Yale Medicine doctor investigates whether a synthetically created molecule that mimics properties and effects of CBD could treat diseases. An impressive amount of research suggests that CBD is effective against pain and inflammation. For that reason, many people with lupus are turning to full-spectrum CBD oils for relief. What is the truth about lupus and CBD oil? Can it actually help you control the symptoms and reach the underlying problem? See what we know about CBD oil as a potential treatment for lupus, what the side effects are, and what you need to know about the legal status.
Can Cannabinoids Help Lupus and Other Diseases?
A lupus diagnosis can be devastating. The disease causes the body’s immune system to attack its own tissues and can affect internal organs—including the brain, heart, and lungs—which can start to deteriorate. Lupus flare-ups can leave patients so fatigued and in pain that they’re unable to do the simplest of things, such as walk, cook, or read. Many can’t go outdoors without layers of sunscreen, because the disease can make them extremely susceptible to sunburn.
Lupus affects approximately 240,000 people in the United States, and yet at present doctors neither know the exact cause nor have a cure. Instead, current treatments focus on improving quality of life by controlling symptoms and minimizing flare-ups to reduce risk of organ damage.
“The landscape for treatment of lupus is a bit bleak,” says Fotios Koumpouras, MD, a rheumatologist and director of the Lupus Program at Yale Medicine. “A multitude of drugs have failed in the last 10 to 15 years. Most of the drugs we use are being repurposed from other conditions and are not unique to lupus. Many of them can’t be used during pregnancy, which is a problem because lupus mostly affects young women. All of these issues create the impetus to find new and more effective therapies.”
This is why he’s exploring a candidate for a new lupus treatment option: a molecule with a cannabinoid template structure that binds to cannabinoid receptors, the same receptors involved in the chemicals found in the marijuana plant.
What is CBD?
CBD is a form of cannabinoid called “cannabidiol.” Cannabinoids are a type of chemical that binds to CB1 and CB2 receptors found throughout the body. CB1 receptors are mostly located in the nervous system, connective tissues, gonads, glands, and organs; CB2 receptors are primarily found in the immune system, along with the spleen, liver, heart, kidneys, bones, blood vessels, lymph cells, endocrine glands, and reproductive organs. (Collectively this is called the endocannabinoid system.)
What these cannabinoids do when they bind to the receptors depends on which receptor is activated, and thus can produce effects ranging from the firing of neurotransmitters (the chemical messengers sent from the brain to the rest of the body) that alter mood, to reducing inflammation and promoting digestion.
So, our bodies have their own endocannabinoid system, but cannabinoids can also be found in nature, most abundantly in the marijuana plant. The two most well-known types of cannabinoids in the marijuana plant are THC (tetrahydrocannabinol) and CBD (cannabidiol). THC binds to both the CB1 and CB2 receptors, but the CB1 receptor seems to be responsible for many of the well-known psychoactive effects of marijuana, such as euphoria, increased heart rate, slower reaction times, and red eyes. CB2 receptor binding results in the production of a series of proteins that reduce inflammation. (These proteins are called “resolvins” because they appear to resolve inflammation.) The pharmacology of CBD at cannabinoid receptors is complex and highly variable, but CBD has been shown to activate the endocannabinoid system.
Fotios Koumpouras, MD, is researching a synthetically created cannabinoid molecule that binds preferentially to CB2 receptors (called Lenabasum) to see if it can help ease pain and inflammation in patients with lupus.
Dr. Koumpouras learned from a colleague of ajulemic acid, a side-chain analog of Δ8-THC-11-oic acid, which was designed as a potent therapeutic agent free of the psychotropic adverse effects typical of most cannabinoids. This molecule may help relieve pain and reduce inflammation in systemic lupus erythematosus (SLE), the most common type of lupus. “Reducing inflammation is crucial for patients with lupus because it is what causes the buildup of scar tissue in vital organs that can eventually lead to their deterioration and malfunction,” he says. This cannabinoid molecule was already in study for other diseases, including systemic sclerosis and dermatomyositis.
In 2018, Dr. Koumpouras joined a multi-site randomized clinical trial that aims to recruit 100 participants to examine whether a drug using a synthetically created cannabinoid molecule that binds preferentially to CB2 receptors (called Lenabasum) can help ease pain and inflammation in patients with lupus. Participants will receive Lenabasum or a placebo for almost three months and will continue to be monitored for pain and inflammation levels, as well as lupus disease activity. The study is ongoing, but Dr. Koumpouras anticipates that it will wrap up by early next year.
From “miracle drug” to medicine?
Dr. Koumpouras’ excitement over the new drug comes at a time when products containing CBD have flooded supermarkets, labeled with claims that they treat everything from back pain to insomnia. Although CBD is not yet approved by the FDA, the hype around it stems from the popularity of the marijuana plant it is derived from.
But whether CBD actually provides those benefits in a significant way remains to be seen. Only a few studies—small ones—have definitively proven the effectiveness of medicines that involve the endocannabinoid system. To date, the only FDA-approved medication containing CBD is Epidiolex, a medication used to treat two rare forms of severe epilepsy—Lennox-Gastaut syndrome and Dravet syndrome, both which begin mostly in infancy and early childhood. In a group of three clinical trials, Epidiolex seemed to reduce the number of seizures significantly. And yet, Vinita Knight, MD, a Yale Medicine pediatric neurologist, says her patients who take Epidiolex have had mixed results. Some have had reductions in seizures and others haven’t shown much improvement. “We’re not seeing as much success as what’s been reported on Facebook and Twitter,” she says, but adds that so far it has only been prescribed for children with the most debilitating and difficult-to-treat seizures. In addition, some researchers believe that CBD works most effectively in combination with other cannabinoids and compounds found in the marijuana plant, in what is known as the “entourage effect.” Thus, it would be less effective as an isolated chemical in pill form, but that, too, remains unproven.
But these questions are why Dr. Koumpouras is focusing on a compound that, until recently, few have studied.
His research is one of many new studies at Yale and elsewhere looking at the endocannabinoid system and molecules related to CBD action for use in treating everything from Crohn’s disease to psoriatic arthritis, and he hopes that this new data will be used to help paint a more complete picture about the chemical for future treatment options.
“The more data the better,” he says. “The more we’re able to make informed decisions.”
CBD Oil for Lupus: Benefits, Dosage, & How to Use?
This article covers everything there is to know about lupus and CBD oil — from the involvement of the endocannabinoid system (ECS) to CBD’s efficacy in treating lupus to finding the best dosage for your individual situation.
Lupus is an autoimmune condition that can take several forms; the most common type of lupus is systemic lupus erythematosus (SLE). It is marked by general inflammation of the immune system, causing it to attack its own tissues.
Although there’s no cure for lupus, it has a range of treatments, including CBD oil, which can help mitigate symptoms, prevent flare-ups, and improve the quality of life of those living with the disease.
Read on to learn more about the potential benefits of using CBD oil for lupus and how to tackle the condition for the best results.
Does CBD Help with Lupus?
CBD becomes the go-to alternative to pharmaceutical medications for people living with lupus due to its much better safety profile. CBD has remarkable anti-inflammatory and pain-relieving properties, but it doesn’t come with the dangerous side effects associated with prescription drugs.
According to a review of different treatments for lupus patients, 50% of people with lupus use complementary and alternative treatments for symptom control. The therapies highlighted by the review include natural remedies, meditation, chiropractic treatment, breathing exercises, and health supplements such as CBD .
CBD, or cannabidiol , is one of the major botanical compounds found in cannabis plants. It is extensively studied regarding its effects on human health through endocannabinoid modulation and interactions with over 65 molecular pathways.
The endocannabinoid system (ECS) is the master regulatory network that maintains homeostasis throughout the body by sending its own endocannabinoids to bind to cannabinoid receptors type 1 and 2 (CB1 and CB2).
CBD indirectly interacts with the ECS receptors through certain enzymes and hormones that optimize the release of endocannabinoids by the body and the time they circulate in one’s system .
Medical researchers have investigated the therapeutic potential of CBD in a range of physiological and mental ailments, including anxiety and depression , epilepsy , chronic pain , sleeping disorder and insomnia , and autoimmune diseases .
The last category involves lupus, which — as mentioned — is characterized by widespread inflammation.
How Does CBD Work for Lupus Treatment?
While direct research on CBD use for lupus is in the early stage, many studies are underscoring the anti-inflammatory and analgesic properties of CBD. Since chronic inflammation is the root cause of lupus, researchers hypothesize that it can be an effective treatment for its symptoms.
Let’s take a look at what science says about the most prominent areas of lupus treatment with CBD oil.
CBD for Pain and Inflammation
While there’s no universal course of illness regarding lupus, the National Resource Center on Lupus reports that more than 90% of patients experience inflammation and pain in the joints or muscles . As a matter of fact, more than 50% of people with lupus mention joint pain as their first symptom. Lupus pain is certainly triggered by inflammation.
A 2018 study on CBD use identified pain as the most commonly cited reason for using CBD oils. While CBD hasn’t been directly studied concerning lupus, there’s a solid scientific ground suggesting its use for pain and inflammation . A 2018 study published in the Journal of Pain Research shows that CBD has significant benefits for pain management compared to placebo .
CBD blocks the release of inflammatory proteins by acting on adenosine receptors . It can also mitigate pain signaling to the brain by interacting with TRPV-1 cells .
CBD for Anxiety and Depression
Depression is a comorbid condition in many autoimmune diseases. Lupus often goes through periods of remission and flare-ups, which can take a toll on your mental health. Dealing with any chronic disease can cause psychological distress manifested by episodes of anxiety or depression — not to mention the destructive impact of the disease on the nervous system itself.
According to one study, 25% of lupus patients experience depression, while anxiety affects 37% . Another study confirms the prevalence of mood and anxiety disorders in women with SLE compared to the general population .
Learn more about CBD and anxiety here.
One study examining the reasons for CBD use identified anxiety as the second most common cause of taking CBD oil. CBD has been shown to interact with serotonin receptors. Serotonin is a neurotransmitter linked to mood and emotions . Given this, CBD can modulate the functioning of serotonin receptors and thus be used as a potential treatment for generalized anxiety disorder, panic disorder, and social anxiety disorders. Studies on animal models have also demonstrated the antidepressant effects of CBD.
CBD for Opioid Addiction
Chronic pain is a common issue for many lupus patients. Doctors usually recommend opioid-based painkillers for severe lupus pain, which may not be the best solution considering the dangerous side effects of long-term opioid use.
A 2019 study showed that 31% of lupus patients use prescription opioids. Of them, 68% had been taking opioids for more than one year, and 22% used a combination of two or more opioid medications .
When used as prescribed by a doctor, opioid medications can help in short-term pain control, but they aren’t recommended for long-term use due to the high risk of dependence and severe withdrawal. Opioid use is a growing epidemic in the United States that can be challenging to treat. Meanwhile, some studies suggest that CBD has the potential to intervene against opioid addiction and withdrawals.
THC and CBD Effects on Lupus (The Entourage Effect)
CBD isn’t the only anti-inflammatory compound in cannabis. THC, the other major compound, is a potent anti-inflammatory and analgesic agent too.
When you take THC and CBD together — either in a herbal extract or by inhaling vapor from the flowers or concentrates — they work synergistically to produce the entourage effect. This phenomenon has been identified in 1988 and presumes that the sum of all active ingredients in cannabis is more effective therapeutically than each of them alone.
Cannabis has long been used to reduce inflammation in the body in patients with autoimmune diseases, such as ulcerative coliti s, atopic dermatitis , psoriasis , rheumatoi d arthritis , and neurodegenerative disorders like Alzheimer’s or Parkinson’s disease .
Researchers have found that cannabis lowers levels of a compound called interleukin-2 and increases the concentrations of interleukin-19, which is an anti-inflammatory protein. These are the driving factors behind marijuana’s analgesic effects; they’re also the reason why people with lupus turn to the combination of THC and CBD for effective symptom control .
If you’re afraid of getting too high from using cannabis for lupus, you may opt for selectively-bred high-CBD strains, which often come with ratios like 20:1, 12:1, 10:1, 5:1, or 2:1. Such strains provide the anti-inflammatory and painkilling benefits of cannabis but without an overwhelming buzz in large doses.
Learn more about CBD and THC, head over to our comprehensive post on the topic.
Best Type of CBD for Lupus
Proponents of the entourage effect suggest full-spectrum CBD oil as the best type of CBD for lupus. That’s because the aforementioned synergy between the botanical compounds in cannabis leads to a greater therapeutic effect.
This, in turn, translates into more effective symptom control on top of reaching the underlying cause of lupus — chronic inflammation.
The only federally legal type of CBD that evokes the entourage effect is full-spectrum CBD oil from hemp. This type of CBD contains all cannabinoids, terpenes, and flavonoids that naturally occur in hemp plants — including trace amounts of THC.
The THC in full-spectrum CBD oil is only at 0.3% or less due to federal regulations ruled out by the 2018 Farm Bill.
If you’re concerned about the trace amounts of THC in your product, there are also broad-spectrum extracts and CBD isolates.
Broad-spectrum CBD is very similar to its full-spectrum counterpart — but it doesn’t have any THC. The intoxicating compound is removed from the end product after initial extraction.
CBD isolate exactly what it sounds like — pure, isolated cannabidiol. This type of CBD ensures the highest dose per serving for people with lupus and is free of any aroma and flavors. While these are obvious advantages for people fussing over the natural taste of CBD oil, isolated CBD has one serious drawback: the lack of the entourage effect.
People typically choose isolates over other formats when they have a job that requires drug testing for THC.
CBD Dosage for Lupus
Though CBD oil may help reduce joint pain and inflammation, as well as other lupus-related symptoms, it’s important to note that CBD hasn’t been widely examined as the treatment for lupus. Therefore, there are no established dosage guidelines or charts for people with lupus who would like to start taking CBD.
The effective dosage may vary between individuals based on several factors, including age, weight, gender, metabolism, unique body chemistry, and more. Trial-and-error is inevitable if you want to find the best dosage for lupus in your case.
If you’re new to CBD, you may want to start with a low-potency oil and take small doses to see how your body responds to CBD in the first place. From there, you can adjust the dosage as needed; you’ll know you’ve found your optimal dose when the pain will start to go away along with other symptoms — but without causing drowsiness or lethargy.
The side effects of taking CBD oil include dry mouth, dizziness, sedation, changes in appetite, or diarrhea. That being said, it’s impossible to overdose on CBD lethally; the WHO has acknowledged its safety profile, claiming that people can use even 1,500 mg daily and go on without any dangerous side effects.
Since CBD interacts with many pharmaceutical medications, it’s important to consult your doctor before buying CBD oil for lupus if you had been prescribed any medication. Doing so will help you fit CBD into your existing routine to avoid negative interactions.
What Is Lupus?
Lupus is an autoimmune disease. The immune system of a person with lupus starts to malfunction, attacking healthy cells instead of the malignant ones because it treats them as foreign invaders. So, instead of protecting you against pathogens, it turns against the body by killing normal cells and creating widespread inflammation.
Chronic inflammation can lead to tissue damage and even trigger some serious complications that can be life-threatening.
Different Types of Lupus
There are 5 identified types of lupus:
- Systemic Lupus Erythematosus (SLE) – the most prevalent form of lupus, SLE is also the most severe type because it affects the entire body.
- Subacute Cutaneous Lupus – this type of lupus only affects the skin and is characterized by a widespread rash often worsened by exposure to sunlight.
- Drug-Induced Lupus – as the name suggests, this form of lupus is caused by certain medications, including hypertension drugs and pills for rheumatoid arthritis.
- Neonatal Lupus – a rare type of lupus that occurs in infants of women who have lupus.
As mentioned at the beginning of the article, lupus symptoms may vary from one person to another depending on the type and intensity of symptoms.
In many cases, people with lupus also experience arthritis of the small joints and a rash. Oftentimes, these symptoms are accompanied by fever, hair loss, abdominal pain, fatigue, swollen lymph nodes, dry mouth, and mood disorders.
The first clinical sign of lupus is an abnormal blood test result such as protein in the urine, indicating kidney disease for many patients. The pattern in which the flare-ups occur may change over time; the diagnosis of lupus generally relies on laboratory testing.
What Causes Lupus?
Similar to many autoimmune diseases, the exact cause of lupus is unknown. That being said, researchers believe that it may involve a combination of genetic, hormonal, and environmental factors. Others attribute the onset of lupus to severe stress and excessive exposure to sunlight.
Although anyone can have lupus, the newest epidemiological reports point to women under 45 as the most affected group. Lupus also tends to develop more often in people of color, particularly Asian, Latin, and African. Children forms of lupus usually develop after 15 years of age.
How Is Lupus Treated?
As a complex condition, lupus has various treatments whose effectiveness may vary depending on the organs involved and the patient’s symptoms. Sometimes, more than one therapy may be required for effective symptom control. The treatment may also change over time depending on the progress of the disease.
Many people with lupus live a normal lifespan but may experience some level of disability.
The most common treatments for lupus include:
- Biological agents
- Immunosuppressive drugs
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Intravenous immunoglobulin
- Antimalarial drugs (like Hydroxychloroquine)
Unfortunately, most of these treatments entail the risk of severe side effects, some of which can be life-threatening. For this reason, although not extensively studied, CBD oil has become an appealing alternative for patients with lupus. It exerts potent anti-inflammatory and analgesic effects without posing a threat to your life.
Final Thoughts on Using CBD Oil for Lupus
Every year records an estimated 16,000 new cases of lupus. It is a life-changing autoimmune disease that has no cure and can significantly worsen the quality of your daily life.
Living with a compromised immune system can be difficult. However, knowing the right way to take alternative treatments such as CBD oil may be a significant step towards a better life. Finding the right type and dosage of CBD for lupus takes time and isn’t as obvious as some go-to therapies, but it’s definitely much safer.
CBD can reduce certain lupus symptoms, such as pain and inflammation, skin infections, hypertension, anxiety, and photosensitivity.
Because of the possible interactions with certain drugs, people with lupus should consult their doctor before adding CBD oil to their regimen.
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Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
Is CBD Oil for Lupus Safe or Effective?
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Riteesha G. Reddy, MD, is a board-certified rheumatologist and internist at a private practice in Dallas, Texas.
CBD oil, which is derived from marijuana, has become a trend when it comes to treating diseases involving pain and inflammation. But is it effective for lupus?
So far, we don’t have conclusive evidence that CBD oil can safely treat lupus, but research is currently being conducted to help make this possible.
Because medical marijuana is still fairly controversial, and the laws are confusing, there’s a lot of confusion and misinformation out there about CBD. That can make people hesitant to try it. Good news though—a new law is simplifying the matter for many of us.
What Is CBD Oil?
CBD is short for cannabidiol. While it comes from cannabis, it doesn’t get you high because it doesn’t have psychoactive properties. The high comes from a different chemical in the plant called THC (tetrahydrocannabinol).
Marijuana growers focus on strains and techniques that increase THC levels. Cannabis that’s grown for hemp tends to have a lot more CBD than THC.
If you look online, you can find a lot of claims about using CBD oil for medicinal purposes. Claims are so glowing, in fact, that you might start to wonder if they can possibly be true. Certainly, when they come from websites that promote marijuana legalization and use, you may be wise to question the veracity.
It’s too early in the research process for us to be able to say “yes” about many of the claims. However, we’re learning enough to be able to say “it’s possible,” or even, “we think so.”
CBD oil is used to treat a host of different conditions, although it’s not approved for any of these conditions, as of mid-2018:
- Chronic pain and inflammation pain
- Sleep disorders, including insomnia and nightmares
- Bipolar disorder
- Movement disorders (Huntington’s disease)
- Assistance with smoking cessation
- Stopping the growth of cancerous tumors
When it comes to taking CBD oil, you have a lot of options: smoking, taking capsules, drops or sprays under the tongue, and as a topical ointment. Research in the United States is in the early stages, though, since for decades, legal restrictions made it extremely difficult to study the medical benefits of marijuana.
CBD Oil for Lupus
With a lack of research on CBD oil for lupus, we have to go on what we know about CBD in general and can understand from research into conditions with similar symptoms or pathology. This potential treatment is likely to get attention from lupus researchers eventually, though, for several reasons.
- Lupus contributes to an epidemic of pain, including untreated and undertreated pain. Current treatments are far from perfect, so drug companies have a sizable financial incentive to find more effective medications.
- The opioid addiction/overdose epidemic is a huge problem for society and puts a lot of strain on the resources of the medical community, as well as law enforcement. Meanwhile, several studies have shown that when marijuana becomes legal in a state, the number of opioid prescriptions—and overdose deaths—drops. That’s bound to get the attention of healthcare providers who want to protect their patients, law enforcement agencies battling the problem, and lawmakers seeking solutions.
- A wealth of research suggests that CBD oil is effective against pain and inflammation, both characteristics of lupus. In its pure form, CBD oil is generally regarded as safe.
- We have abundant anecdotal evidence from people with lupus who say it’s effective. That can’t substitute for scientific proof, but it’s one more thing that gets healthcare providers interested.
Additionally, a 2018 study published in Cellular Immunology found that CBD may alter T-cell activity after spinal cord injury. Abnormal activity of T-cells—which are part of the immune system—are believed to be involved in lupus.
Lupus can include pain from neuropathy (nerve damage), and multiple studies suggest that CBD can alleviate that type of pain from diabetes, HIV, and other sources.
CBD Side Effects
We probably don’t yet know all of the possible side effects of CBD. Some side effects that have been reported are:
- Changes to liver enzymes used to process drugs
- Dry mouth
- Low blood pressure
- Increased tremor in Parkinson’s disease (at high doses)
The World Health Organization says CBD oil may also:
- Alter hormonal levels
- Stimulate the immune system at low levels, and suppress it at higher levels
CBD doesn’t appear to lead to addiction or abuse. It’s also believed to have a low toxicity level, which means it takes a lot to cause an overdose.
Is CBD Legal?
You’d think the question of whether CBD is legal would get a straightforward, yes or no answer, but the legality issue can be confusing.
A lot of pro-marijuana websites have long claimed that it’s legal in all 50 states as long as it doesn’t have more than 0.3% THC. They based that argument on the provisions of a specific farm bill. But in 2018, the 9th Circuit Court of Appeals ruled that the old bill didn’t apply to hemp or products derived from it.
Then came the 2018 Farm Bill. This piece of legislation was wildly popular in both the Senate, where it was passed in June of 2018, and the House, where it was passed in December of 2018 and then quickly signed into law. It re-classifies hemp as a legal agricultural product, which makes CBD products legal at the federal level.
In states where marijuana and/or CBD is legal, there’s no longer a clash between state and federal law, so the products are legally safe to use. Still, some states have specific laws on the books banning hemp products. So what does the Farm Bill mean for those states?
Technically, federal law overrules state law. However, that doesn’t mean those states will stop arresting and trying people for CBD use, especially if they want to challenge the new federal law. If you’re in one of those states, talk to an expert about any possible trouble you could get into for using CBD products. The website ProCon.org has information about which states have laws specific to CBD oil. A site called Governing maintains a map of where marijuana is legal in some form.
The only form of CBD that is FDA-approved is Epidiolex, a purified formulation of CBD used for rare forms of epilepsy. All the other CBD sources being enthusiastically marketed today are unregulated. They often contain amounts of CBD that are substantially different (too much or too little) than the labels indicate, and frequently contain higher levels of THC (the intoxicating chemical found in marijuana) than is permitted in a legitimate CBD product. Anyone choosing to use CBD should be cautious about the product they select and ideally consult with their healthcare provider before using it.
A Word From Verywell
Treatment decisions should never be taken lightly, and that applies to “natural” treatments like CBD as well—especially when you take the law into account. Consider the pros and con carefully, and be sure to discuss this option with your healthcare provider. As with any treatment, it’s important to watch for side effects.
With legal changes in store and lots of research coming out, we can probably expect a lot of change, and quickly, when it comes to CBD oil.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fraguas-sánchez AI, Torres-suárez AI. Medical use of cannabinoids. Drugs. 2018;78(16):1665-1703. doi:10.1007/s40265-018-0996-1
Bradford AC, Bradford WD, Abraham A, Bagwell Adams G. Association between US state medical cannabis laws and opioid prescribing in the Medicare Part D population. JAMA Intern Med. 2018;178(5):667–672. doi:10.1001/jamainternmed.2018.0266
By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.