CBD has been shown to be effective in treating a vast range of ailments, from dementia to multiple sclerosis to even cancer, and it’s growing in popularity with each passing year. CBD carries virtually no potential for abuse and does not cause addiction or dependence, making it an especially attractive alternative for people taking a variety of prescription drugs, especially opioids.
Despite its ever-expanding use among patients, CBD hasn’t been embraced by the medical community with the same enthusiasm. While unsurprising (medical practice tends to run years behind current research), this presents a challenge for patients seeking to supplement or replace their current pharmaceutical regimen with CBD, as it makes having an honest and informative conversation about CBD with your doctor difficult.
CBD In Your Area
While hemp-derived CBD is legal in all fifty US states, it’s still a potentially sensitive subject in the medical community. Medical practice tends to run about 17 years behind current research, meaning there’s a lag between when research scientists reach a conclusion and when that conclusion is adopted by common medical practice. Doctors, as a group, tend not to be early adopters—while some CBD providers are working with pain management clinics to ease patients off of opioids, they tend to be the exception rather than the rule. Additionally, there has been some confusion about the legality of CBD, making some physicians reluctant to discuss it with their patients.
If you’re lucky enough to live in a state where medical cannabis is available, or if you have a particularly research-savvy doctor, that’s wonderful! If you’re not so blessed, don’t despair: we’re here to help you navigate this conversation, making it as easy as possible. We’ll help you prepare yourself, teach you the questions to ask, and talk about potential drug interactions to discuss with your doctor. We’ll also lay out a fallback plan, in the event that your doctor can’t (or won’t) help you.
Remember, doctors are humans just like we are, and they may not have all the answers you’re looking for. In that case, you can seek a second opinion, beef up your research game, seek advice from other patients, or any combination thereof. Don’t give up — your health is worth fighting for!
Before the Appointment: Preparing to Talk to Your Doctor
Before you go into the appointment, it’s important to have a clear idea of what you want to say to your doctor. Why do you want to take CBD? Are you experiencing problems or side effects with your current medication that you’d like to be rid of? What symptoms do you want to help alleviate: anxiety? Chronic pain? Muscle spasms? Multiple symptoms? Something else? Do you have any concerns or questions about using CBD? You’ll need to communicate your goals clearly to your doctor, so that you can work together to achieve them safely.
You’ll also want to really do your research beforehand, making yourself as knowledgeable as possible. There are a number of studies available for free online from academic journals (be sure to check your sources!), but they can be kind of…dense. If you’re looking for a readable breakdown of the science of CBD by condition, check out our free case studies to outline how CBD can help your symptoms, as well as an appendix full of sources for further reading. You can even take these case studies with you to the appointment to support yourself.
If you’re looking to replace your current medication with CBD, you’ll also need to prepare to discuss how to taper off your existing prescription. This means doing even more research, as your doctor may honestly not know how exactly to taper you off. If you do some research on the subject, you’ll see why—there’s just not a lot out there in the scientific literature, and medical schools certainly don’t focus on it. Very few medications, even those with well-established withdrawal risks, have established tapering protocols.
There’s no hard-and-fast rule to tapering schedules, and you’ll need to be prepared to work with your doctor throughout the process in order to taper safely. For more information on preparing to taper, check out our CBD ebook, which covers the basics of tapering and how to avoid withdrawal symptoms with caution and CBD.
During the Appointment: What to Say
You’ve prepared yourself, you’ve done your research, you’ve scheduled the appointment, and now the time has come to talk to your doctor. Don’t stress! For starters, you’re not doing anything illegal by asking your doctor about CBD, and your doctor isn’t breaking the law by advising you about it. Furthermore, thanks to the very recent FDA approval of the drug Epidiolex (a pharmaceutical cannabidiol intended to treat seizures), doctors can now advise you on use of a pharmaceutical CBD (as opposed to one available over the counter), if you — or they — prefer.
Be direct and honest when you speak to your doctor; don’t get cagey or anxious. Remember, there’s nothing to be nervous about! Your doctor is much more likely to be willing to at least try to help you if you’re upfront with them, so state your reasons and goals clearly and respectfully. You can address any side effects your medication is causing and discuss how to go about tapering off your dose.
Your doctor may need to prescribe a different form of your current medication in order for you to begin tapering, such as tablets or syrups as opposed to capsules or softgels, so ask about this during the conversation. Don’t be afraid to ask questions! You’ve done plenty of research up to this point, but your doctor may be able to provide valuable insight or context for something unclear from your research, so if you’ve got something to say, say it!
You’ll also need to discuss any potential interactions that CBD might have with your current medication. We’ll discuss these in more detail in a moment, but it’s worth mentioning here as well. Keep in mind that an interaction doesn’t necessarily mean a negative consequence, but every drug is different and you’ll need to know what to watch out for in the event of an adverse interaction (exceedingly rare, but not impossible). Tell your doctor about any medications you’re taking and plan accordingly.
After the Appointment: Continue to Monitor
You did it! You talked to your doctor, and things went well. You created a plan to taper off your current pharmaceuticals and replace them with organic, full-spectrum CBD. That’s fantastic! However, the journey isn’t over yet.
You’ll need to continue to keep in touch with your doctor, reporting any withdrawal symptoms to them and keeping them abreast of your condition. You may also need to do things like take blood tests or return for checkups, so be sure to keep those appointments. If you’re fortunate enough to have your doctor in your corner during this process, that’s wonderful and you should take full advantage of that blessing.
Now, let’s say your appointment didn’t go so well. Perhaps your doctor doesn’t feel confident in their knowledge of cannabinoids to advise you on their use, or maybe they don’t know how to help you taper off your current medications. Perhaps they simply aren’t willing to help you, for reasons that are their own. Whatever the reason, don’t worry. Of course it’s preferable to make any health decision under your doctor’s supervision, but your health is fully in your hands and you—and only you—have the final say on what you do with your body.
You can still use CBD to replace your medications, but you will need to be especially careful. Read absolutely everything you can about tapering off your medication beforehand, know what to expect if you experience withdrawal, and—this is key—should withdrawal symptoms arise, restore yourself to the previous dose. This doesn’t mean that you’ll be stuck here; after a few days at the previous dose, try to decrease your dose again, this time at a lower increment. Slow and low is key to successful tapering, and it’s okay if it’s not a perfectly linear process for you.
Whatever you do, don’t quit cold-turkey! Not only can withdrawals be debilitating and last for over a month, discontinuation syndrome (a more clinical way of describing withdrawal symptoms) can even be fatal in some cases. Take your time, listen to your body, and be patient. Take good care of your physical and mental health during this time. Make good lifestyle choices and consider your health from a holistic perspective. For further reading on the power of CBD to help ease your transition and treat your symptoms, check out our CBD ebook.
A Note On Drug Interactions
CBD, like any other compound, has the potential to interact with your body’s processing of other substances. While it’s considered one of the safest substances you could possibly be taking, there’s one particular mechanism it affects that can potentially interact with a variety of substances. Keep in mind that interaction doesn’t mean catastrophic issue—this section isn’t meant to scare you, it’s meant to inform you of all possibilities, however remote. Talk to your doctor before making your decision if you’re worried about drug interactions.
CBD inhibits the activity of an enzyme called cytochrome P450, which is responsible for metabolizing many of the compounds you put in your body, including about 60% of the drugs you consume. When CBD slows down the activity of this enzyme, it takes it longer to do its job. This can raise the level of a drug in your system, as well as extend the length of time it takes your body to process it. Drugs that can be affected by CBD include:
- Angiotensin II blockers
- Beta blockers
- Calcium channel blockers
- HMG CoA reductase inhibitors
- HIV antivirals
- Immune modulators
- NSAID pain relievers
- Oral hypoglycemic agents
This isn’t meant to be an exhaustive list, but it should give you a good idea of what to look out for to discuss with your doctor. When in doubt, it doesn’t hurt to ask!
A Quick Note About Drug Testing
Much of the data we have about CBD is anecdotal, and its potential impact on drug testing is no exception. There are very few peer-reviewed studies on the subject, and the ones available paint a rather murky picture: avoiding full-spectrum products containing traces of THC can reduce your risk of a false positive, but that may not eliminate the risk entirely. A single study (as yet unconfirmed) suggests that even isolate-based products may not be completely risk-free under certain circumstances.
If you are concerned about passing a drug test, you’ll need to consider this potential risk when deciding whether CBD is right for you. To learn more about the science of CBD and drug testing, check out our article for a more thorough discussion of how to minimize your risk of a false positive.
Talking about CBD with your doctor can be intimidating, but it doesn’t have to be! You aren’t doing anything wrong or illegal, and you aren’t asking them to either. Go in well-informed, bringing notes with you if you like, and be open and candid with them about what you’re looking for. If they’re receptive, wonderful! But if not, it’s not the end of the world—you can still use CBD. You won’t overdose, you won’t get addicted, and you won’t become tolerant of it. For further reading on how CBD can benefit your health, take a look through our free CBD case studies and check out our CBD ebook.