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CBD (Cannabidiol) for chronic pain, headache and migraine: comprehensive overview, current evidence.


This is an educational video on CBD (Cannabidiol) and its potential use for chronic pain, and headache disorders such as migraine. This was a lecture I did for our Cleveland Clinic Headache Center grand rounds. I get asked a lot of questions about CBD, so I am repeating it here, although I am doing it in a way which still remains partly scientific (for medical professionals), as well as put into layman’s term as much as possible for public education as well. This is not advice or recommendations. It is simply an educational overview based on currently available evidence and data. As scientific studies and updates occur with CBD, the video will be updated as well.

The sections are outlined below if you want to jump to a specific section/topic. However, my recommendation is to watch from beginning to end in order to gain the most comprehensive and up to date understanding of CBD.

00:00-7:20: Brief history of medical cannabis use for pain and headache, and transition to federally illegal Schedule 1 substance.
7:20-10:38: Review of endocannabinoid system, cannabinoid receptors and endocannabinoids.
10:38-18:54: Cannabis derived phytocannabinoids including CBD, CBD specific receptor actions, and their effects.
18:54-22:12: Neurobiology of cannabinoids and migraine.
22:12-26:36: Evidence for CBD in chronic pain and migraine.
26:36-34:08: CBD pharmacokinetics, safety information, adverse effects, and hemodynamic effects.
34:08-36:06: Legal overview of CBD.
36:06-42:37: Non-prescription over the counter CBD products including different categories of CBD products (full spectrum, broad spectrum, CBD isolate, etc.), product safety concerns, reasoning for need for independent 3rd party testing until FDA regulations available.
42:37-44:05: Clinical use suggestions; currently no standard dosing guidelines and this is widely variable between products.
44:05-47:27: Common CBD misconceptions.
47:27-50:28: Conclusions.

1. Russo EB. Cannabidiol claims and misconceptions. Trends in Pharmacological Sciences. 2017;38(3):198-201.
2. Merrick J, et al. Identification of psychoactive degradants of cannabidiol in simulated gastric and physiological fluid. Cannabis Cannabinoid Res. 2016;1:102-112.
3. Grotenhermen F, et al. A Conversion of Oral Cannabidiol to Delta9-Tetrahydrocannabinol Seems Not to Occur in Humans. Cannabis Cannabinoid Res. 2017; 1;2(1):81-86.
4. Pisanti SA, et al. Cannabidiol: state of the art and new challenges for therapeutic applications. Pharmacol Ther. 2017;175:133-150.
5. White CM. A Review of Human Studies Assessing Cannabidiol’s (CBD) Therapeutic Actions and Potential. The Journal of Clinical Pharmacology. 2019;59(7):923-93.
6. Palmieri B, et al. Short-term efficacy of CBD-enriched hemp oil in girls with dysautonomic syndrome after human papillomavirus vaccination. IMAJ. 2017;19:79-84.
7. Manini et al. Safety and pharmacokinetics of oral cannabidiol when administered concomitantly with intravenous fentanyl in humans. J Addict Med. 2015;9:204-210.
8. Arndt DL. Cannabidiol does not dampen responses to emotional stimuli in healthy adults. Cannabis and Cannabinoid Res. 2017;2(1):105-113.
9. Cunetti L, et al. Chronic pain treatment with cannabidiol in kidney transplant patients in Uruguay. Transplantation Proc. 2018;50:461-464.
10. Wade DT, et al. A Preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clin Rehabil. 2003;17:21-29.
11. Philpott H, et al. Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis. Pain. 2017; 158(12):2442-2451.
12. Hammell D, et al. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European Journal of Pain. 2016;20:936-948.
13. Malfait A, et al. The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis. Proc Natl Acad Sci. 2000;97:9561-9566.
14. Costa B, et al. Oral anti-inflammatory activity of cannabidiol, a non-psychoactive constituent of cannabis, in acute carrageenan-induced inflammation in the rat paw. Naunyn Schmiedebergs Arch Pharmacol. 2004;369:294-299.
15. Bonn-Miller MO, Loflin MJE, Thomas BF, et al. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017 Nov 7;318(17):1708-1709.
16. Millar SA, et at. A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans. Front Pharmacol. 2018; 9: 1365. 
17. Epidiolex (Cannabidiol) prescribing information. Carlsbad, CA: Greenwich Biosciences, Inc.;2018.
18. MacCallum CA, Russo EB. Practical considerations in medical cannabis administration and dosing. Eur J Intern Med. 2018 Mar;49:12-19.
19. Baron EP. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science. Headache: The Journal of Head and Face Pain. 2018; July/August;58(7):1139-1186.


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