As the popularity of cannabidiol products grows, more and more questions arise about the optimal CBD dosage and how many drops of CBD oil to take for chronic pain.
Today on the Cannactiva blog we answer the main questions about dosing, with the help of Masha Burelo, cannabis researcher, based on current research. If you are looking for a general overview of the topic, you can also read our guide on CBD for chronic pain.
CBD products, such as CBD oils, are not medicines or food supplements and, in most European countries, are intended for external use. This is an informational article and does not replace medical advice: consult your healthcare professional before using CBD, especially if you are taking medication.
Key takeaways:
- There is no single dose: research uses ranges from around 20 mg up to 1,500 mg per day depending on the type of pain and the person.
- The usual approach is to start low (around 20-25 mg per day) and increase gradually; high doses are typically split into 2-3 intakes.
- CBD is well tolerated, but at high doses it can affect the liver and interact with medication: always consult your doctor first.
What is CBD?
CBD or cannabidiol is a non-psychoactive component of cannabis, which is being studied for its analgesic, anti-inflammatory and anxiolytic properties, useful in the treatment of various conditions involving pain, especially chronic pain.
Unlike marijuana, CBD does not produce euphoric or "high" effects because it lacks the intoxicating compound THC.
There is broad consensus on its safety: the World Health Organization (WHO) concluded that CBD is a well-tolerated compound with a good safety profile, and that it shows no potential for abuse or dependence (10).
How CBD works for pain
CBD can help relieve various types of pain by reducing inflammation and increasing the levels of natural substances in our body that help reduce the sensation of pain such as anandamide (8). This makes it particularly useful for those conditions where pain is associated with inflammation.
What dose of CBD is used to treat pain?
The optimal CBD dosage is influenced by several factors, such as type of pain, individual body chemistry and weight.
Determining the right dose of CBD for pain management can be complex, as there is no amount of CBD that works for everyone the same.
Although scientific research has begun to offer some guidance, it is important to remember that the amount of CBD drops that works best can vary considerably from person to person. Therefore, it is essential that you consult with your physician before using CBD for pain.
Quick Guide: How to Use CBD for Pain
Safety and adverse effects of CBD
CBD is generally considered safe and few and minor side effects are reported.
Possible side effects include drowsiness, dry mouth and gastrointestinal discomfort such as abdominal pain and mild diarrhea (4). However, these are usually mild and temporary. While higher doses of CBD may offer more significant pain relief, they also carry a higher risk of adverse effects. It is crucial to balance the need for effective pain management with the potential for side effects of CBD.
In addition, CBD may interact with certain medications. It is important to consult a health professional before starting to consume CBD, especially if you are taking medication.
Combination of THC, CBD and other cannabinoids
In addition to dosage, another consideration to keep in mind when using CBD for pain is its possible combination with THC or tetrahydrocannabinol. THC is a phytocannabinoid that is found in the greatest quantity in the cannabis plant and whose psychoactive effect is responsible for the psychoactive effects of marijuana.
Many clinical studies that have demonstrated the effectiveness of CBD for pain have observed greater effectiveness when CBD is administered in combination with doses of THC.
While some studies suggest that CBD is a well-tolerated natural compound for inducing analgesia, the combined use of CBD and THC has been shown to produce pain relief with lower doses of both compounds, and with minimal psychoactive effects. The reduction of psychoactive effects is an effect that CBD has, as CBD reduces the "high" of THC.
In addition, the type of CBD oil (full-spectrum, broad-spectrum or isolated) can also affect its efficacy. Full-spectrum CBD oil, which includes minor cannabinoids and terpenes, can provide enhanced pain relief due to the synergistic effect between the various natural compounds found in the plant.
Many studies suggest dividing the total dose of CBD into several doses to improve absorption and minimize side effects. The frequency varies according to the dose and the therapeutic objective.
In most studies, low doses of CBD have been used effectively once daily. While high doses of CBD are usually divided into two or even three times a day.
Splitting the dose throughout the day helps to reduce adverse events and maintain a constant CBD concentration throughout the day.
Frequently asked questions on the use of CBD for pain
How many drops of CBD for chronic pain?
There is no fixed number: it depends on the concentration of the oil and the person. A sensible approach is to start with 2-3 drops of a CBD oil 1-2 times a day and adjust every 3-4 days according to your response. Consult your doctor for your specific case.
How much CBD can you take per day?
Studies have used everything from low doses (under 150 mg/day) up to 1,500 mg/day in clinical settings. For self-care, low-to-moderate doses are usual, starting low and increasing gradually.
Does CBD work for chronic pain?
Research suggests that CBD may help modulate pain (especially inflammatory pain) and works better when combined with THC, but the evidence is still limited and does not replace medical treatment.
Is it safe to use CBD for pain?
CBD is considered well tolerated; the most common adverse effects are mild (drowsiness, dry mouth, digestive discomfort). At high doses it can raise liver enzymes and interact with medication.
How often should you take CBD for pain?
Low doses are usually taken once a day; higher doses are split into 2-3 intakes to keep levels stable and reduce side effects.
Scientific research: Proven dosage and efficacy of CBD
Scientific research has studied different ranges of effective doses: low, moderate and high. The efficacy of each dose varies according to the type of pain and individual response, highlighting some key doses observed in the research.
Low doses of CBD (less than 150 mg/day).
Studies indicate that low doses of cannabidiol may be effective for certain types of pain. For example, low-dose CBD has shown benefits for chronic pain and improves mental health, while maintaining good tolerability and safety (1).
Moderate doses of CBD (150-500 mg/day)
Moderate doses of CBD have also been shown to relieve acute pain and some types of neuropathic pain.
This range has been investigated in clinical trials, both in single doses, that is, in a single dose of CBD orally to relieve pain (2); and in treatments of up to 8 weeks, twice a day, to protect the nervous system and help in some types of neuropathic pain, improving its effectiveness when associated with THC (3).
One study showed that CBD can relieve up to 70% of dental pain in the event of an emergency when a single dose of 20 mg/kg body weight is administered. Not only can this dose of CBD be effective, but it maintains an adequate safety profile as no significant adverse effects have been observed (4).
High doses of CBD (500-1500 mg/day)
High amounts of CBD are generally used in clinical settings for pain that is severe or resistant to other treatments.
Doses of 600 mg per day have been used successfully in conjunction with paracetamol for 8 weeks to obtain an analgesic effect in osteoarthritis (5). On the other hand, it has even been postulated that doses higher than 1000 mg (1 g of CBD) could be effective in treating pain, and although it has been observed that CBD doses of up to 1500 mg/day can be tolerated (6), it can cause stress on the liver resulting in elevated liver enzymes (7). See the effects of CBD on the liver.
Conclusion
It is essential to balance the need for effective pain management with the potential for side effects and possible drug interactions. Although CBD may be a natural and well-tolerated compound with analgesic properties, its long-term use and drug-drug interactions should be carefully considered.
In conclusion, there is no standard dosage of CBD for pain relief, what we have, are examples of the paths that can be taken. Finding the right dose of CBD for pain is an individualized process. It is recommended to start with low doses and adjust according to the response and needs of each person, always under the supervision of a physician.
Note: This is an informational article and is not intended to prevent, diagnose or treat any disease. Its contents may complement, but should never replace, any diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines and are intended for external use. Cannactiva is not responsible for the misuse of this information. Please note that new scientific evidence may become available since the date of publication. Therefore, consult your doctor before using CBD.
References
- Henson, J. D., Vitetta, L., & Hall, S. (2022). Tetrahydrocannabinol and cannabidiol medicines for chronic pain and mental health conditions. Inflammopharmacology, 30(4), 1167-1178. https://doi.org/10.1007/s10787-022-01020-z
- Arout, C. A., Haney, M., Herrmann, E. S., Bedi, G., & Cooper, Z. D. (2022). A placebo-controlled investigation of the analgesic effects, abuse liability, safety and tolerability of a range of oral cannabidiol doses in healthy humans. British journal of clinical pharmacology, 88(1), 347-355. https://doi.org/10.1111/bcp.14973
- Nielsen, S. W., Hasselsteen, S. D., Dominiak, H. S. H., Labudovic, D., Reiter, L., Dalton, S. O., & Herrstedt, J. (2022). Oral cannabidiol for prevention of acute and transient chemotherapy-induced peripheral neuropathy. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 30(11), 9441-9451. https://doi.org/10.1007/s00520-022-07312-y
- Chrepa, V., Villasenor, S., Mauney, A., Kotsakis, G., & Macpherson, L. (2023). Cannabidiol as an Alternative Analgesic for Acute Dental Pain. Journal of dental research, 220345231200814. Advance online publication. https://doi.org/10.1177/00220345231200814
- Pramhas, S., Thalhammer, T., Terner, S., Pickelsberger, D., Gleiss, A., Sator, S., & Kress, H. G. (2023). Oral cannabidiol (CBD) as add-on to paracetamol for painful chronic osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial. The Lancet regional health. Europe, 35, 100777. https://doi.org/10.1016/j.lanepe.2023.100777
- Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139-154. https://doi.org/10.1089/can.2016.0034
- Watkins, P. B., Church, R. J., Li, J., & Knappertz, V. (2021). Cannabidiol and Abnormal Liver Chemistries in Healthy Adults: Results of a Phase I Clinical Trial. Clinical pharmacology and therapeutics, 109(5), 1224-1231. https://doi.org/10.1002/cpt.2071
- Barnes, R. C., Banjara, S., McHann, M. C., Almodovar, S., Henderson-Redmond, A. N., Morgan, D. J., Castro-Piedras, I., & Guindon, J. (2024). Assessing Dose- and Sex-Dependent Antinociceptive Effects of Cannabidiol and Amitriptyline, Alone and in Combination, and Exploring Mechanism of Action Involving Serotonin 1A Receptors. The Journal of pharmacology and experimental therapeutics, 388(2), 655-669. https://doi.org/10.1124/jpet.123.001855
- Frane, N., Stapleton, E., Iturriaga, C., Ganz, M., Rasquinha, V., & Duarte, R. (2022). Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study. Journal of cannabis research, 4(1), 47. https://doi.org/10.1186/s42238-022-00154-9
- World Health Organization (WHO). Cannabidiol (compound of cannabis): questions and answers. Expert Committee on Drug Dependence.
