Patients With Fibromyalgia Substitute CBD Products for Conventional Pain Medication

Patients with fibromyalgia are substituting conventional pain medicines such as opioids with cannabidiol (CBD) products, despite a lack of evidence on the effectiveness of CBD as a pain reliever for the illness, according to new research published in the Journal of Pain.

In this secondary analysis from a cross-sectional survey, researchers examined the substitution patterns of 878 patients with fibromyalgia who currently used CBD.

The study population was mostly Caucasian females with an average age of 55.5 years old. Patients were subgrouped by their most commonly used CBD products, which included CBD isolate, hemp, CBD-cannabis, or no preference; and whether or not they substituted the CBD products for other medications.

“We investigated rationale for substituting, substitution-driven medication changes, CBD use patterns, and changes in pain-related symptoms,” wrote Kevin F. Boehnke, PhD, University of Michigan Medical School, Ann Arbor, Michigan, and co-researchers.

A total of 632 patients, or 72%, reported using CBD products as a substitution for conventional medications.

Over 53% of participants substituted CBD for opioids while over 23% substituted CBD for benzodiazepines, with other common substitutions including NSAIDs and gabapentanoids.

The most commonly recorded reason for the substitution was harm reduction, such as fewer side effects.

Patients who substituted for CBD products reported larger improvements in pain relief when compared to patients who continued use of conventional pain medicines.

Patients who most frequently used CBD-cannabis additionally saw increased improvements in pain, health, memory, and sleep when compared to the CBD isolate, hemp, or no preference subgroups.

Researchers said these findings highlight a need for more study designs to examine the effects of substituting CBD products for conventionally prescribed pain medications.

“This article shows that people with fibromyalgia are deliberately substituting CBD products for conventional pain medications despite the dearth of evidence suggesting CBD products may be helpful for fibromyalgia,” explained Dr Boehnke et al.

Researchers concluded, “CBD's medication-sparing and therapeutic potential should be examined in more rigorous study designs.”

—Erin McGuinness

Boehnke KF, Gagnier JJ, Matallana L, Williams DA. Substituting Cannabidiol for Opioids and Pain Medications Among Individuals With Fibromyalgia: A Large Online Survey [published online ahead of print, 2021 May 13]. J Pain. 2021;S1526-5900(21)00220-0. doi:10.1016/j.jpain.2021.04.011