The final section of last week’s ‘Ask a Doctor’ session with Dr Leah Zachar had some interesting facts about CBD and pain, and how it could be used to help the symptoms of MS…
Question: I have MS also and recently had to leave my employment due to increased pain. Please, can you help me? Any information is appreciated!
Answer: MS is a most frustrating disease as it effects myelinated fibers all over the body. The pain can have many forms – tingling, weakness, spasms, heaviness, instability, arthritic and so forth.
CBD works centrally. It binds to target proteins in the spine which block the transmission of pain from the body to the brain. Therefore, for instance, the pain from a slipped disc in the back, or from the “difficult to describe” pain of MS, the pain will be reduced – or eliminated – as the pain fibers will be blocked from being “felt” by the brain.
CBD also has anti-inflammatory properties. By acting on immune cells, CBD helps to lower inflammation and the pain of arthritis. In the pain due to arthritis, CBD is most effective when applied to the skin overlying the area of discomfort.
Question: How do opioids cause death when taken in excess?
Answer: The reason death occurs is because one of the locations of the body where the opioids work is the medulla, located in the brainstem.
The medulla controls the heartrate and the breathing. In the medulla, the opioids slow the breathing. When too much opioids are taken, breathing ceases. When breathing ceases, you die.
Question: I have chronic pain & I take opioids. CBD is good for chronic pain, but isn’t opioid also good for chronic pain?
Answer: Opioids help treat chronic pain, but they are less than ideal because when opioids are taken on a long-term basis there are the problems of tolerance (needing a progressively higher dose to get the same benefit), dependence (needing to take the opioid just to prevent the withdrawal symptoms) and addiction (craving the opioid and neglecting all other responsibilities). This risk is not present when using CBD to control chronic pain.
Question: How is it that CBD when taken in excess does not cause death?
Answer: CBD does not bind the receptors located in the part of the body that controls the vital autonomic functions that keep the body alive. There has not been even one case since time immemorial a single recorded death from overdose of cannabis or CBD.
Question: What is the difference between oral (softgels caps) vs sublingual (oil drops) medication delivery?
Answer: Theoretically, sublingual medication starts working faster and is more potent, but this is not true in the “real world setting” because 25% of the medication taken under the tongue is swallowed.
Therefore, much of the medication taken in the form of oil drops, ends up in the stomach. This is because the salivary glands in the mouth produce saliva and the saliva is swallowed automatically, and with it, any medication that is placed under the tongue.
However, there is one important situation that may make softgels preferable to oils sublingually and that is in a smoker. Smoking decrease the absorption of sublingual medication because it causes vasoconstriction of the blood vessels in the oral cavity.
As per your request, we are moving the weekly In-house doctor session from Thursday at 1 pm EST, to Thursday at 3 pm EST (That’s UK’s 20:00, NYC’s 15:00 and LA’s 12:00)
If you liked these questions and answers and want more, why not check out the Q&A from – Ask a Doctor- How Does CBD Work And Is It Addictive?