More than one in five American adults lives with chronic pain. Pain can negatively affect every aspect of health and quality of life, including cardiovascular fitness, mental health, sleep quality, sexual function, and cognitive processes.

Modern scientific research is uncovering new links every day between the endocannabinoid system and pain. Innovative water-soluble cannabinoid ingredients have the potential to reduce opioid consumption and improve pain outcomes for people living with chronic pain.

History of Cannabinoids for Pain Treatment

Increasing numbers of consumers are turning to cannabinoids like cannabidiol (CBD) to treat pain, but cannabis has been used since ancient times for pain relief. Chinese texts from 2900 B.C. contain the oldest documented use of cannabis for pain. Cannabis was used by 1000 B.C. to treat pain and inflammation in Ayurveda, the traditional medicine system of India. By the 19th century, physicians in the United States and Europe commonly prescribed cannabis for pain treatment.

How Does the Endocannabinoid System Modulate Pain?

Researchers are unlocking clues about how cannabinoids like CBD could help treat pain by studying the endocannabinoid system. The body naturally produces endocannabinoids such as anandamide and 2-Arachidonoylglycerol (2-AG) in response to tissue injury. These endocannabinoids act on CB1 and CB2 receptors to regulate the body’s response to painful stimuli. Cannabinoid molecules from hemp and cannabis act on the same endocannabinoid system receptors as anandamide and 2-AG, perhaps partially inducing pain-modulating effects.

Cannabinoids and the Opioid Crisis

Cannabis is an important avenue for pain treatment, especially in light of the opioid public health crisis. According to the Centers for Disease Control and Prevention, opioids were involved in approximately 75% of drug overdose deaths in 2020. Cannabinoids have significant advantages over opioids, including no risk of fatal overdose, and a lower risk of side effects and dependence.

Research on Water-Soluble Cannabinoids for Pain

A growing body of evidence shows the potential of water-soluble cannabinoids in treating pain.

• A 2010 double-blind, randomized, placebo-controlled study examined cannabinoids for pain treatment in 177 patients with advanced cancer whose pain was not adequately managed with opioids. The study assigned patients to receive tetrahydrocannabinol (THC) and CBD extract, THC extract, or placebo for two weeks. The patients who received a combination of THC and CBD experienced significant pain reduction of 30% from baseline compared to placebo.

• A 2015 study examined patterns of cannabis consumption in 229 medical cannabis patients, finding that 70% of participants experienced pain reduction and improved general well-being.

• A 2016 open-label study in 274 patients with treatment-resistant chronic pain found that medical cannabis consumption was associated with improved pain and reduced opioid consumption.

Mainstream medical clinicians and publications are increasingly embracing the potential of cannabinoid therapies for pain. For example, a 2015 systematic review of 28 studies on cannabinoids for medical use published in the Journal of the American Medical Association concluded that there was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain. The Annals of Internal Medicine published a systematic review in 2022 of 18 studies on cannabis-based products for chronic pain, concluding that products with high THC-to-CBD ratios may be associated with short-term improvements in chronic pain.