Researchers have started delving deeper into the safety and efficacy of using cannabidiol (CBD) for post-surgery pain management.

New study findings were unveiled to attendees at the American Orthopaedic Society of Sports Medicine annual meeting held from July 11-14 in Colorado Springs.Fronted by a sports orthopedic specialist at NYU Langone Health in New York City, Dr. Michael J. Alaia, the research effort's findings are yet to be peer-reviewed or featured in a medical journal. Nonetheless, the study results included a lot of valuable information.

Attendees learned that the non-psychoactive hemp- and cannabis-derived compound demonstrated powerful pain-relieving properties after rotator cuff surgery. As per the study's findings, CBD could be, at the very least, as safe as (if not safer than) opioids.The low risk of addiction associated with using the cannabinoid for pain relief appeals to experts who believe that CBD could soon gain its rightful place in the world of postoperative pain treatment for numerous surgeries. The perks associated with using cannabis for post-op pain extend beyond the fact that cannabis is not addictive as opioids. Cannabis, especially CBD, has been touted for its anti-inflammatory, analgesic, anti-convulsant, anti-oxidant, antiemetic, anxiolytic, and antipsychotic effects.

CBD for Postoperative Pain: What Did the Study Entail?

Alongside his trusty investigators, Alaia launched a multi-center trial that observed 80 study subjects aged between 18 and 75. One group consumed CBD with a dosage of 25 mg or 50 mg daily over 14 days, while the other group consumed a placebo. It should be noted that CBD dosage was dependent on the subject's weight.Each study subject's pain scores were logged on days one, two, seven, and 14. To accurately assess each participant's experience, the visual analog scale (VAS) was utilized. This pain rating scale provided insights into pain relief, pain control satisfaction, and opioid consumption.In addition to assessing each person's experience with pain after using CBD or the placebo, Alaia and his team measured liver function on days seven and 14. The purpose of this was to evaluate patient safety.

Participants were also monitored for nausea.According to the results, the VAS pain score was much lower among the CBD-consuming study subjects. While the pain level wasn't significantly different from those who used a placebo, the researchers confirmed that the CBD group was more satisfied with pain control.Dosage-wise, the study subjects who consumed 50mg of CBD recorded lower VAS scores on the first day of the experiment and increased pain control satisfaction on days one and two compared with the participants who were administered 25mg of CBD, as well as the control group.

The researchers added that there were no significant differences in BAS score, pain control satisfaction, and opioid consumption on days seven and 14. Furthermore, during these trial stages, no significant differences were noticed in liver function or nausea."Based on our findings, CBD is safe and effective in reducing pain in the immediate perioperative period following rotator cuff repair and should be considered in postoperative multimodal pain control," Alaia was quoted as saying in a statement after the trial took place.One of the most unpredictable findings of the study into the effects of CBD on postoperative pain was that CBD's pain-relieving effects appeared to dwindle as the trial progressed.

CBD for Postoperative Pain: What Do Other Studies Show?

On April 15, 2021, researchers at Syracuse University learned that "CBD pain relief is driven by both pharmacological action and psychological placebo." The outcome of the experimental study, which was carried out on humans, was published in Science Daily.The team's first experimental pain trial on CBD drew noteworthy results. On the other hand, Syracuse University researchers noted that pain intensity is not entirely reduced by CBD but instead helps to relieve unpleasant sensations. "The data is exciting but pretty complex in that different pain measures responded differently to the drug effect, to the expectancy, or both the drug and expectancy combined -- so we're still trying to figure out what is behind the differential data with different kinds of pain measures," said university researcher Stephen A. Maisto. Maisto says the next step involves investigating the "mechanisms underlying these findings and figuring out why giving instructions or CBD itself causes certain reactions to a pain stimulus."

Separate studies have demonstrated that CBD can successfully enhance endogenous anandamide signaling indirectly. Since anandamide acts in appetite, depression, fertility, memory, and pain, scientists have good reason to believe that CBD may possess significant pain-relieving potential.

Legality of CBD: Is it Legal in Europe?

A report published by the World Health Organization (WHO) clarified that "in humans, CBD exhibits no effects indicative of any abuse or dependence potential. No evidence of public health-related problems associated with using pure CBD."CBD-derived products containing 0.2% THC or less are legal in most countries across the continent.

So much so that CBD is not considered a 'narcotic drug' under European law. This fact, combined with the growing field of medical research into CBD, has thrust this cannabinoid into the global limelight.The European Court of Justice confirmed the cannabinoids' legal status in November 2020. At that point, a judgment was published stating that cannabis-extracted CBD should not be deemed a drug under the 1961 United Nations Single Convention on Narcotic Drugs. Because of this, CBD is now considered to be a novel food by the European Union.Impressively, Europe boasts the world's second-largest CBD market. A report by Graphical Research found that the European CBD market size exceeded €1.8 billion and is forecast to inflate at a compound annual growth rate (CAGR) of 33.5% between 2021 and 2027.

The popular cannabis-derived ingredient CBD is readily obtainable in most of the United States. The passing of the 2018 Farm Bill made it impossible to outlaw the use, sale, and production of CBD despite its legal status being in flux. A report by Graphical Research indicates that North America is paving the way for the global CBD market. By 2027, the North American CBD market could reach USD $61.2 billion.Cannabis industry analysts from Vantage Market Research foresee the global CBD market topping €47.24 Billion by 2028, a substantial increase from the €4.9 billion generated in 2021. The market is expected to continue growing at a CAGR of 21.3%.

Written and Published by Bethan Bee Rose in Weed World Magazine Issue 160

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