Examine publishes rigorous, unbiased analysis of the latest and most important nutrition and supplementation studies each month, available to all Examine Members. Click here to learn more or log in.

In this article

CBD and pain: mechanism, mind, or both?

This study explored whether CBD's analgesic effect comes from its impact on people's biology or psychology.

Study under review: The Effects of Cannabidiol and Analgesic Expectancies on Experimental Pain Reactivity in Healthy Adults: A Balanced Placebo Design Trial

Introduction

Before modern medicine, supernatural theories driven by social influence were used to explain and treat disease, leading to the use of techniques like bleeding or applying leeches to remove ‘bad blood’. While human understanding of disease has progressed tremendously, pain, despite our physiological understanding, can be heavily influenced by perception. For example, in a meta-analysis[1] of 58 studies, the description of a placebo treatment as a painkiller resulted in a large pain-relieving effect on experimentally induced pain in healthy adults.

In the context of an opioid abuse epidemic, people are seeking alternative pain-relieving treatments and, as stigma surrounding cannabis[2] slowly erodes with increasing legalization, cannabis has been overwhelmingly reported[3] by people to provide similar pain relief when compared to other medication. Indeed, a recent meta-analysis of RCTs reported that cannabinoids[4], such as cannabidiol (CBD) and psychoactive delta-9-tetrahydrocannabinol (THC), can have a medium–large effect on self-reported pain. Interestingly, the placebo treatment had a small–medium effect on self-reported pain. Thus, it is unclear whether the pain-relieving effects attributed to cannabinoids are due to intoxication, the expectation of an effect (a placebo effect), and/or a direct pharmacological action on pain. One RCT[5] reported that THC alone did not improve pain in patients with advanced cancer, while THC combined with CBD did, compared to a placebo. This suggests that the some benefits of cannabinoids may not depend on the psychoactive effects of THC. CBD is relatively safe and well tolerated[6], shows low abuse potential[7], is non-psychoactive, and is most commonly[8] used to manage pain. However, CBD’s mechanism of action[9] is not completely understood. Hence there’s a heated scientific debate on the proportion of the effects that can be attributed to expectations of an effect (placebo effect) or pharmacological action. The authors of this balanced placebo experimental pain study aimed to determine the independent and/or combined effects of expecting to take, or actually taking, CBD on pain reactivity.

Pain can be heavily influenced by perception. Cannabidiol (CBD) has demonstrated pain-relieving potential, but whether its effects are driven by expectations, pharmacological action, or a combination of both, is unclear. This study was designed to tease out the independent and/or combined effects of expecting to receive or actually receiving CBD on pain reactivity.

What was studied?

Become an Examine Member to read the full article.

Becoming an Examine Member will keep you on the cutting edge of health research with access to in-depth analyses such as this article.

You also unlock a big picture view of 400+ supplements and 600+ health topics, as well as actionable study summaries delivered to you every month across 25 health categories.

Stop wasting time and energy — we make it easy for you to stay on top of nutrition research.

Try free for two weeks

Already a member? Please login to read this article.

What were the findings?

Become an Examine Member to unlock this article.

Already a member? Please login to read this article.

The bigger picture

Become an Examine Member to unlock this article.

Already a member? Please login to read this article.

Frequently asked questions

Become an Examine Member to unlock this article.

Already a member? Please login to read this article.

What should I know?

Become an Examine Member to unlock this article.

Free 2-week trial »

Already a member? Please login to read this article.

Other Articles in Issue #80 (June 2021)