It has been hailed as a miracle drug and it is certainly creating wonder profits. By some estimates, the Cannabidiol (or CBD) market could be worth $20 billion dollars by 2024. While consumers tout its effectiveness in pain relief up until now there’s been limited experimental human study about the actual effectiveness of this medication. But a new study led by researchers at Syracuse University sheds light on the ability of CBD to decrease pain along with the impact that the so-called placebo effect may have on pain results.
“For science and the public at large the question remained, is the pain relief that CBD users claim to experience due to pharmacological effects or placebo effects,” asked Martin De Vita, a researcher in the psychology department at Syracuse University’s College of Arts and Sciences. “That’s a fair question because we know that simply telling someone that a substance has the ability to relieve their pain can actually cause robust changes in their pain sensitivity. These are called expectancy effects.” De Vita, together with Syracuse Emeritus Psychology Professor Stephen Maisto, were distinctively prepared to answer that exact question. The pair, together with fellow laboratory member and doctoral candidate Dezarie Moskal, previously conducted the first systematic review and meta-analysis of experimental research examining the effects cannabinoid drugs on pain. As the first experimental pain trial to examine CBD, their study yielded consistent and remarkable outcomes. Among other findings, the statistics showed that CBD and expediencies for getting CBD don’t appear to decrease experimental pain intensity, but do make the pain seem less unpleasant.
De Vita and Maisto used sophisticated equipment that securely induces experimental heat pain, letting them quantify the way the recipient’s nervous system responds and reacts to it. “Then we administer a drug, like pure CBD, or a placebo and then re-assess their pain responses and see how they change based on which substance was administered,” explained De Vita. Researchers then took it a step further by manipulating the info given to participants regarding which substances they obtained. Sometimes, participants were advised that they got CBD when they actually received a placebo or told they’d be getting a placebo when they actually got CBD. “That way we can parse out whether it was the drug that alleviated the pain, or whether it was the anticipation that they had received the medication which reduced their pain,” according to De Vita. “That way we could parse out whether it was the drug that relieved the pain, or whether it was the expectation that they had received the drug that reduced their pain,” according to De Vita. “We hypothesized that we would primarily detect expectancy-induced placebo analgesia (pain relief). What we found though after measuring several different pain outcomes is that it’s actually a little bit of both. That is, we found improvements in pain measures caused by the pharmacological effects of CBD and the psychological effects of just expecting that they had gotten CBD. It was pretty remarkable and surprising.”
“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 Maisto. “The next step is studying the mechanisms underlying these findings and figuring out why giving instructions or CBD itself causes certain reactions to a pain stimulus.”
Most men and women think of pain as an on and off switch, you either have it or you don’t. However, pain, as De Vita describes it, is a complex phenomenon with various dimensions influenced by biological and psychological elements. As an instance, whereas pain intensity reflects a “sensory” dimension of pain, unpleasantness signifies an “affective,” or psychological, aspect of pain. “If you think of pain as the noxious noise coming from a radio the volume can represent the intensity of the pain, while the station can represent the quality,” explained De Vita. Results from his previous study showed that although cannabinoid drugs weren’t reducing the volume of pain, they had been “changing the channel making it a little less unpleasant.” Based on De Vita, “It’s not sunshine and rainbows pleasant, but something slightly less bothersome. We replicated that in this study and found that CBD and expectancies didn’t significantly reduce the volume of the pain, but they did make it less unpleasant–it didn’t bother them as much.” As part of the analysis De Vita and Maisto developed innovative experimental pain measurement protocols to pop the hood and start looking at some of these other mechanistic pain processes,” said De Vita. “It’s not just pain, yes or no, but there are these other dimensions of pain, and it would be interesting to see which ones are being targeted. We found that sometimes pharmacological effects of CBD brought down some of those, but the expectancies did not. Sometimes they both did it. Sometimes it was just the expectancy. And so, we were going into this thinking we were going to primarily detect the expectancy-induced pain relief but what we found out was way more complex than that and that’s exciting.”
1 important thing to also think about is the source of the CBD. “What we used in our study was pure CBD isolate oil,” said De Vita. “Commercially available CBD products differ in their content and purity, so results might be different for different CBD products, depending on what other compounds they may or may not contain.”