Survey of 878 fibromyalgia patients finds most use low-dose CBD with no clear dose-response relationship | Research

The takeaway

Among 878 people with fibromyalgia using CBD, typical doses were under 50 mg/day, one-third did not know their dose, purchasing was driven by personal research rather than medical advice, and higher doses did not correlate with greater reported benefit.

Fibromyalgia patients using or considering CBD, clinicians, and researchers designing CBD clinical trials.

No dose-response relationship for CBD at typical doses under 50 mg/day

What the researchers found

Average CBD dose per session was 16 mg, with 24-27 mg per day. About one-third of participants did not know their CBD dose. Purchasing was driven by personal research (63%) rather than medical professionals (16%). Tinctures and topicals were most common. Those using both inhalation and non-inhalation routes reported greater symptom relief. No consistent relationship between CBD dose and reported effects was found.

Why it matters

With fibromyalgia patients commonly turning to CBD products, this study reveals that most are self-directing their treatment with low doses and no medical guidance, and that standard dose-response assumptions may not apply.

The numbers in context

878 participants (93.6% female, mean age 55.5); 16 mg CBD per session, 24-27 mg/day average; 63% relied on personal research; 16% guided by medical professionals; ~33% did not know their dose.

How the study worked

Secondary analysis of a cross-sectional survey of 878 people with fibromyalgia using CBD products. Participants were subgrouped by past-year high-THC cannabis (HTC) use. Administration routes, dosing patterns, and perceived effects were analyzed.

What this study cannot tell us

Self-report data. No verification of product contents or diagnoses. Cross-sectional design. Predominantly female and white sample. No placebo control. CBD product quality and actual cannabinoid content likely varied.

How to read the evidence

Large survey with detailed dosing data, but self-report and lack of verified products limit conclusions.

When this study was published

Published in 2022.

The bigger picture

The lack of a dose-response relationship for CBD in fibromyalgia raises important questions: are patients underdosing, or is the reported benefit largely driven by expectancy? This finding should inform clinical trial design.

Questions still open

Would higher, verified doses of CBD produce measurable dose-response effects? Is the benefit driven by expectancy, the entourage effect from other cannabinoids, or genuine CBD pharmacology at low doses?

Common questions

How much CBD do fibromyalgia patients typically take?

Most used less than 50 mg per day, with an average of 16 mg per session and 24-27 mg per day. Notably, about one-third of users did not know what dose they were taking.

Does taking more CBD provide more relief for fibromyalgia?

In this survey, there was no consistent relationship between higher CBD doses and greater reported benefit. The researchers suggest this could be due to expectancy effects, individual variability, or the doses being too low to see a pharmacological dose-response.

Read the original research

Cannabidiol Product Dosing and Decision-Making in a National Survey of Individuals with Fibromyalgia.

The journal of pain, 23(1), 45-54

View on PubMed ↗Publisher’s paper ↗

Citation

Boehnke, Kevin F; Gagnier, Joel J; Matallana, Lynne; Williams, David A. (2022). Cannabidiol Product Dosing and Decision-Making in a National Survey of Individuals with Fibromyalgia.. The journal of pain, 23(1), 45-54. https://doi.org/10.1016/j.jpain.2021.06.007