CBD for Fibromyalgia: Is it Effective, Safe, or Legal?

CBD is from cannabis, but without the high

CBD oil
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CBD oil is getting a lot of popular attention as a potential treatment for fibromyalgia. So far, we don't have a lot of research on it, but we do have some—and it's promising.

Still, a lot of people don't really understand what CBD oil is or how it works, and it tends to be wrapped up in the controversy over medical marijuana. That can make people hesitant to try it.

There's also a lot of confusion over whether it's legal.

What Is CBD Oil?

CBD stands for "cannabidiol," which comes from the cannabis plant. Yes, the cannabis plant is where we get marijuana from. However, CBD oil doesn't have any psychoactive properties, which means it doesn't get you high.

The substance responsible for the high associated with marijuana comes from a different substance, which is called THC (tetrahydrocannabinol.) Growers who want to maximize the plant's high use breeds and techniques that focus on higher THC levels. Meanwhile, cannabis that's grown for hemp is generally richer in CBD than THC, and that's where CBD is derived from.

CBD that's extracted from cannabis is being used for a lot of medical purposes, and you can find a lot of impressive-sounding claims online. Are they true? From a scientific standpoint, the answers are more like "possibly" and "some of them appear to be" than a firm "yes," and it depends on which claims you're looking at.

People are using CBD oil for a lot of different medical purposes, including:

  • Stopping the growth of cancerous tumors

As of mid-2018, CBD oil is not FDA-approved for any conditions. Research is still in its early stages, though, which isn't surprising because it was illegal to even study it for a long time. We may see applications submitted to the agency as research continues to move forward.

CBD oil is used in various ways. You can smoke it, swallow capsules, use it under the tongue, in spray or drop form, and topically.

Research for Fibromyalgia

General CBD research is in its infancy, so research on CBD for fibromyalgia could be considered embryonic. We just don't have much to go on right now. A 2016 survey of the literature concluded that there's not enough evidence to recommend any cannabis-based treatments for fibromyalgia or other rheumatic conditions.

However, this topic is likely to get a lot of future attention, for several reasons.

First, we have a pain epidemic in the U.S., and fibromyalgia is a major contributor to that. Current treatments just aren't good enough for most of us, so there's an enormous financial incentive to find something that's better at relieving our pain and other symptoms.

Second, we have an opioid addiction and overdose epidemic in this country.

Numerous studies have demonstrated that when a state legalizes marijuana, the number of opioid prescriptions drops. That's good news for doctors looking for safer pain treatments, law enforcement agencies struggling to control the tide of illegal opioid use, and lawmakers looking for solutions to the opioid problem.

Third, CBD oil is believed to be effective against pain and inflammation, and, in its pure form, it's generally regarded as safe.

Fourth, while anecdotal evidence certainly isn't scientific proof of anything, we have an abundance of it from people with fibromyalgia who say CBD helps them, and you can bet that when patients who have hard-to-treat conditions tell their doctors something works, it piques their interest.

As for the scientific motivations behind further study, consider that CBD is believed to help relieve:

  • Pain
  • Insomnia
  • Anxiety

When it comes to fibromyalgia symptoms, those three are significant.

A 2017 paper published in Expert Opinion on Therapeutic Targets suggested CBD as a possible way to diminish the activity of brain cells called glia, which leads to central sensitization. That's a major feature of fibromyalgia and other central sensitivity syndromes such as chronic fatigue syndrome, irritable bowel syndrome, and migraine.

Fibromyalgia also involves something called endocannabinoid deficiency. That's the system that deals with your body's natural endocannabinoids as well as cannabis products that you may take in. That makes cannabis products a promising treatment.

A 2016 review published in Cannabis and Cannabinoid Research found evidence that CBD is effective in migraine and irritable bowel syndrome, which are related to fibromyalgia. It also stated that some cannabis-based treatments appeared effective for fibromyalgia. The authors stated that CBD is often preferable to patients due to the high and other effects associated with THC.

Several studies have suggested that CBD can fight inflammation. Fibromyalgia isn't currently classified as an inflammatory condition, but research suggests that at least some cases may involve inflammation of a body-wide web of connective tissue called the fascia. If that's accurate, it could be one more reason CBD should be considered.

Side Effects

We don't have a full picture of the possible side effects of CBD. Some reported side effects include:

  • Changes to liver enzymes used to process drugs
  • Dry mouth
  • Low blood pressure
  • Lightheadedness
  • Drowsiness
  • Increased tremor in Parkinson's disease, at high doses

These effects are possible but require more study, according to the World Health Organization:

  • Alteration of hormonal levels
  • Immune system stimulation at low levels, and immune suppression at higher levels

Addiction and abuse don't appear to be problems with CBD, and it appears to have a low toxicity level meaning that it takes a lot to overdose.

Is CBD Oil Legal?

You'd think the question, "Is CBD legal?" would be answerable with a simple yes or no. It's not.

You can find a lot of claims by hemp growers and CBD sellers that their product is legal in all 50 states, as long as it contains less than 0.3 percent THC. However, the 9th Circuit Court of Appeals ruled in 2018 that the law the industry uses to justify that claim doesn't apply.

That means CBD, as a cannabis product, is still legally classified by the DEA as a Schedule 1 Controlled Substance, which makes it illegal at the federal level.

On the other hand, the DEA is widely quoted as saying it supports medical research into CBD and other marijuana extracts because of the promise they've shown. An agency spokesperson in April 2018 is quoted by TV station WTHR as saying the agency wouldn't be going after people for medicinal use of CBD. "They are not a priority for us," said the DEA's Rusty Payne. "[I]t would not be an appropriate use of federal resources to go after a mother because her child has epileptic seizures and has found something that can help and has helped. Are they breaking the law? Yes, they are. Are we going to break her door down? Absolutely not."

CBD's federal status could be changing soon. Senate Majority Leader Mitch McConnell (R-Ky) in April 2018 introduced a bill to federally legalize hemp—and the products made from it—as an agricultural crop, as long as it contains less than 0.3 percent THC. The bill has been fast-tracked, as well.

Meanwhile, many states have legalized marijuana (some for medicinal use and some for recreational use), and others have passed laws specifically legalizing CBD. So, at the state level, it's legal in some places and not others.

The website ProCon.org has information about which states have laws specific to CBD oil. A site called Governing maintains a map of where marijuana is legal in some form. People have been arrested, tried, and convicted on drug charges for possessing CBD, so before you go out and buy some, it pays to know its legal status in your state.

A Word From Verywell

Certainly, you have a lot to consider when it comes to any treatment, and even more so when it comes to CBD. Consider the pros and cons—including the legal ones—carefully. Be sure to discuss this option with your doctor to make sure you're safe, and, as with any treatment, watch for side effects.

With legal changes in store and more research coming, expect things to change rapidly when it comes to CBD oil and other cannabis-based treatments. We'll likely know a great deal more about the effectiveness and safety of these products a few years from now.

View Article Sources
  • Burstein SH, Zurier RB. Cannabinoids, endocannabinoids, and related analogs in inflammation. The AAPS Journal. 2009 Mar;11(1):109-19. doi: 10.1208/s12248-009-9084-5.
  • Fitzcharles MA, Baerwald C, Ablin J, Hauser W. Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis): A systematic review of randomized controlled trials. Schmerz. 2016 Feb;30(1):47-61. doi: 10.1007/s00482-015-0084-3.
  • Hill KP, Saxon AJ. The role of cannabis legalization in the opioid crisis. JAMA internal medicine. 2018 May 1;178(5):679-680. doi: 10.1001/jamainternmed.2018.0254.
  • Nijs J, Loggia ML, Polli A, et al. Sleep disturbances and severe stress as glial activators: key targets for treating central sensitization in chronic pain patients? Expert opinion on therapeutic targets. 2017 Aug;21(8):817-826. doi: 10.1080/14728222.2017.1353603.
  • Piomelli D, Weiss S, Boyd G, Pacula RL, Cooper Z. Cannabis and the opioid crisis. Cannabis and cannabinoid research. 2018 Apr 1;3(1):108-116. doi: 10.1089/can.2018.29011.rtl.
  • Russo EB. Clinical endocannabinoid deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes. Cannabis and cannabinoid research. 2016 Jul 1;1(1):154-165. doi: 10.1089/can.2016.0009.