What is Cannabis Oil?

Cannabis oil is made by extracting cannabidiol (CBD) from the Medical Cannabis plant. It is worth noting here that CBD does not produce the highs or give the hallucinagenic properties of tetrahydrocannabinol (THC) that is also produced by the marijuana plant.

Many claims have been made for the efficacy and health benefits of cannabis oil, and advocates claim that many common ailments, health conditions and infections can be treated by taking cannabis oil. For example:

• pain relief
• high blood pressure
• infections
• chronic inflammation
• arthritis
• asthma
• drug addiction
• depression
• multiple sclerosis

However there is little reliable clinical evidence to support these claims

Experts say the evidence is scant for most of these touted benefits and clinicians have raised concerns over the quality of cannabis oil being produced and its potential side effects.

Marcel Bonn-Miller, adjunct assistant professor of psychology at the Pennsylvania School of Medicine says "Worse, CBD is being produced without any regulation, resulting in products that vary widely in quality."
Bonn-Miller goes on to say "It really is the Wild West, Joe Bob who starts up a CBD company could say whatever the hell he wants on a label and sell it to people."

One type of cannabis oil that has many advocates is Rick Simpson Oil (RSO) named after the marijuana advocate and activist who created it. This oil has a larger proportion of THC than many other CBD products

CBD in Pain Relief

CBD can offer an alternative for people who have chronic pain and rely on medications, such as opioids, that can be habit-forming and cause more side effects. However, more research is needed to verify the pain-relieving benefits of CBD oil and other products.

Epidiolex, a drug prescribed for epilepsy, is the only CBD product on the market that the U.S. Food and Drug Administration (FDA) has approved.

There aren't any FDA-approved, non-prescription CBD products because they aren’t regulated for purity and dosage like other medications.

Keep reading to learn more about the possible benefits of CBD use for pain. You can also talk with your doctor to see if it’s an option for your condition.

CBD for chronic pain relief

Everyone has a cell-signaling system known as the endocannabinoid system (ECS).

Some researchers think that CBD interacts with a core component of the ECS — endocannabinoid receptors in your brain and immune system.

Receptors are tiny proteins attached to your cells. They receive signals, mostly chemical ones, from different stimuli and help your cells respond.

This response creates anti-inflammatory and pain-relieving effects that help with pain management. This means that CBD oil and other products may benefit people with chronic pain, such as chronic back pain.

One set of 2018 reviews from Serbia assessed how well CBD works to relieve chronic pain. The review looked at studies conducted between 1975 and March 2018. These studies examined various types of pain, including:

• cancer pain
• neuropathic pain
• fibromyalgia

Based on these studies, researchers concluded that CBD was effective in overall pain management and didn’t cause negative side effects.

CBD for arthritis pain relief

A 2016 study looked at CBD use in rats with arthritis.

Researchers applied CBD gel to rats for four days in a row. The rats received either 0.6, 3.1, 6.2, or 62.3 milligrams (mg) per day. The researchers noted reduced inflammation and overall pain in the rats’ affected joints. There were no obvious side effects.

Rats who received low doses of 0.6 or 3.1 mg didn’t improve their pain scores. The researchers found that 6.2 mg/day was a high enough dose to reduce the rats’ pain and swelling.

In addition, rats who received 62.3 mg/day had similar outcomes to the rats that received 6.2 mg/day. Receiving a substantially larger dosage didn’t result in them having less pain.

The anti-inflammatory and pain-relieving effects of CBD gel could potentially help people with arthritis. However, more human studies are needed.

CBD for cancer treatment relief

Some people with cancer also use CBD. Research on mice has shown that CBD can lead to the shrinking of cancerous tumors. However, most studies in humans have investigated the role of CBD in managing pain related to cancer and cancer treatment.

The National Cancer Institute (NCI) has pointed to CBD as a possible option for reducing chemotherapy side effects, such as:

• pain
• vomiting
• lack of appetite

In a 2010 study on cancer-related pain, study subjects received oral sprays of a combination THC-CBD extract. The THC-CBD extract was used in conjunction with opioids. This study revealed that using the extract provided more effective pain relief than using the opioids alone.

A 2013 study on THC and THC-CBD oral sprays had a similar finding. Many researchers from the 2010 study worked on this study as well. More evidence is still needed.

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The Multiple Sclerosis (MS) Society in the UK gives more information on the use of cannabis oil for people with MS in the UK.

Unlicensed medicinal cannabis

There are products made using chemical CBD found in cannabis. These include oils you take by mouth (for example, under your tongue or with a mouth spray) or by vapourising. They won’t get you 'high' as they have little or no THC in them.

The law in the UK now says that these oils can be prescribed for medicinal use, but this is on a case-by-case basis and only when there is a special clinical need for individual people. You may see them still being sold as ‘food supplements’.

It’s not against the law in the U.K. to have these products if they only have CBD in them (and no THC).

Readers should note that in the U.S. the law surrounding the use of cannabis oil varies from Federal and State jurisdiction. Persons wishing to use cannabis oil are advised to seek medical and legal advice before buying or using cannabis oil in their home country, or when travelling abroad.

Medical cannabis

In the U.K. there are two cannabis-based drugs that have gone through trials and have a licence:

Nabilone (brand name Cesamet) – a drug cancer patients take to stop them feeling sick during chemotherapy. Nabilone has an artificial version of THC in it. It doesn’t have a licence to be used for MS but some doctors prescribe it for MS pain or muscle spasms.

Sativex (brand name for the drug nabiximols) - the only drug made from cannabis that’s licenced to treat muscle spasms and stiffness in MS. It’s a mouth spray made from an equal mix of THC and CBD.

The benefits of Sativex are seen, in the U.K., as too small to justify its cost to the Health Service. So you can’t get it on the National Health Servie (NHS) except in Wales (and even there, it’s not easy to get). Anywhere in the UK, a doctor can give you a private prescription for Sativex if you can afford the cost.

How cannabis can affect you

You can’t be sure how strong cannabis is when you buy it illegally or what it might be mixed with. So its effects might not always be the same. As well as the effects you might want, cannabis can cause less welcome changes:

• dizziness
• sleepiness
• feeling drunk
• impaired driving
• feeling sick
• anxiety
• increased risk of seizures
• harm to unborn babies

High doses may slow down reaction time, change your blood pressure and heart beat and affect your sight and coordination.

Smoking cannabis long term can affect your lungs and raise your heart attack and cancer risk. It’s possible to become dependent on cannabis, especially if you use it regularly.

If you or your family have a history of mental health problems (such as schizophrenia or bipolar disorder) using cannabis can trigger these or make them worse.

Smoking cannabis mixed with tobacco has the well-known risks of tobacco smoking but has extra risks for people with MS. Smoking tobacco can:

• speed up how fast you go from relapsing MS to secondary progressive MS
• make some MS drugs (disease modifying therapies) work less well.

Some studies of people with MS who regularly smoke cannabis show they do worse in tests measuring their memory and how fast they process information. MRI scans have also shown abnormal brain activity. None of this is seen in people who use the cannabis-based drug Sativex.

Research into cannabis

When the American Academy of Neurology (AAN) looked at the research in 2014, they didn’t find enough evidence that smoking cannabis was safe or effective against MS. They did find that people with MS said cannabis-based drugs (pills or sprays) helped with muscle stiffness (spasticity) and pain.

A review by America’s National Academies of Sciences, Engineering and Medicine (NASEM) in 2017 found that patients who took cannabis-based treatment by mouth said it helped with their spasticity. When their spasticity was tested it was less clear if it had got better.

The MS Society in the UK states, 'Our medical advisors believe that about one in ten people with MS with pain or muscle spasticity might benefit from cannabis treatment, when other treatments for these symptoms have not worked. But smoking cannabis, especially if mixed with tobacco, is harmful to the health of people with MS'.

Read more on Medical Marijuana on the American Academy of Neurology website: 'Medical marijuana in certain neurological conditions'. AAN: Minneapolis; 2014.

Read about the health effects of cannabis on the US National Academies of Sciences, Engineering and Medicine website: 'The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research'. National Academies Press: Washington DC; 2017

Comment

It is fair to say that cannabis oil is currently receiving a lot of media and social networking attention with many advocates and many detractors.

It is also fair to say that there is very little, reputable, hard clinical evidence to support the claims for the efficacy and effectiveness of cannabis oil. However there is also very little evidence to refute and disprove the claims of users.

At UGH we remain unconvinced of the effectiveness of cannabis oil and warn particularly against using unlicensed cannabis oil produced by unlicensed and, usually, unscrupulous people and companies.
Always remember "If it appears too good to be true, it usually is". Caveat emptor

References:

https://www.healthline.com/health/cbd-oil-for-pain

https://www.frontiersin.org/articles/10.3389/fphar.2018.01259/full

Cannabis for treatment of Multiple Sclerosis (MS)

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