One lesson learned from the terrible opioid crisis of the past few years: a lot of Americans are in a lot of pain. With doctors increasingly reluctant to prescribe narcotics for pain relief, people are looking around for substitutes. One compound that has garnered a good bit of interest lately is cannabidiol, aka CBD. Cannabinoids are being utilized for cancer pain (Journal of Pain Research, April 23, 2018). People who suffer severe recurrent migraines are also turning to cannabis compounds (Journal of Headache Pain, May 24, 2018). Will use of such agents result in a person being identified as a drug abuser?

Cannabinoids for Back Pain:

Q. The discs and vertebrae in my spine are degenerating and causing me severe pain. I started taking CBD oil for pain a few months ago.

Once it had time to build up in my system, the pain relief was miraculous. Sadly, I recently did a home drug test and it was positive for THC. I need to talk to my doctor because I have no idea how to address this. It’s legal to buy CBD oil OTC in my state, but there’s no way to prove it is the source of any THC in my test.

A. Cannabidiol (CBD) oil is legal in many states because it does not make people euphoric. It is not supposed to have any tetrahydrocannabinol (THC) in it. THC is the compound that produces a marijuana high. State by state regulation means that anyone who wishes to use this compound for pain relief will need to become familiar with the relevant laws of that state.

The FDA has approved one purified form of cannabidiol as a prescription anticonvulsant medication, Epidiolex. Research on CBD oil suggests some benefit against pain and inflammation (Molecules, online, Sept. 27, 2018).

Side Effects of Cannabidiol:

People using cannabidiol have reported fatigue, nausea, diarrhea and irritability. People on the anticoagulant warfarin (Coumadin) should avoid cannabidiol, as it may raise blood levels of warfarin. Like grapefruit, CBD can inhibit the intestinal enzyme CYP3A4, which the body uses to process a wide range of medications (Current Drug Metabolism, 2016).

But Will It Lead to a Positive Urine Test for Marijuana?

Unfortunately, certain CBD manufacturers are not able to remove all traces of THC. One study found that some people tested positive for THC after taking CBD oil (Journal of Pain Research, Feb. 12, 2016). ConsumerLab.com has written that people taking CBD oil aren’t likely to fail a marijuana drug test, but it is not impossible.

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