Question

I keep reading about people with ME/CFS who are using cannabis oil (CBD oil) for pain relief – with varying degrees of benefit. My GP said that he isn’t allowed to prescribe cannabis oil for pain relief and he wasn’t convinced by the claims that are being made. So is there any evidence that CBD oil can help with pain relief? And given the link to cannabis is it safe to try if you have ME/CFS?

Answer

CBD (short for cannabidiol) is one of the many chemicals that are found in natural cannabis. As you say, there is quite a lot of anecdotal information from people who report that cannabis oil preparations help with pain relief.

A wide range of commercial CBD products – oils, vapes, creams – are now available in health food shops. However, there are concerns about the quality and ingredients in some of these products, especially those that are advertised on the internet. 

A recent report from the University of Bath, which reviewed all the clinical trials evidence, has concluded that there is no sound evidence to demonstrate that CBD oil is a safe and effective treatment for pain. There is, however, evidence that CBD oil can be used to treat some types of childhood epilepsy and it is also being assessed as a treatment for some types of neurological disease. Possible side-effects of medical cannabis and cannabis oils include decreased appetite, diarrhoea, drowsiness and fatigue, dry mouth and nausea.

The University of Bath report concluded that CBD products are probably a waste of money and potentially harmful. Consequently, in our current state of knowledge, this is not an approach to the management of pain in ME/CFS that we can recommend.

If you are going to use CBD oil, I would check with your local pharmacist to try and ensure that you are using a reputable product. 

More Information:

• University of Bath report: CBD products don’t ease pain and are potentially harmful – new study finds
• NHS information on medical cannabis and cannabis oils
• The ME Association has produced leaflets on pain management and the various medications used to manage it in the Free Literature. In particular, the following may be of relevance:
  
  • Pain Management: We discuss the various types of pain and how each can best be managed.
  • Medication: Duloxetine (Cymbalta): Depression & Pain Relief
  • Medication: Amitriptyline: Depression, Pain & Sleep Relief
  • Medication: Gabapentin (Neurontin): Moderate to Severe Pain Relief
  • Medication: Lyrica (Pregabalin): Moderate to Severe Pain Relief
• We also have a free leaflet on other Alternative and complementary approaches to managing ME/CFS that may be of interest.