cbd oil for fibromyalgia uk

Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials

It is understandable that the BMJ should seek to inform its readers about cannabis in pain management, given the very large number of people with untreated chronic pain [1], together with the massive growth in a new market claiming pain relief with cannabis-based products – with projections of compounded 20% market growth to over $16 billion by 2027 in the USA alone. [2]

The BMJ systematic review of cannabinoids for cancer and chronic non-cancer pain [3] starts with the premise that a new systematic review is needed because limitations of analytical approaches and interpretation of findings produced conflicting results previously. It oddly does not point out that an overview of 57 previous self-declared systematic reviews investigated just this point in substantial detail [4; posted online in May 2020]: reviews with industry links are typically of low quality and quite positive about effects of cannabinoids for pain, while Cochrane reviews tend to be much more conservative.

That overview was part of a major investigation by the International Association for the Study of Pain (IASP) task force comprehensively examining preclinical, clinical, and epidemiological evidence for the benefits and harms of cannabinoids, cannabis, and cannabis-based medicine for pain. The IASP position statement concludes that “Due to the lack of high-quality clinical evidence IASP does not currently endorse general use of cannabis and cannabinoids for pain relief”. [5]

For efficacy, the IASP investigation included a new comprehensive systematic review of randomised, double-blind trials of all cannabinoids, at all doses, in all types of pain, using not only standard risk of bias but also others critical in the assessment of pain trials [6; posted online in August 2020]. The IASP efficacy review differs (inter alia) from the Wang review in the GRADE-ing of evidence (low or very low certainty, rather than moderate or high certainty), which meant that there was little confidence in the estimates of any effect. Any estimates of efficacy were perforce based on studies with uncertain and high risk of bias, and any effect size was small. It is also critical to acknowledge that some important adverse effects encountered in real-world clinical settings are not necessarily captured in clinical trials [7] – an issue not emphasized by the Wang review.

It was disappointing that the Wang review omitted any discussion of the many differences with the systematic review produced by IASP. It is a disservice to readers and people living with pain that authors, peer-reviewers, and editors did not address the major differences in conclusions between the BMJ and IASP approaches.

For cannabinoids and pain, we are faced with major differences in opinion between the series of articles in the BMJ, and the IASP endorsed task force. These differences come down to interpretation of what the evidence concludes and the standards used to assess that evidence. As task force authors we are clearly biased by our many decades of working in pain and evidence. It is interesting that results of three new randomised trials published in 2021 are profoundly negative, finding no analgesic effects for cannabidiol in acute low back pain [8] or hand osteoarthritis or psoriatic arthritis [9], or cannabidivarin for HIV-associated neuropathic pain [10]. Only one trial found some benefit for THC-enriched cannabis oil – in eight fibromyalgia patients in Brazil [11].

There is a perfect storm ahead when the growth of the cannabis market meets the overwhelming desire of patients for treatments. What patients deserve most are evidence-supported treatments. We need to be very careful with the claims made about both efficacy and harm, appling the highest possible standards of research integrity and scholarship. After all, chronic pain patients have been failed before; we are still dealing with the fallout of market driven expansion in opioid use, overclaiming, and the failures in both science and regulation to offer rational and evidence-based options [12].

Perhaps the responsible BMJ editorial position is to let readers know about the thorough investigation by IASP, and its finding that: “IASP does not currently endorse general use of cannabis and cannabinoids for pain relief”. [4]

Andrew Moore
Retired researcher into (inter alia) pain and evidence
Plymouth, United Kingdom.
COI: personal payment for advice to Biogen Inc on design of future neuropathic pain trials

Emma Fisher
Department for Health Centre for Pain Research, University of Bath, Bath, United Kingdom.
COI: E fisher reports grants from vs Arthritis and NIHR outside the submitted work.

Christopher Eccleston
Professor, Department for Health Centre for Pain Research, University of Bath, Bath, United Kingdom; Cochrane Pain, Palliative, and Supportive Care Review Groups, Oxford University Hospitals, Oxford, United Kingdom; Department of Clinical and Health Psychology, Ghent University, Ghent, Belgium.
COI: C. Eccleston reports grants from vs Arthritis, MayDay Foundation, Cochrane, and NIHR outside the submitted work.

Simon Haroutounian
Associate Professor and Chief of Clinical Pain Research in the Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
COI: In the past 36 months Simon Haroutounian has received research funding from the US National Institutes of Health, US Department of Defense, and Disarm Therapeutics. SH has received personal fees from Vertex Pharmaceuticals, Medoc Ltd, and Rafa Laboratories.

Ian Gilron
Director of Clinical Pain Research, Research Committee Chair, Professor of Anesthesiology & Perioperative Medicine, Biomedical & Molecular Sciences, Centre for Neuroscience Studies, and School of Policy Studies, Queen’s University Kingston Health Sciences Centre, 76 Stuart Street, Vic 2 Pavillion, Kingston, Ontario, CANADA
COI: I. Gilron reports personal fees from GW Research, Adynxx, Biogen, Eupraxia, Novaremed and Teva.

Hemp Oil: How to Use CBD Oil for Cancer Pain, Anxiety, Fibromyalgia and Other Chronic Diseases

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Hemp Oil: How to Use CBD Oil for Cancer Pain, Anxiety, Fibromyalgia and Other Chronic Diseases has been created out of a passion to help you learn about the amazing health benefits of cannabis oil. It is my sincere desire to also clear the confusion about CBD hemp oil and provide well-researched answers to the most disturbing and frequently asked questions about CBD hemp oil such as:

  • Is there a difference between CBD oil and hemp oil?
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In Hemp Oil: How to Use CBD Oil for Cancer Pain, Anxiety, Fibromyalgia and Other Chronic Diseases, you will:

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Medical Cannabis for Fibromyalgia

At Cannacares we feel the legislation surrounding Cannabis consumption is fundamentally wrong.

After all, 1.4 million people in the UK are currently using Cannabis for a wide variety of ailments.
We feel very strongly that people that suffer with a chronic medical condition should not only be entitled to use alternative medication to help reduce their symptoms but should be supported by their GP’s who should have a better understanding of Medical Cannabis and how it interacts with the body.

No two fibro is the same

It is commonly known within the Fibromyalgia community that “no two fibro is the same”. The NHS and the recent guidelines that NICE published has called for more clinical studies into the efficacy of using Medical Cannabis for Fibromyalgia.

We are of the opinion that as the symptoms of each patient diagnosed with Fibromyalgia vary so greatly, it would be wrong to suggest that one type of Medical Cannabis formulation will work for every Fibromyalgia patient.

How can clinical studies on cannabis and CBD change this?

Instead a more focused randomised clinical study must be used, asking patients what their main symptoms are and testing different THC and CBD ratios on a group of patients that have a similar ailment. Only through practical trial and error will it be possible to come up with a range of Medical Cannabis Formulations that are suitable for different symptoms and different needs at different times of the day.

Medical Cannabis should fit around a patient’s life, not the other way around. For example, a high THC low CBD dose may help alleviate more pain on bad days but when you are having a better day or week, this stronger formulation would be impractical to perform daily routines. A more sensible formulation may be a low THC high CBD on better days.

Another example could be for sleep. It is well known Chronic Fatigue is one of the major symptoms of Fibromyalgia and a lack of sleep has been said to worsen sufferers’ anxiety and mood. CBD and CBN are the cannabinoids that are more effective solution for sleep.

How Cannacares is trying to help with our own CBD research

At Cannacares our mission to produce a range of Medical Cannabis formulation that specifically help people living with Fibromyalgia live a better life. This cannot simply be done with a one formulation fits all approach.

We endeavour to undertake more and more insightful research, constantly striving to improve our own range of products and improve the lives of those who are suffering from Fibromyalgia and other ailments. We currently offer CBD Oil tinctures, CBD capsules and CBD creams but there are a variety of new and exciting products in the pipeline that we hope will be available in the very near future. Stay tuned to Cannacares for all the latest news!