Among 878 fibromyalgia patients using CBD, 72% reported substituting it for medications, most commonly NSAIDs (59%) and opioids (53.3%), with the majority reducing or stopping those medications.
People with fibromyalgia considering CBD, pain management clinicians, pharmaceutical policy researchers
53.3% of CBD-using fibromyalgia patients substituted it for opioids
What the researchers found
72% of CBD-using fibromyalgia patients substituted CBD for medications: NSAIDs (59%), opioids (53.3%), gabapentinoids (35%), and benzodiazepines (23.1%). Most reported decreasing or stopping these medications, citing fewer side effects and better symptom management. Those who substituted reported larger improvements than non-substituters.
Why it matters
If fibromyalgia patients are independently substituting CBD for opioids and other medications at this scale, it signals a major unregulated shift in pain management that warrants clinical investigation.
The numbers in context
878 CBD users with fibromyalgia; 93.6% female; mean age 55.5; 72% substituted for medications; 59% for NSAIDs; 53.3% for opioids; 35% for gabapentinoids; 23.1% for benzodiazepines
How the study worked
Secondary analysis from a cross-sectional survey of 878 fibromyalgia patients currently using CBD, sub-grouped by product type (CBD isolate, hemp, CBD-cannabis, no preference) and substitution behavior.
What this study cannot tell us
Self-selected sample of CBD users (likely biased toward positive experiences), no clinical verification of diagnoses or medication changes, cross-sectional design, 93.6% female and 91.5% Caucasian sample.
How to read the evidence
Large survey but self-selected CBD-using sample with self-reported outcomes
When this study was published
Published in 2021. Rigorous clinical trials of CBD for fibromyalgia are still needed.
The bigger picture
This widespread naturalistic medication substitution is happening without clinical evidence that CBD is effective for fibromyalgia, highlighting the gap between patient behavior and the evidence base.
Questions still open
- Is CBD actually providing therapeutic benefit for fibromyalgia or are patients experiencing placebo effects? Are there risks to stopping opioids and gabapentinoids in favor of CBD? Do different CBD formulations have different efficacy?
Common questions
Are people with fibromyalgia replacing opioids with CBD?
Which CBD products were most effective?
Read the original research
Substituting Cannabidiol for Opioids and Pain Medications Among Individuals With Fibromyalgia: A Large Online Survey.
The journal of pain, 22(11), 1418-1428
Citation
Boehnke, Kevin F; Gagnier, Joel J; Matallana, Lynne; Williams, David A. (2021). Substituting Cannabidiol for Opioids and Pain Medications Among Individuals With Fibromyalgia: A Large Online Survey.. The journal of pain, 22(11), 1418-1428. https://doi.org/10.1016/j.jpain.2021.04.011
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