Since my last post in this thread (back in the summer, not long after I was hit by a car), I've tried several brands and types of CBD:
+CBDoil (Plus CBD Oil)
Green Mountain from Vermont
Pinnacle
Lazarus
Jolly Green Oil e-liquid for vaping
I may have a higher tolerance than some folks and need at least 25 mg per dose for any effect. I've taken as much as 100 mg in a single dose and felt only slightly light-headed, which passed after about 15 minutes. My personal therapeutic dose seems to be around 100-200 mg per day, taken in increments of 25-50 mg per dose.
Unfortunately CBD is too expensive and the benefits too subtle to be practical for me. CBD works for me pretty much the same way coffee does. But coffee is much more cost effective, even the better and pricier coffee. And I enjoy it more.
After my current batch of CBD is gone I doubt I'll use it again. Until CBD reaches the level of coffee in terms of price per dose, it's not really cost effective. But I'm open to trying it again if there's a promising new product that's priced reasonably.
Of those I listed above I can only recommend Green Mountain (highly recommended), Lazarus and Pinnacle. The others had no discernible effect. I dislike smoking, didn't enjoy vaping and the e-liquid had no effect anyway. Supposedly vaping is the most effective way to ingest CBD but I couldn't discern any effects.
Green Mountain and Lazarus are closest in price to my personal standard for affordability and cost-effectiveness: The cost per dose is comparable to a decent cup of coffee.
Green Mountain may be both the best quality and best value -- they do everything themselves, from raising the plants to making the finished product, which is among the lowest priced around. They use oil extraction rather than CO2 or alcohol. The oil in the capsules has a distinctive but pleasant hempy flavor, reminiscent of floral hops. I usually dissolved the gel caps under my tongue, then swallowed the rest.
Lazarus is the best value for folks who are eligible for their discounts (veterans like me, disabled folks and those on low income). And Lazarus seems committed to improving their product, including responding to customer comments about flavor, etc. Their RSO oil is the best value, a neutral hemp flavored oil, not as pleasant tasting as Green Mountain but not objectionable. I've also tried the isolate crystals dissolved in hot tea -- it's essentially flavorless despite the added terpenes. Their high potency oils and capsules smelled and tasted fishy to me, but recently Lazarus announced they were reformulating their products to improve the flavors. One of the complications of oral/sublingual CBD is that it supposedly works best in fatty acids. MCT is commonly used but some folks find the flavor unpleasant.
Pinnacle's sublingual/oral oil is a premium product and priced accordingly but good quality. Potent but pleasant flavor. It helped reduce the gagging reflex I experienced during the summer when my thyroid was so swollen I couldn't swallow without a lot of discomfort. I was losing too much weight and the Pinnacle oil relaxed my gag reflex just enough that I could eat and swallow solid food. Some studies indicate the added terpenes may be as significant as the CBD content in helping with some types of nausea and related discomfort.
However, after several months of trying CBD, the most I'd be willing to say is that CBD is roughly comparable to coffee or caffeinated beverages in terms of pain relief and mood enhancement. That's a good thing. It's useful for reducing moderate pain (1-4 on a scale of 10), and subtle mood enhancement without any perceptible "high" or unwanted side effects. It may benefit folks who struggle with depression or other mood disorders. I won't discourage anyone from seeking competent psychiatric and psychological help and appropriate prescription meds, but CBD may be useful for some folks as an alternative or supplement.
But CBD is far too expensive. Even the lowest priced good quality CBD isn't really an affordable alternative medicine. I can get a lot more good quality coffee for the same money and enjoy basically the same effects.
And I'm still skeptical of assertions that CBD or THC can replace opiates. There's a huge difference between the extreme, unbearable pain opiates can handle... and everything else.
For example, I just had surgery this week to remove part of my thyroid. The immediate post-op pain wasn't unbearable and I was actually chattering a bit with the post-op staff, took a selfie to amuse my Facebook friends, etc. The incision area wasn't bad -- it was a shallow incision. And at the moment the worst pain was a sore throat from intubation. So I didn't need any opiates for several hours.
But after 10 pm, a little more than 12 hours post-op, the pain was unbearable. I couldn't swallow or do respiratory therapy without pain. I had one of the worst headaches I've experienced, and I've had migraines and cluster headaches most of my life -- this post-op headache felt like the sinus headache from hell, like my sinuses were filled with lava and trying to explode. It took three doses of hydrocodone, each 4 hours apart, before the pain finally eased up around 6 am. That's a damned long time to be in pain at a level of 7-9 on the scale of 10.
And what really helped was the cup of strong black coffee the overnight RN brought me along with my hydrocodone. That's why I'm only half joking when I say coffee is medicine. The combination of heat, steam, caffeine and a moderate strength pain reliever finally kicked the headache. (Hydrocodone, like Tramadol, is considered only a moderate strength opiate, despite the media hype and disinformation, and not among the most commonly abused meds compared with black market fentanyl and others)
Since being discharged I've needed only one hydrocodone, mostly to ease the throat pain just enough to do my respiratory therapy. By the next day I could do the therapy without any real discomfort, so I probably won't need the prescription meds again. Suits me because I don't like the slightly fuzzy headed side effect.
But that's what opiates are for and I don't see any possibility for any cannabis product to replace opiates for severe pain.
However CBD might be a practical alternative to ibuprofen, aspirin or acetaminophen for folks with moderate chronic pain that isn't directly related to a recent injury or inflammation, especially if low level anxiety or depression are involved -- and it's common for folks with chronic pain to also experience anxiety and depression. I don't see any downside to taking CBD for this kind of moderate low grade chronic pain and associated anxiety/depression.
But the prices will need to come way down. Hopefully mainstreaming CBD and mass production will resolve the cost issue.