Chronic pain is pervasive in our society. In 2018, the Centers for Disease Control and Prevention released a report that an estimated 50 million Americans, or just over 20%, have some form of chronic pain.

As a chronic migraine sufferer, I understand the challenges of a chronic pain condition. As a healthcare provider, I know that chronic pain is one of the most difficult conditions to treat, as pain perception is a multidimensional experience that is unique to the individual.

Given the significant ramifications of our national opioid epidemic, it's very important to approach the treatment of chronic pain in effective but nonaddictive ways. Cannabis (commonly obtained from the Cannabis indica and Cannabis sativa plants) is comprised of three major components: cannabinoids, terpenoids and flavonoids. Cannabinoids have two major components: tetrahydrocannabinol (THC) and cannabidiol (CBD). Marijuana — also called weed, herb, pot, grass and a vast number of other slang terms — is a greenish-gray mixture of the dried flowers of C. sativa. The main psychoactive component in marijuana is THC, which is equated with euphoria, or "getting high." On the other hand, CBD is a nonpsychoactive component of the cannabis plant.

Cannabis is one of the fastest growing industries in the United States. In recent years, there has been an increasing acceptance of cannabis for both recreational and medical use. The legalization of marijuana has spread across the country since 1996, when California became the first state to legalize medical marijuana. Currently, 21 states allow for adult use and 37 allow for medical use. More states are likely to legalize marijuana in 2023.

CBD has emerged as a promising agent to treat pain, as well as a variety of other conditions such as seizures, headaches and anxiety, to name a few. CBD exerts its pain-relieving effects through interactions and modulation of the endocannabinoid, inflammatory and nociceptive (pain sensing) systems. The endocannabinoid system is interesting in that it consists of cannabinoid receptors that interact with a person's naturally occurring cannabinoids.

While CBD is widely available and even more widely advertised for its potent effects on pain (and other conditions), there is a lack of scientific research supporting such claims. Nevertheless, CBD has become big business. CBD sales in the U.S. hit $4.6 billion in 2020.

Below are five important tips to help you make informed decisions as a consumer about use of CBD:

No. 1: CBD is only approved by the United States Food and Drug Administration (FDA) as adjunct therapy for the treatment of rare and severe forms of epilepsy; it is not approved for treatment of pain.

No. 2: There is a lack of reliability of the purity and dosage of CBD in products. Most CBD products are not regulated. The FDA has tested the chemical content of cannabinoid compounds in some products and many of these did not contain the levels of CBD claimed by the manufacturers. This led the FDA to issue warning letters to several firms that market unapproved new drugs that allegedly contain CBD.

No. 3: According to the FDA, it is "illegal to market CBD by adding it to a food or labeling it as a dietary supplement."

No. 4: CBD may interact with other medications such as blood thinners, heart medications and immunosuppressants.

No. 5: CBD can have side effects including dry mouth, diarrhea, nausea, reduced appetite, drowsiness and fatigue. It can cause liver injury and may affect the male reproductive system. The safety profile of CBD in special populations such as the elderly, pregnant women and children is not fully understood.

CBD is widely available in the marketplace but not as widely researched. Consult with your healthcare provider prior to using products containing CBD for chronic pain or other conditions.

To find out more about Julie Rosenberg and read features by other Creators Syndicate writers and cartoonists, visit the Creators website at www.creators.com.

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