided that he no longer wanted to live anymore.  After all, he had already undergone 4 years of treatment, he was very sick and in a lot of pain (despite painkillers including morphine and fentanyl), he hadn’t been able to eat for 7 months, his mouth was covered in blisters, he could not swallow and his body had wounds that were simply not healing.

Deryn even went so far as to plan his own funeral.  However, Deryn’s mother, Callie, was not ready to give up on her son yet …    

While his cancer was successfully eradicated, his immune system was now severely compromised.  According to his mother, without antibiotics, morphine and fentanyl, Deryn would only be able to survive 3 – 7 days at best unless Deryn’s 4th bone marrow transplant finally succeeded.  Unfortunately on Day 70, his blood tests still showed ‘nothing in his bone marrow’, indicating that his 4th transplant was failing.  Deryn was running out of options and his prognosis did not look good.  

Enter Cannabis Tincture …

By  now, Callie had read a lot about the medicinal benefits of cannabis oil.  She asked the doctor to add Bedrocan, a cannabis-based pain reliever, to Deryn’s hospital medication.  The doctor said that she was unable to do this as Bedrocan was not licenced for children in the UK.

Desperate and completely out of (legal) options, Callie gave a cannabis tincture under the tongue (sublingually) to Deryn for the first time at the end of Day 70 (with Deryn’s consent, but without the doctor’s knowledge).  After all, Callie thought, what did she have left to lose?  Her son was dying anyway.

Guess what happened next??

Within only 30 – 60 minutes of his first cannabis oil treatment, Deryn felt completely relaxed for the first time in a long time.  His anxiety had stopped.  Five (5) days later on Day 75, his overall health and well-being had improved significantly including his wounds on his injured fingers that had disappeared altogether within a mere 5 days.  The now-healed wounds on his fingers had been bandaged only 5 days earlier, on Day 70 – the same day when his blood tests still showed absolutely ‘nothing in his bone marrow’.

In her opinion, Callie’s decision to secretly add cannabis tincture to Deryn’s treatment protocol on Day 70 was the key turning point for Deryn.  It was the cannabis tincture that had (somehow) stimulated the 4th failing bone marrow transplant into finally becoming a success. 

And now, thanks to the cannabis tincture, Deryn is finally 100% painfree and healthy.

To celebrate this significant milestone, Callie wrote a book called ‘The Boy in 7 Billion’ (available in Amazon).

Here’s the video link dated 27 March 2017:

Credit: This Morning/Youtube

(4) Other Comments and Testimonials About CBD 

Phil Schwarz 

Born in Scotland, Phil Schwarz (82) suffered painful rheumatoid arthritis (pain levels up to 7) for many years.  One day a family member encouraged her to try CBD (nicknamed ‘cannabis with the fun bit taken out’) for her severe pain.  Phil started taking two 15% raw hemp oil drops, three times a day (without changing her other medication).  Quoting Phil:

“So the first time I took some was at night time before I went to sleep. The next day I was out of bed like a spring chicken and I’ve been pain free ever since’  ‘I’ve just been out and I’ve walked about ¾ of a mile’ … ‘before I couldn’t do about a hundred yards. It’s like a miracle worker, and I don’t care if it’s in my head or in a bottle, whatever it is, it’s doing it”.

For the story, please click:

CBD Made Me Pain Free, Now I’ll Have to Break the Law to Get It

https://www.endoca.com/blog/cbd-made-pain-free-now-ill-break-law/

Wendy Primeau

Wendy Primeau suffered fibromyalgia, Lupus, rheumatoid arthritis and a painful and deteriorating spine.  She took Hydrocodone for almost 5 years, and occasionally, she also took Vicodin, Roxicet and Perkicet.  Only 6 hours after trying a high dose of CBD oil, she was pain-free.  Quoting her:

“My husband was worried, and asked me said what was wrong. I just kept crying because I was so happy, I couldn’t believe it, but I was pain free for the first time in YEARS.

https://www.endoca.com/blog/community-stories-wendy-primeau-part-1/

David Wells

David Wells, a former pitcher in Major League Baseball, has endured many painful episodes over his career.  He tells his story here:

Other Stories

For more stories, see:

https://www.marijuanabreak.com/best-cbd-oils-pain-relief

Quoting ‘Peter’ on 9 February 2018:

Buy it over the internet. I had 7 vertebrae fused in my neck 3.5 years ago, which popped up as a problem when my lower back was so bad that after 20 years of drugs, injections, and booze I was ready to get that operated on. Was in agonizing lower back pain in addition to the post-cervical operation pain. Two sprays under the tongue and 5 minutes later [pain] was gone. Haven’t even taken an Advil since, stopped drinking too. I spray twice a day, and when I don’t, pain comes back after a couple days, so I know it is working. No side effects whatsoever!”

Here is another link describing many pain patients’ experiences with CBD (in German only, for German readers):

CBD-Erfahrungsberichte

http://cbd360.de/erfahrungen/

Peer-Reviewed Science Papers

So what does the science say about CBD for pain and inflammation?

A study found that decreased leukocyte (white blood cell) migration was observed in the injured lungs of CBD-treated mice for up to 4 days following lung injury.  A reduction in leukocyte migration into these lung regions resulted in less leukocyte activation as well as reduced pro-inflammatory mediators including TNF and IL-6 in CBD-treated mice.  This can lead to lower tissue damage and enhanced tissue regeneration.  It is likely that CBD’s anti-inflammatory effects occur via enhanced adenosine release as well as increased signaling via the adenosine A2A receptor (and other biological mechanisms).  Other studies showed that CBD can decrease the production and release of IL-1β and IL-6, together with other anti-inflammatory effects (Ribeiro et al, 2012; Pisanti et al, 2017).

Mice with MS-like symptoms that underwent CBD treatment had reduced IL-1β and other immunoregulatory actions, and that this likely occurred via increased A2A adenosine receptor signalling (Mecha et al, 2013; Pisanti et al, 2017).

Another animal study found that transdermal CBD decreased inflammation and pain behaviours in rats with arthritic-like symptoms.  Specifically, there was a dose-dependent reduction in pro-inflammatory cytokines including TNF (up to an optimal dose of 6.2 mg CBD/day for 4 days).  The rats did not display any psychoactive effects.  The results of this study suggest that topical (skin) applications of CBD may offer localized pain relief and reduced inflammation with minimal side effects in arthritis patients  (Hammell et al, 2016).

Further details pertaining to medicinal cannabis including CBD are available in many papers (Likar and Nahler, 2017, and other science papers).

Many videos on CBD also exist including this YouTube link (in English, with German subtitles):

Is Cannibidiol (CBD) Oil Legal in Australia?  

A friend with back pain just asked me where he could legally buy CBD oil in Australia.  This section tries to answer his question as best as possible:

First, the good news:

Yes, in theory, CBD oil is now legal in Australia.  Cannabidiol is now listed as a ‘Prescription Only Medicine’ in Australia.

Specifically, after 1 October 2017, CBD Oil (Full Spectrum CBD Oil Extract) was classified as a ‘Schedule 4 – Prescription Only Medicine OR Prescription Animal Remedy’.  Thus, assuming you can find a doctor who will prescribe CBD oil, it is now legal.  

And now, the bad news:

There may only be 23 Paediatric Neurologists in all of Australia who are actually authorised to prescribe to children with neurological conditions.  (Don’t quote me on this one though.) 

https://eternalplants.com.au/is-cbd-oil-legal-australia/

If this is true, what can the adult chronic pain patients in Australia do if they would like to legally obtain the non-pyschoactive and non-addictive CBD oil for pain relief??

Chronic pain is a serious issue.  It is one thing to legalize CBD oil.  It is another thing to then unnecessarily delay legal access to it, for whatever reasons.  The current situation is simply unacceptable.  More has to be done to ensure that chronic pain patients in Australia can obtain a prescription for CBD from their doctor, should they wish to do so.  For the sake of chronic pain patients all across Australia, this issue needs to be sorted out as a matter of highest priority.  

For more information, please refer to these articles:

(1) Medical Cannabis Process Still “Heavily Laden With Red Tape” and Hard to Navigate: AMA (1 March 2017)

http://www.abc.net.au/triplej/programs/hack/medical-cannabis-doctors-respond/8314222

(2) Is Cannabidiol (CBD) Oil Legal in Australia? (updated Feb 2018)

https://eternalplants.com.au/is-cbd-oil-legal-australia/

Please read the following section for Switzerland’s more enlightened approach to CBD:

Switzerland and Cannabidiol (CBD)

In Switzerland, chronic pain patients no longer have to obtain a medical prescription to buy CBD as long as it contains less than 1% THC.  After all, the Swiss authorities acknowledge that psychoactive effects can not arise in the first place if THC content is less than 1%.  Furthermore, because CBD does not compromise mental clarity, it does not increase the risk of falls in seniors.  Equally important, the Swiss authorities accept that (unlike opioids), CBD is not addictive. 

Cannabidiol legalization helps to remove the stigma and adverse social consequences related to its use.  People who use CBD for medicinal purposes only are often mistakenly accused of simply wanting ‘an excuse to get high’.  In actual fact (as already stated), CBD has nil psychoactive effects.    

By allowing CBD containing less than 1% THC to be legally available without a prescription, greater pain treatment options are now available in Switzerland. 

A question:

Why are there so many diverse approaches to the legalization of CBD between different countries?  Can we learn anything from Switzerland, Austria and other countries whose pain patients are able to legally access CBD, with or without a prescription, more easily than in Australia?  Finally, are we doing the best that we can for pain patients in Australia?  If not, why not??  

Summary

Some doctors believe that CBD’s medical benefits are ‘purely anecdotal in nature’ and that more CBD research is needed.

However, there is a growing number of medical practitioners that recognize CBD’s medicinal benefits including pain relief.  Daily CBD use does not result in any psychoactive effects (given its virtual absence of THC), tolerance nor other adverse effects.

Many patients including Laura Bryant, Hope Bobowski and Deryn Blackwell say that, based on their own personal experiences, they have all the evidence they will ever need that CBD offers effective pain relief for their chronic pain.  

In Hope Bobowski’s words,  

“I’m spreading the word.”

In Laura Bryant’s words (quoting),

“The medical system failed me.  The hospitals failed me.  There are medical journals out there supporting the use of medical cannabis.  Why did I have to get to the point where my mother had to sedate me on the side of the road and my little brother had to go through that?  Why did I have to get to the point where I didn’t want to live anymore when there is a medication out there that has changed my life but I’m not supposed to have it? … 

I want to show the sceptics that I am not some 20-year-old stoner with no job.  [CBD oil has] given me my independence back.  I didn’t have to go through that guilt!”

” … this is a medicine and … it has given me my life back.  I want them to know that without it, I will go back to the way I was, and even if my condition isn’t life-threatening, the side effects of it are.

While CBD (containing less than 1% THC) may not work for everyone, the first and foremost step is to allow legal access to CBD in the most acceptable, practical and expedient manner possible.  Switzerland, Austria and other countries have paved the way for pain patients to legally access CBD (with negligible THC content) via prescription or otherwise.  It is hoped that many more countries will find a humane and compassionate way to help ease the pain and suffering of its patients by offering as many pain treatment options as possible including CBD.

NB Please obtain proper medical advice and ensure compliance with local laws before using medicinal cannabis including CBD oil.

 

Here’s to Laura, Hope, Deryn and many other patients for sharing their inspiring stories that offer hope to other pain patients.

In Laura’s words, 

“…there is hope.  I want them to know not to stop trying.”

Thank you, Laura, Hope and Deryn for spreading hope!

Sabina Walker

Blogger, Pain Matters (in WordPress)

If you find this blog post helpful, please share this link via social media including Facebook.

REFERENCES

In English

Media

(1) Hoffman, Andy. A Swiss Startup Is Pumping Out Legal Hashish. Bloomberg (8 December 2017).

https://www.bloomberg.com/news/features/2017-12-08/a-swiss-startup-is-pumping-out-legal-hashish

(2) Swiss Oasis for Legal Cannabis, Without the High. The Local (14 April 2017).

https://www.thelocal.ch/20170414/swiss-oasis-for-legal-cannabis-without-the-high

(3) Killalea, Debra. AAP (22 February 2017).

Medical Marijuana Legal in Australia: What It Means for You

http://www.news.com.au/lifestyle/health/medical-marijuana-legal-in-australia-what-it-means-for-you/news-story/b61f0238f84be843855c20605bc17ed1

(4) Calvo, Amberley. How Does Cannabidiol (CBD) Work? Elixinol (19 August 2015).

https://elixinol.com/blog/how-does-cannabidiol-cbd-work/

(5A) Marsh, Sarah. Study Looks at Cannabis Ingredient’s Ability to Help Children’s Tumours.   UK Research into Cannabidiol (CBD) Comes After Surge in Parents Administering it to Children Without Medical Advice. The Guardian (3 May 2017).

https://www.theguardian.com/society/2017/may/02/study-cannabis-cannabidiol-cbd-ability-to-help-children-brain-tumours

(5B) Waugh, R. Four-Year-Old Brain Cancer Patient Sees Tumour Shrink – Thanks to Cannabis Oil. Metro News (3 May 2017). 

Four-year-old brain cancer patient sees tumour shrink – thanks to cannabis oil

(6) Isodiol – The World Leader in CBD

https://isodiol.com

Anecdotal Case Studies

(7) Barton, Adriana. Seniors turning to cannabis for relief – and businesses are all in. The Globe and Mail (20 April 2017).

https://beta.theglobeandmail.com/life/health-and-fitness/health/seniors-turning-to-cannabis-for-relief-and-businesses-are-all-in/article34760076/?ref=http://www.theglobeandmail.com&service=mobile

(8A) Hannaford, Scott. The Canberra Times (2015).

Pain, and a Future on Hold

http://www.canberratimes.com.au/interactive/2015/cannabis-and-pain/

(8B) Brown, Andrew. The Canberra Times (29 October 2016).

Medicinal Cannabis Now Legal After Law Change Comes Into Effect

http://www.canberratimes.com.au/act-news/medicinal-cannabis-now-legal-after-law-change-comes-into-effect-20161029-gsdmto.html

(9) Hussain, Danyal. Mother Who Gave Her Dying Son Cannabis to Ease His Cancer Symptoms Says It’s Saved His life And HERS After She Used It To Treat Her Depression. Daily Mail (4 February 2018).

http://www.dailymail.co.uk/news/article-5349749/Mother-gave-dying-son-cannabis-said-saved-lives.html

Medical and Science Papers

(10) Hammell DC, Zhang LP, Ma F, et al. Transdermal Cannabidiol Reduces Inflammation and Pain-Related Behaviours in a Rat Model of Arthritis. European Journal of Pain (2016); 20(6): 936-948.

doi:10.1002/ejp.818.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851925/pdf/nihms737474.pdf

(11) Mecha, M et al. Cannabidiol Provides Long-Lasting Protection Against the Deleterious Effects of Inflammation in a Viral Model of Multiple Sclerosis: A Role for A2A Receptors. Neurobiology of Disease (11 July 2013); 59: 141–150.

https://ac.els-cdn.com/S0969996113001939/1-s2.0-S0969996113001939-main.pdf?_tid=112c4b30-0439-452d-b7f4-ccbb039a1689&acdnat=1522893833_6b9a541d2bf01af00090396fad8b5d5f

(12) Ribeiro et al. Cannabidiol, A Non-Psychotropic Plant-Derived Cannabinoid, Decreases Inflammation in a Murine Model of Acute Lung Injury: Role for the Adenosine A2A Receptor. European Journal of Pharmacology (12 January 2012); 678: 78–85.

https://ac.els-cdn.com/S0014299912000052/1-s2.0-S0014299912000052-main.pdf?_tid=f06b8205-b148-4724-ac0c-a5e7af7e8644&acdnat=1522896643_83233be18ca5782f59dc71b757083571

(13) Pisanti et al. Cannabidiol: State of the art and new challenges for therapeutic applications. Pharmacol Ther. (July 2017); 175: 133-150.

doi: 10.1016/j.pharmthera.2017.02.041.

https://www.ncbi.nlm.nih.gov/pubmed/28232276

(14) Giampietro, C and Fautrel, B. Anti-Interleukin-1 Agents in Adult Onset Still’s Disease. International Journal of Inflammation (2012), Vol. 2012, Article ID 317820, 6 pages. doi:10.1155/2012/317820

https://www.hindawi.com/journals/iji/2012/317820/abs/

(15) Likar, R, Nahler, G. The Use of Cannabis in Supportive Care and Treatment of Brain Tumor. Neuro-Oncology Practice (1 September 2017); 4(3): 151–160.

(16) Hayakawa K, Mishima K, Fujiwara M. Therapeutic Potential of Non-Psychotropic Cannabidiol in Ischemic Stroke. Pharmaceuticals (2010); 3(7): 2197-2212. doi:10.3390/ph3072197.

https://doi.org/10.1093/nop/npw027

(17) Kogan et al. Cannabidiol, a Major Non-Psychotropic Cannabis Constituent Enhances Fracture Healing and Stimulates Lysyl Hydroxylase Activity in Osteoblasts. J Bone Miner Res. (30 Oct 2015); (10):1905-13.

doi: 10.1002/jbmr.2513.  

https://www.ncbi.nlm.nih.gov/pubmed/25801536

(18) Grundy, R. New Research to Test Effect of Cannabidiol on Child Brain Tumours. Children’s Brain Tumour Research Centre, University of Nottingham, UK (2 May 2017).

http://www.cbtrc.org/newsandevents/news/2017/new-research-to-test-effect-of-cannabidiol-on-child-brain-tumours.aspx

(19) A Safety Study of Sativex Compared With Placebo (Both With Dose-intense Temozolomide) in Recurrent Glioblastoma Patients. ClinicalTrials.gov Identifier: NCT01812616.

https://clinicaltrials.gov/ct2/show/NCT01812616

 

In German

Media

(1) Die Schweiz im Cannabis-Light-Rausch: So Professionell Läuft das CBD-Geschäft. Watson (26 November 2017)

https://www.watson.ch/Schweiz/Drogen/462446747-Die-Schweiz-im-Cannabis-light-Rausch–So-professionell-laeuft-das-CBD-Geschaeft

(2A) Likar, Rudolf.  Cannabidiol: Schmerzreduktion bei Therapieresistenten Fällen.  Universum Innere Medizin (2016); 08/16: 96-97.

(2B) Cannabis-Inhaltsstoff CBD Hilft Bei Schmerzen. Kaernten News (20 January 2017).

http://kaernten.orf.at/news/stories/2821011/

(2C) Kofler, B. Hanf-Inhaltsstoff Cannabidiol Dämpft Schmerzen Ohne Effekt Auf Gehirn – Hinweise Auch Auf Entzündungshemmende Wirkung. B&K (20 January 2017).

http://www.bkkommunikation.com/de/journalistenservice/aktuell/hanf-inhaltsstoff-cannabidiol-daempft-schmerzen-ohne-effekt-auf-gehirn-hinweise-auch-auf-entzuen/

(2D) Cannabidiol: Schmerzlindernd ohne Nebenwirkungen. Der Standard (20 Jänner 2017).

https://derstandard.at/2000051213430/Cannabis-Inhaltsstoff-koennte-auch-entzuendungshemmend-wirken

Medical Paper

(3) Likar Rudolf. Cannabidiol: Schmerzreduktion bei Therapieresistenten Fällen. Universum Innere Medizin (2016); 08/16: 96-97.

Anecdotal Case Studies

(4) rpw. Weil Nichts Mehr Half – Mutter Verabreichte Ihrem Krebskranken Sohn Heimlich Cannabis. Stern (28 March 2017)

http://www.stern.de/familie/kinder/mutter-verabreichte-ihrem-krebskranken-sohn-deryn-heimlich-cannabis-7388940.html

 

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