By Emily Blum, M.D.
In September 2019, the Arthritis Foundation, the largest arthritis advocacy group in the U.S., acknowledged the growing trend of arthritis patients using CBD by releasing guideline statements. The Arthritis Foundation has been outspoken to the FDA about the need for oversight, and their guidelines are yet another step in the growing acceptance of CBD in the mainstream.
What Are People Using CBD For?
The guidelines were prompted by a recent Arthritis Foundation survey of 2,600 patients with osteoarthritis and rheumatoid arthritis. The survey was conducted to assess CBD utilization in these patients. They found that 79% of respondents have used, are currently using, or are considering using CBD. Of those, 29% are currently using CBD either topically or orally. Interestingly, the overwhelming majority of respondents state they use CBD for pain control: two-thirds of the respondents stated they had improvement in their physical symptoms and three-quarters reported improvements in their sleep. Another two-thirds stated they had improvement in their depression or anxiety. Unfortunately, the Arthritis Foundation found that only half of the population was given information about CBD by their health care provider, which ultimately prompted releasing the first guidelines for use.
Who Should Use CBD?
The guidelines acknowledge the fact that there is a need for more research, and the recommendations are appropriately broad because of the lack of clinical evidence. They address the fact that while CBD appears to help with symptoms such as pain, insomnia, and anxiety, no rigorous studies have been performed. They also recognize that while no serious safety concerns have been found in moderate doses of CBD, more thorough testing needs to be performed. Currently, the specifics of drug interactions with CBD is not well established either, and the guidelines encourage people to talk with their doctors prior to starting a CBD regimen if they take any of the following common arthritis medications: corticosteroids (such as prednisone), tofacitinib (Xeljanz), naproxen (Aleve), celecoxib (Celebrex), tramadol (Ultram), certain antidepressants, including amitriptyline (Elavil), citalopram (Celexa), fluoxetine (Prozac), mirtazapine (Remeron), paroxetine (Paxil), sertraline (Zoloft), and certain medications for fibromyalgia, including gabapentin (Neurontin) and pregabalin (Lyrica).
How to Take CBD
How you take CBD is an important topic as well, especially with a rise in vaping-related lung injuries. Because of this, the Arthritis Foundation does not endorse the use of vaping as a route of administration. They discuss other options such as sublingual (a.k.a. under the tongue), edible, and topical application options like salves or patches. Of course, it’s important to find what delivery mechanism works best for you. The Arthritis Foundation recommends starting with a low dose (though they do not specify dosing) twice a day, and tapering up until symptoms relief is established.
Their last guideline statement is one that Healios CBD takes seriously and was previously discussed in our CBD Regulation & Contaminant Testing blog post. They recommend only using products manufactured grown in the US, that follow GMP standards, that test each batch and can provide certificates of analysis from independent labs.