One-third of Patients with Fibromyalgia Use CBD

A new survey shows that one-third of the patients with fibromyalgia use CBD. Patients with fibromyalgia use CBD for pain, anxiety, and sleep, with 30 to 40% reporting much or very much relief of symptoms.

Fibromyalgia is a condition that affects an estimated 3-6% of the world population, mostly women. It can develop in childhood or young age, but it’s usually being developed in middle age, and the known risk factors include lupus and arthritis. 

Fibromyalgia is characterized by widespread chronic pain, sleep disorders, fatigue, and depressive episodes. People with fibromyalgia may be more sensitive to pain – a condition called abnormal pain perception processing. It is a complex disease that lacks thorough understanding. Like with migraine, recent scientific evidence suggests that there might be important benefits in the use of cannabinoids in the treatment of fibromyalgia. Many retrospective trials and patient surveys suggest the significant alleviation of pain, improvement in sleep, and abatement of associated symptoms. 

21% of patients seized using other drugs entirely

A study published last year in Clinical and Experimental Rheumatology showed that administration of THC and CBD in almost the same dosage helped 50% of the patients with fibromyalgia with the anxiety and depression, and the improvement of the sleep and the decrease of other fibromyalgia symptoms were observed in 44% and 33% of the patients. 

The research was conducted on over a hundred patients at the Luigi Sacco University Hospital in Milan, Italy. Sixty-six of them were interviewed over six months of treatment. The average participant was 52 years old, and over 90% were women.

The recommended dose was 10-30 drops each morning and evening, with titrating to up to 120 drops per day. The starting point was 4 mg THC and 2 mg CBD daily, and the higher doses were 27 mg THC and 8 mg CBD, with most of the THC taken in the evening.

The focus of this study was placed on treating patients who are permanently taking medications to ease fibromyalgia symptoms but without success. Almost half of the patients were taking two other drugs, and nearly a third took at least three. The drugs involved were severe central sedatives, including opioids, anti-convulsants, nerve blockers, and anti-depressants. By the end of the trial, almost half of the patients reduced their other drug use, and 21% seized to take other medications entirely.

Another interesting point came out during this research. Given that the majority of patients were overweight or obese, the effectiveness of cannabis was observed to rise with the weight of the patent. In the search for the possible reason for this observation, the authors speculated that people with more fat may absorb cannabinoids better.

The CED theory

Cannabinoids seem to more than just help symptoms of fibromyalgia. Migraine, fibromyalgia, and irritable bowel syndrome have all endured the stigma of psychosomatic diseases, but their underlining condition might in fact be clinical endocannabinoid deficiency (CED). This theory was first proposed in 2001 but more thoroughly explored in 2004 in an article frequently cited in the literature.

How does endocannabinoid deficiency affect human health? All humans possess an underlying endocannabinoid tone that reflects levels of anandamide (AEA) and 2-arachidonoylglycerol (2-AG), the centrally acting endocannabinoids, their synthesis, catabolism, and the relative density of cannabinoid receptors in the brain. If endocannabinoid function is decreased, it leads to a lowered pain threshold, along with disorders of digestion, mood, and sleep. According to the CED theory, such deficiencies could arise due to genetic or congenital reasons or be acquired due to intercurrent injury or disease that consequently produces characteristic pathophysiological syndromes with particular symptomatology.

A study published in 2016 suggests that the greatest evidence for CED is present for migraine, fibromyalgia, and irritable bowel syndrome (IBS). 

CBD helps when other drugs don’t work

A large survey published in The Journal of Pain at the beginning of this year shows that close to 60% of patients with fibromyalgia had tried CBD in the past or currently use it to relieve their symptoms. The survey conducted on 2.701 participants with fibromyalgia shows that 32% of them currently use CBD, mostly for pain, anxiety, and sleep. Around 30 to 40% of participants reported much or very much relief of symptoms, and they typically tried CBD due to inadequate relief from other medications.

In the survey, 38.1% of participants reported never using CBD, 29.4% reported past CBD use, and 32.4% reported current CBD use. Past-year cannabis use was strongly associated with past or current CBD use. Those using CBD typically did so due to inadequate symptom relief, while those not using CBD typically cited safety concerns as their reason for not using CBD. Two-thirds of participants disclosed CBD use to their physician, although only 33% asked for physician advice on using CBD.

CBD is widely advertised as helpful for chronic pain management but research is limited. Clinicians should discuss CBD use with fibromyalgia patients, and future studies are needed to rigorously assess CBD’s therapeutic value for fibromyalgia symptoms, the scientists conclude.

Reviewed by Sasha Bajilo, founder of ILESOL Pharmaceuticals, an industrial scale producer of CBD products and formulations. Expert on Hemp/Cannabis policy, member of the Croatian Ministry of Health regulatory commission for medical cannabis.