Does CBD Oil Work For Pain And Anxiety

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Despite some claims, there’s no scientific evidence that conclusively proves that CBD can help relieve anxiety. CBD oil and other supplements containing cannabidiol are gaining popularity, but does CBD work for treating chronic pain?

Does CBD Help With Anxiety?

It’s likely that in the last few years, you’ve come across a lot of discussion and anecdotes about cannabidiol, also known as CBD. Availability and sales of CBD have exploded across the U.S. since it became legalized on the federal level and is now legal in most states.

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You can find CBD on shelves in many stores, with various brands promoting benefits that range from alleviating pain to aiding sleep. It also comes in many forms like CBD gummies, CBD oils, CBD lotions and even CBD-infused sodas. And one big claim CBD supporters tout is its ability to relieve anxiety, a feeling many of us have experienced over the last few years thanks in part to the COVID-19 pandemic.

But not all CBD is created equally, and the truth about the benefits is kind of, well, complicated. To dig deeper into whether or not CBD actually curbs anxiety and what else you should know before trying it, we spoke to psychiatrist David Streem, MD.

What is CBD?

“CBD is one of the chemicals present in cannabis-containing plants,” explains Dr. Streem. CBD mostly comes from hemp and, notably, contains very small traces of tetrahydrocannabinol (THC), the psychoactive ingredient that causes the “high” in marijuana. In fact, the U.S. government limits hemp-derived products from having a THC content of more than 0.3%.

As far as proven health benefits, there has been some evidence that CBD might serve as a treatment for chronic pain, but data is still mixed. More substantially, though, Dr. Streem says, “CBD has particular health benefits that have been demonstrated in scientific studies and it’s the active ingredient in an FDA-approved medication for the treatment of particular childhood seizure disorders.”

Specifically, he notes that CBD has shown benefits for children experiencing Lennox-Gastaut and Dravet syndromes, both rare conditions. “In these cases, the more common seizure medications don’t work very well.” CBD is part of a treatment package that includes other medications and even brain surgery.

Does CBD really help curb anxiety?

In short, no. CBD probably doesn’t help curb anxiety the way advertisements or anecdotal evidence claim. “The science isn’t there yet,” says Dr. Streem, adding that while there are scientific studies backing the use of CBD for the previously mentioned seizure conditions, no such high-quality data exists for CBD and anxiety yet.

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And if you’re waiting on those studies to turn out evidence, get comfortable. As Dr. Streem notes, studies that yield the necessary data are difficult for researchers to conduct for two reasons.

A lack of oversight

The first is government oversight and federal laws that make research into cannabinoids, including marijuana, difficult. While the number of states that have legalized some form of marijuana — whether for medical or recreational use — has dramatically increased in recent years, cannabis containing THC remains illegal on a federal level.

The U.S. Food and Drug Administration (FDA) also has its hands full trying to regulate it. Many states allow selling CBD over-the-counter as a dietary supplement even though that’s, technically, against FDA regulations. The FDA has warned dozens of companies about this practice but, so far, little has been done to change these practices. Dr. Streem says, “The FDA has to have evidence that there’s a safety risk before they can intervene.”

That overlaps with the second issue with CBD, which is a troubling lack of quality control. You can buy CBD just about anywhere now, from boutiques that specialize in CBD to your corner convenience store. But not all CBD is created equally, and neither is the labeling.

A 2017 study published in the Journal of the American Medical Association (JAMA) tested 84 CBD products from 31 different companies and found that 26% had less CBD than claimed on their respective labels, while 43% had more CBD than claimed on their labels.

Just as troubling, Dr. Streem points out that a number of the tested products had what he calls “relevant amounts of THC.” In other words, enough THC to trigger a positive on a drug test even if the label said there wasn’t any THC in their oil. And if you ingest CBD with a certain amount of THC, you’re also subject to the side effects, including delusions and hallucinations. Plus, there’s a chance these effects won’t go away when the effects of the drug wear off.

Risks of taking CBD

If you’re thinking of trying CBD without consulting with your healthcare provider, Dr. Streem has a simple response: Don’t. It’s about the unknowns, including the unregulated nature of most products and the possible inclusion of enough THC to flag a drug test.

“Trying a CBD product with consultation from your doctor is less risky,” advises Dr. Streem, “but you should still be aware of how the product makes you feel. If it makes you feel strange at all, stop using that product immediately.”

He continues, “If you could confirm that a product had no THC and had a CBD percentage close to what the label claims, there’s little concern it would do any harm regardless of the benefits. But that’s not what we’re dealing with right now.”

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The bottom line

While data shows there are some benefits of using CBD in certain medically approved settings, for now, the scientific evidence just isn’t there for using CBD to help with anxiety, concludes Dr. Streem. Trying over-the-counter products without more stringent regulation carries more risk than reward.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Should You Take CBD for Pain?

People looking for a safer pain reliever are turning to cannabis-derived CBD. Michigan Medicine experts weigh in on what’s currently known about the trendy supplement.

Want to learn more on this topic? Listen to this podcast from the Rogel Cancer Center on Medical Marijuana for Cancer Patients.

CBD, short for cannabidiol, is undergoing a surge in popularity as the hot new supplement, with a promise to treat a variety of conditions including pain, anxiety, and insomnia, just to name a few. It’s also available in all manner of forms, from lotions and oils to CBD-infused food and drink. But does it work?

CBD is one of the compounds in the cannabis plant, better known as marijuana. Unlike the famous cannabinoid tetrahydrocannabinol (THC), CBD doesn’t cause the psychological effects typical of being “high”. Both CBD and THC act on the body’s natural endocannabinoid system, which plays a role in many processes including appetite, pain and memory.

The scientific evidence around CBD use is thin, a fact that is mainly due to politics. “Cannabis has been a Schedule 1 drug for a long time, which has limited the type of research needed to figure out how best to use it therapeutically,” says Kevin Boehnke, Ph.D., research investigator in the department of anesthesiology and the Michigan Medicine Chronic Pain and Fatigue Research Center. Under the U.S. Federal Controlled Substances Act, Schedule 1 drugs are defined as having no currently accepted medical use and a high potential for abuse.

Yet marijuana has been used as a medicinal plant for thousands of years, he notes. In fact, one of the first recorded uses of cannabis was for rheumatism, also known as arthritis. Cannabis products were widely used as medicines in the 19th and early 20th centuries, and were listed in the U.S. Pharmacopoeia before the onset of Federal restriction in 1937 under the Marijuana Tax Act.

Much of the research literature around CBD in particular supports its use as a treatment for childhood epilepsy. Indeed, in 2018 the FDA approved the CBD-based drug Epidiolex as a drug for childhood epileptic conditions. In a substantial policy shift, Epidiolex was designated as Schedule V, which is the least restrictive drug schedule and indicates little potential for abuse.

While there aren’t any published clinical trials on CBD in pain, Boehnke notes that ongoing preclinical studies in animals have demonstrated that CBD reduces pain and inflammation, and studies of CBD in humans show that it is well-tolerated and has few negative side effects. “There are also observational studies that ask why people use CBD and if it’s effective, and results tend to be quite positive. People report using CBD for anxiety, pain, sleep — all things that go hand-in-hand with chronic pain,” he says. The passage of the 2018 Farm Bill removed hemp-derived CBD (

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So many people are turning to CBD as an alternative pain reliever, especially in light of the opioid crisis, that in a commentary published in Annals of Internal Medicine, Boehnke and Daniel Clauw, M.D., director of the Chronic Pain and Fatigue Research Center, provided advice for clinicians on how to counsel their patients about CBD and cannabis use.

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They also provided guidance for the Arthritis Foundation, who recently surveyed 2,600 people with arthritis and found that 29% currently use CBD to treat arthritis symptoms.

Boehnke and Clauw recommend that people with chronic pain talk to their doctor about adding CBD to their treatment plan, and continue to use their prescribed medication. They offer the following advice for people wanting to try CBD:

Don’t smoke or vape. Bottom line is smoking anything harms the lungs. Vaping has been associated with a recent epidemic of lung disease, according to the Centers for Disease Control & Prevention.

Purchase from reputable sources. Like vitamins and other supplements, CBD products aren’t regulated or FDA approved to treat disease, so buyer beware. Look for products that have been tested by an independent third party lab “so you don’t end up with a product that has THC in it or a product contaminated with heavy metals or pesticides,” says Boehnke.

Route of administration matters. CBD is best taken in pill or capsule form for slow extended release or as an oral tincture (infused oil that contains CBD) for faster effect onset.

Start low, go slow. Take a small amount and slowly increase your dosage until you start to get symptom relief over a matter of weeks. Track your symptoms to get a sense of whether or not CBD is a helpful part of your treatment plan.

Check your state laws. While medical marijuana is legal in many states, it’s still illegal at the Federal level, putting CBD in a legal gray zone in many areas.

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