Ann: Dosing begins in topical CBD pain study, page-14

Results from three more recent studies, reporting on the successful use of CBD in the treatment of pain - oral CBD in the treatment of pain related to Scleroderma digital ulcers, oral CBD for pain related to fibromyalgia and topical CBD in the treatment of peripheral neuropathy of the lower extremities.

The Use of cannabidiol in the Treatment of Pain Related to Scleroderma Digital Ulcers
2021 (Italy)

Systemic Sclerosis (SSc) is an autoimmune disease and digital ulcers represent frequent complications. They are recurrent, painful and often resistant to traditional treatments. Standard therapy, in particular oral opioids, is often inadequate or limited by side effects.

In this study of 31 SSc patients, the efficacy of CBD oral drops in pain management was measured using standard rating scales - VAS (pain), PSQI (sleep quality, higher score = worse sleep quality) and HAQ-DI (disability). All patients had painful digital ulcers resistant to analgesics and pain was classified as severe, according to WHO guidelines.

Twice-daily dosage was used, progressively increasing from 27.6 g to 55.2 g.

All subjects were provided with a daily diary to record self-evaluation of pain using VAS, PSQI, hours of sleep per night, use of other analgesics, eventual side effects. HAQ-DI was also administrated.

Results: CBD was administered for a mean period of 5.9±3.2SD-months. After the first month, VAS decreased from 94.80±8.72SD to 54.70±9.40SD (p<0.0001), PSQI decreased from 9.27±2.9SD to 4.47±1.06SD (p<0.001), total hours of sleep increased from 2.56±1.28 SD to 5.67±0.85SD (p< 0.0001). The additional analgesic therapy was necessary in 22/31 patients: 6/22 only paracetamol, 12/22 paracetamol+oxycodone reducing the dosage of oxycodone at the minimum, 2/22 oxycodone 20 mg twice-a-day, 2/22 need fentanyl transdermal patch. After 3 months, VAS further reduced to 40.90±12.90, PSQI decreased to 3.1±1.4SD, the mean total hours of sleep per night was 6.10±0.79SD and the HAQ-DI decreased from 2.19±0.67SD (baseline) to 0.79±0.46SD at the last patients’ evaluation. At the end of the observation, 18/31 patients (58%) showed DUs healing. We also interestingly reported improvement of dysphagia and appetite in 70%, and an improvement in constipation related to opioids in 48%. No patients experienced severe side effects….

https://ard.bmj.com/content/80/Suppl_1/672.2


Substituting Cannabidiol for Opioids and Pain Medications Among Individuals With Fibromyalgia: A Large Online Survey
2021 (USA)

This study examined substitution patterns among 878 individuals with fibromyalgia who were currently using CBD.

The majority (n = 632, 72.0%) reported substituting CBD products for medications, most commonly NSAIDs (59.0%), opioids (53.3%), **apentanoids (35.0%), and benzodiazepines (23.1%). Most substituting participants reported decreasing or stopping use of these pain medications. The most common reasons for substitution were fewer side effects and better symptom management. Those who substituted reported larger improvements in health and pain than those who did not. Participants using CBD-cannabis reported significantly more substitutions than any other group (P's ≤ .001) and larger improvements in health, pain, memory, and sleep than other subgroups.

https://pubmed.ncbi.nlm.nih.gov/33992787/#affiliation-1


The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities
2020 (USA)

The efficacy of a topically delivered CBD oil in the management of neuropathic pain was examined in a 4 week, randomized and placebo controlled trial of 29 patients with symptomatic peripheral neuropathy. The treatment product contained 250 mg CBD.

Results: The study population included 62.1% males and 37.9% females with a mean age of 68 years. There was a statistically significant reduction in intense pain, sharp pain, cold and itchy sensations in the CBD group when compared to the placebo group. No adverse events were reported in this study.

https://pubmed.ncbi.nlm.nih.gov/31793418/