How to Talk to Your Doctor About CBD

A Note on Using CBD Instead of Prescription Painkillers

Living with chronic pain is challenging, especially since the Center for Disease Control (CDC) recently changed its official dosage recommendations for opiate pain medications.

The change came for a good reason — opiate addiction is both common and incredibly debilitating, especially for long-term patients.

CBD is being touted as a new and improved option for people with chronic pain. It’s non-addictive and has its own set of painkilling and anti-inflammatory effects. Some of the effects work through the same mechanisms as opiate painkillers — opioid receptor agonism (activation) [1].

It doesn’t stop there. CBD also activates the vanilloid (TRPV1) receptors [2] — which are also involved in pain transmission. The combined interaction with these pain transmission pathways effectively reduces the signal reaching the brain — thereby reducing the intensity of pain we perceive in the brain.

On top of directly inhibiting pain, CBD is well-known for its powerful anti-inflammatory effects. Chronic inflammation is one of the key drivers of pain, making CBD effective in addressing long-term pain. This is something prescription opioids don’t offer.

The most important point in all of this is that CBD is an effective painkiller, without the negative consequences. CBD is much safer than opioid painkillers, which are the leading cause of overdose-related death around the world [3]. CBD lacks the addictive potential of opioids, isn’t psychoactive, and won’t cause an overdose, even in very high doses [4].

Tips: Talking to Your Doctor About CBD

So you’ve decided you’d like to give CBD a try — now what?

We highly recommend speaking with your doctor before using CBD, especially if your goal is to treat an existing medical condition.

It’s important to talk to your doctor before starting to take the supplement to make sure there isn’t a good reason to avoid it (more on this later).

Most doctors aren’t well-versed in the endocannabinoid system or cannabinoids because they’re not part of a conventional form of medicine taught in medical schools.

The best way to find out if your doctor will give you a recommendation or not is to bring it up in your next appointment.

Ultimately, your health is your responsibility, so don’t be afraid to ask for what you want — even if you think your doctor might not be very excited about swapping your medications for something such as CBD.

1. Check the Legal Status of CBD in Your Country and State

Before you speak with your doctor, make sure you understand the laws in your area.

The regulations for CBD can vary from one country to the next. Even within the United States, different states can have radically different laws from one another.

Depending on the local laws, there may be medical programs available for which you need to have a doctor’s prescription or recommendation to buy and use CBD products.

Other countries, such as the United States and Canada, consider CBD a nutritional supplement. In these places, you can buy CBD from local shops or online without needing a prescription.

Always check the local laws before buying CBD.

2. Prepare for Your Appointment

Doctors are busy and don’t have time for a long conversation about your curiosity to try CBD.

To save time, take notes about your symptoms and research how CBD can be used for alleviating them. This will show your doctor that you’re serious about giving it a try and have done your research.

Write down any questions you might have beforehand, so you can be prepared when seeing the doctor.

Additionally, it’s useful to have an understanding of what the general dose of CBD would be for your bodyweight. In general, the most common dose for therapeutic effects of CBD is around 50 mg to 100 mg per day. However, this can vary a lot from one person to the next.

Learn more about calculating CBD doses based on your weight and desired strength of effects.

3. Don’t Hesitate to Get a Second Opinion

Some doctors don’t stay up to date with current research. Even those who do can’t possibly read every piece of new research published.

If your doctor doesn’t know enough about CBD to make a recommendation or isn’t open to talking about it, you may want to find another for a second opinion. There’s nothing wrong with this.

Even doctors will often get a second opinion from other health professionals for some of their patients. Nobody knows everything, so you should be able to ask for a second opinion whenever you want to compare results.

4. Forget About the Stigma

For decades, there’s been a negative stigma around medicinal cannabis, including CBD.

People associate the plant with psychoactive effects — even though CBD doesn’t have any.

However, in recent years, information surrounding CBD has become widely available.

Most people these days understand the differences between using CBD medicinally and the intoxicating effects of THC. Therefore, if you think you should give CBD a try, don’t hesitate to mention it to your doctor.

5. Find a Doctor Familiar With Medical Cannabis

There are doctors around the world that are well-educated on cannabis. There’s a ton of research on the compound’s uses for treating all kinds of different medical conditions. Most of these studies have a team of doctors behind them to oversee the study.

Many doctors involved with this research also run clinics. You can usually find these doctors through some simple Google searches or by contacting a local company that specializes in connecting doctors with patients.

Leafly offers an excellent tool for finding cannabis-friendly doctors in the United States.

Why Your Doctor May Not Approve of Using CBD

There are a few situations when a doctor will disapprove of CBD for medical reasons.

Although CBD has a high level of safety, is nearly impossible to overdose on, and isn’t physically addictive, there are some instances when it shouldn’t be used.

Negative Drug Interactions

The main reason why your doctor might not approve the use of CBD is due to the potential for interactions with some of your other medications.

There are a few ways CBD can negatively interact with other drugs:

1. Antagonistic interactions (inhibition) — this type of interaction means the CBD has the opposite effect to the medication you’re already taking, which can reduce the latter’s effectiveness on the condition it’s meant to treat.
2. Agonistic interactions (potentiation)  — this interaction involves CBD producing similar effects to the medication you’re already taking, causing the overall effects to become too strong.
3. CYP450 liver metabolism — all drugs are metabolized by the liver through specific enzymes. If CBD shares too many of the same enzymes as another drug, it can hinder their breakdown, potentially causing a buildup in the bloodstream — sometimes to dangerous levels.

Drug Classes That May Negatively Interact With CBD:

Key Takeaways: Talking to Your Doctor About CBD

CBD is a popular natural supplement for alleviating a wide spectrum of symptoms and medical disorders. It’s especially useful for anything involving pain, inflammation, hyperactivity in the nervous system, and immune problems.

Many people may be eligible to use CBD to help manage their symptoms instead of addictive or dangerous pharmaceuticals. However, before using CBD for any medical condition, it’s crucial that you first speak with your doctor.

We recommend taking the time first to learn how to talk about CBD with your doctor and understand why they may disapprove of you using CBD alongside or instead of other prescription medications.

Have you had a discussion with your doctor about using CBD? Is there anything on this list that we may have missed? Leave your comments below.

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References

1. Kathmann, M., Flau, K., Redmer, A., Tränkle, C., & Schlicker, E. (2006). Cannabidiol is an allosteric modulator at mu-and delta-opioid receptors. Naunyn-Schmiedeberg’s archives of pharmacology, 372(5), 354-361.
2. Iannotti, F. A., Hill, C. L., Leo, A., Alhusaini, A., Soubrane, C., Mazzarella, E., … & Stephens, G. J. (2014). Nonpsychotropic plant cannabinoids, cannabidivarin (CBDV) and cannabidiol (CBD), activate and desensitize transient receptor potential vanilloid 1 (TRPV1) channels in vitro: potential for the treatment of neuronal hyperexcitability. ACS chemical neuroscience, 5(11), 1131-1141.
3. Calcaterra, S., Glanz, J., & Binswanger, I. A. (2013). National trends in pharmaceutical opioid-related overdose deaths compared to other substance-related overdose deaths: 1999–2009. Drug and alcohol dependence, 131(3), 263-270.
4. Johnson, J. R., Burnell-Nugent, M., Lossignol, D., Ganae-Motan, E. D., Potts, R., & Fallon, M. T. (2010). Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC: CBD extract and THC extract in patients with intractable cancer-related pain. Journal of Pain and symptom management, 39(2), 167-179.