It is likely that many of your patients are using or have seriously considered using products made from cannabis sativa – CBD oil (hemp oil) or marijuana – to help alleviate their painful symptoms. Hemp oil, administered orally, is highly complementary to chiropractic care. Its main ingredient, cannabidiol (CBD), one of more than 85 cannabinoids contained within the cannabis plant, has been shown to be beneficial in models of pain and inflammation. Human studies also corroborate that it is beneficial in depression and anxiety.
The Science of Hemp Oil
Unlike marijuana, hemp oil has a negligible concentration of the psychoactive component tetrahydrocannabinol (THC), the most abundant cannabinoid in marijuana. Because it contains less than 0.3 percent of THC, hemp oil is legal in all 50 states.
In my own clinical practice as a naturopathic doctor, I have used hemp oil successfully in patients who are experiencing physical discomfort, as well as those with depression, anxiety and post-traumatic stress disorder (PTSD). It has been interesting to see the researched benefits play out in clinical practice.
However, many clinicians including chiropractors may not be familiar with the nuances of using hemp oil. For example, what is the proper dosage for patients experiencing pain or anxiety? How can it be incorporated into dietary supplement regimens you are already prescribing? What are some of the safest and most effective brands? How does hemp oil's effects on the body differ from that of marijuana? Are there any contraindications?
First, it's important to understand why hemp oil can be effective in pain management and in reducing inflammation. Its mechanism of action involves the endocannabinoid system.
Here's an introduction (or for some of you a refresher course) on the endocannabinoid system and how it relates to the body's control of pain and inflammation.
Endocannabinoids and the Body's Natural Pain Management System
The endocannabinoid system is an endogenous system in the body for modulating inflammation and pain. This system is made up of lipid mediators known as endocannabinoids, which act on the cannabinoid-1 (CB1) and cannabinoid-2 (CB2) receptors. CB1 is primarily expressed in the brain, although it is found in other areas of the body. CB2, meanwhile, is found mostly outside the brain, especially immune cells.
We all have endogenous endocannabinoids that act on these receptors. But the components of cannabis act on them as well. THC, the psychoactive component of cannabis, interacts with CB1 receptors. The CBD in hemp oil activates CB2 receptors. Evidence indicates that both receptors are involved in pain management, and CB2 in particular also exerts anti-inflammatory effects.
Research Support for CBD
Many human studies have investigated the effects of combined use of THC/CBD in pain management. However, there is indication that CBD alone can be useful in this regard by acting not only on CB2, but also other endocannabinoid receptors involved in pain control.
Interesting evidence in both humans and animals suggest CBD has a calming effect and can reduce anxiety. Furthermore, a number of studies have found CBD can mitigate depression. It reduces the decline in hippocampal neurogenesis and dendrite spines density caused by chronic stress. These two changes in the brain are linked to the damaging effects of stress on mental health, and CBD's ability to inhibit these stress-induced changes may in part account for its ability to support mental health.
Since a lot of chiropractic patients who are suffering from pain also experience depression and anxiety, this adds even more clinical relevance to the use of hemp oil.
New Certification Program
With a legal environment favorable to its use, hemp oil has become a more acknowledged therapeutic. However, the busy chiropractor needs a solid scientific and clinically relevant understanding of how to employ hemp with various health conditions.
Consequently, the International Center for Cannabis Therapy (ICCT), a partnership of qualified doctors and scientists who specialize in the medical application of cannabis, has introduced a new online certification program for health care practitioners. Highlights include:
- Incorporating cannabinoids into a practice safely, effectively and legally
- Proper dosing based on researched and proven protocols.
- How to be certain of the cannabinoid content in the CBD/cannabis oil recommended for patients.
- Examination of the current clinical literature supporting hemp's use in conditions related to immunity, autoimmunity, inflammation, insomnia, anxiety, PTSD, etc.
One of the modules will also discuss clinical cases and give participants a better grasp of the regulatory freedom to flex your ability to help patients with hemp therapeutics. Participants in the online certification program will walk away with important evidence-based skills on using hemp oil in clinical practice.
The online certification program includes an additional marketing module, offering instruction on how to market your ICCT certification and newly acquired knowledge of hemp to patients and to the community to assist with building your practice.
Clearly, hemp oil has a number of intriguing applications in clinical practice. However, properly implementing its safe and effective use requires a strong knowledge base.
Resources
- Miller RJ, Miller RE. Is cannabis an effective treatment for joint pain? Clin Exp Rheumatol, 2017 Sep-Oct;35 Suppl 107(5):59-67.
- Crippa JA, et al. Effects of cannabidiol (CBD) on regional cerebral blood flow. Neuropsychopharmacol, 2004 Feb;29(2):417-26.
- Campos AC, et al. Plastic and neuroprotective mechanisms involved in the therapeutic effects of cannabidiol in psychiatric disorders. Front Pharmacol, 2017 May 23;8:269.
