what is better for pain cbd or hemp oil

Full Spectrum Hemp Oil For Pain and Inflammation: Does It Work

Studies have established a clear link between the endocannabinoid system (ECS), full spectrum hemp oil and pain.

Full spectrum hemp oil is rich in cannabinoids and other bioactive phytochemicals that affect pain and inflammation.

Cannabinoids such as CBD interact with the ECS, which plays a key role in regulating our sensation of pain.

Our bodies produce their own endogenous cannabinoids such as anandamide and 2-AG when and where they are needed in response to painful stimuli.

When the body experiences chronic pain and inflammation the endocannabinoid system can become taxed. We can supplement our body made endocannabinoids with phytocannabinoids such CBD, CBN, or THC .

Cannabidiol or CBD, a plant-based cannabinoid found in large quantities in hemp flowers, has been shown to help alleviate inflammatory and neuropathic pain.

-Other bioactive plant compounds found in full spectrum hemp oil, like the terpene linalool for example, have also been shown to have a positive impact on pain outcomes.

Full spectrum hemp oil is derived from a variety of the cannabis plant that contains low amounts of the cannabinoid THC, which produces the high associated with marijuana and high CBD quantities, which will not make you feel high.

Research shows that CBD moderately inhibits the breakdown of the endogenous cannabinoid anandamide.

Anandamide, known as the bliss molecule, is responsible for loads of processes within our bodies including pain perception and the runner’s high we feel when we exercise.

Anandamide is also found in cacao works to regulate happiness, pain, inflammation, stress, sleep and much more.

One theory is that CBD reduces pain by acting as an anandamide reuptake inhibitor and leading to increases of anandamide in the bloodstream.

Another theory (mine) is that supplementing your hemp oil products with dark chocolate may maximize their benefits.

Pain management research shows that a combination of cannabinoids and opioids is stronger than opioids alone. This suggests that incorporating hemp oil cannabinoids as an adjunct to opioids may help reduce opioid dosage.

Different strains of hemp have varying combinations of cannabinoids and other organic phenolic compounds such as terpenes, flavonoids, stillbenes, lignans, phloroglucinols and others.

Research shows that due to their phenolic compound compositions, different hemp strains can have different effects on our bodies. Both patients and studies report the importance of finding a hemp strain to suit your unique pain symptoms.

Currently, studies are underway connecting specific strain characteristics to their effects based on survey data from medical cannabis patients and their prescribing doctors.

Pain Management Via The Endocannabinoid System

Research suggests that CBD and other cannabinoids found in full spectrum hemp oil may alleviate pain while promoting whole-body healing.

This is in part due to the ability of cannabinoids to interact with our body’s endocannabinoid system (ECS), which among many other things is responsible for maintaining homeostasis and regulating the stimulation of nerve cells to increase or decrease pain. The ECS plays a role in pain related immune responses like inflammation.

The ECS is a main signalling and control network located throughout every part of our body. Because it is responsible for our experience of pain and inflammation, it is a critical target of research into pain therapeutics.

The ability of hemp cannabinoids like CBD to target the ECS is why hemp oil and its constituents have been heavily researched for their analgesic or pain reducing and anti-inflammatory properties.

Recent studies have even compared the efficacy of CBD rich hemp oil to that of opioids. In fact, preliminary findings show that not only are some patients able to ween off opioids, but that they can also experience a variety of other improvements in health outcomes such as improvements in sleep.

An 8 week study looked at the effects of hemp derived CBD oil on 97 chronic pain patients between the ages of 30 and 60, who had been on opioids for at least 1 year.

Within 8 weeks of adding CBD rich hemp oil to their regimens, half (53%) of these chronic pain patients reported reducing or eliminating opioids and 94% of study participants reported quality of life improvements.

The researchers state that their findings are consistent with emerging literature on the topic which has concluded that CBD is an effective analgesic that helps reduce barriers to opioid reduction.

So, Why Don’t We Know More About The Endocannabinoid System?

Despite its discovery 27 years ago, the ECS, and therefore its powerful effects on pain, have largely been kept under wraps from the general public and the endocannabinoid system has largely been absent from mainstream education. Can you remember ever reading about it in a textbook? I can’t.

In fact, in her Tedx talk Dr. Rachel Knox, physician and founder of the American Cannabinoid Clinics, states that despite its profound role in our health and wellbeing, and notably the human experience of pain, the endocannabinoid system was completely left out of every single medical textbook she ever read.

In the United States, several hundred people a month search Google for phrases like “is the endocannabinoid system a real thing.” It seems they too are shocked by its secret existence. It’s unsurprising then that most individuals do not automatically seek out the endocannabinoid system as a target for pain management with something as simple and natural as CBD oil.

Throughout our education, we have been taught about the circulatory system, the skeletal system, the immune system, the pulmonary system, the muscular system, and the nervous system. Yet most people’s understanding of the one system that appears to regulate all the rest, the endocannabinoid system, and its role in pain management remains pretty slim.

Although new text books are beginning to add in this fascinating network, they are not able to keep up with the pace of new research. So, it’s up to you to learn how you can optimize your endocannabinoid system to achieve optimal wellness.

Cannabis Use Dates Back 12,000 Years

The medicinal use of cannabinoids for pain and other ailments is not a new development in human history. In fact, cannabis is one of the most ancient plants used medicinally by humans. Findings suggested that humans and animals have used and consumed it for 12,000 years and tools designed for inhaling smoke, such as but not limited to solid gold Scythian bongs have been discovered across the world.

The first record of using cannabis as medicine dates back to 5,000 years ago when in 2,700 B.C. Chinese Emperor Shennong documented the discovery and first use of the healing properties of Cannabis. Then, in 1,213 B.C the Egyptians recorded using cannabis to treat glaucoma and inflammation. In 1,000 B.C. a concoction or drink of cannabis and milk called Bhang was written about as medicine in India. In Russia, a burial mound of a priestess known as the Ice Maiden revealed cannabis seeds dating back to 500 B.C.

Later, ancient Roman texts from 79 A.D. show Pliny the Elder wrote about using Cannabis for pain, gout, and cramps. During the 1700s, settlers brought marijuana from Europe to Jamestown, and in the 1770’s George Washington grew hemp. The history of medicinal Cannabis use by societies throughout the world including Europe, Russia, India, and North America abounds.

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I was surprised to learn that in the United States, Cannabis was once a top 3 most commonly prescribed medication and physicians routinely gave it to their patients well into the 20th century. In fact, from 1850 to 1937 Cannabis was in the U.S. Pharmacopoeia and was allegedly prescribed as the go to remedy for over 100 separate illnesses.

However, in the late 1800s two very wealthy businessmen became friends, and their friendship blossomed to doom the health of millions of Americans for over a century. Following a massive push by the new pharmaceutical industry initially spearheaded by John D. Rockefeller and Andrew Carnegie, Cannabis, an unpatentable and therefore unprofitable natural treatment became heavily taxed, prosecuted, and finally written out of the U.S. pharmacopeia in 1942.

Despite the misguided efforts of the pharmaceutical industry, there have been more than 23,000 studies published on Cannabis uses, and the Cannabis plant remains the most researched plant in human history. Medical studies examining the effects of cannabinoids on multiple sclerosis, anxiety, bone repair, epilepsy, pain, tumors, inflammation, viruses, bacteria, sleep, protecting the brain against trauma, boosting the immune system, and extinguishing bad memories (PTSD) are underway throughout the world.

So What Is The Endocannabinoid System And How Does Hemp Oil Affect It To Relieve Pain?

The endocannabinoid system is a 600 million-year-old communication network that resides in all animals except the insect. It can be activated by both our body made cannabinoids and hemp phytocannabinoids like CBD or CBN. Integral to maintaining balance or homeostasis throughout the body, it mainly consists of 4 core components.

Cannabinoid receptors such as CB1, CB2, and counting make up the first core component. Endogenous or body made ligands like anandamide and 2-AG are the second component. These ligands, also known as endocannabinoids, bind to the cannabinoid receptors to initiate an action. The third and fourth parts are the enzymes. These include the synthesized enzymes that create the endocannabinoids when they are needed and the degradative enzymes that break them down once they are used.

The endocannabinoid system interacts with both internal and external stimuli and is in one way or another involved in every single part of our existence. From sleep and anxiety to embryonic development and immunosurveillance, there is not one body function that is not somehow modulated or influenced by the endocannabinoid system. According to Dr. Rachel Knox, MD it directs, corrects, and overall manages our health.

Since its discovery almost three decades ago, the endocannabinoid system, due to its involvement in the control of inflammatory and nociceptive, or pain-related responses, has emerged as a target for pain treatment. This is not to say that it has not been the target of ancient healing practices of the past or that it has not been used by natural healers such as chiropractors, herbalists, and acupuncturists for as long as these practices have been around. These natural healers knew what worked and had good theories as to why. They just lacked the biophysical model for demonstrating their methods in a way that is acceptable to the modern scientific community. That model emerged with the discovery of the endocannabinoid system.

Unlike neurotransmitters which are formed and stored in vesicles until they are needed, endocannabinoids are synthesized on demand. Formed when and where they are needed, endocannabinoids regulate the release of dopamine, serotonin, and other neurotransmitters. Helping the body to withstand all sorts of damage, they are also involved in healing, regulating appetite, and modulating sleep. Researchers believe that the endocannabinoid system is involved in essentially all human diseases.

Hemp Oil For Pain: What The Research Tells Us

If you have ever dealt with chronic pain you know that it can be crippling in more ways than one. Not only does pain hurt, but it interferes with our ability to think, work, sit at a computer, eat, sleep, enjoy social interactions and so much more.

Today, more than 100 million Americans suffer from chronic pain. Each day, 65,000 pain pills are dispensed at pharmacies across the country. 2 million Americans are addicted to these pills and we are currently experiencing the worst overdose epidemic in American history. Yet we know there is a better way.

Research reveals that cannabinoids and opioids both block the release of pain-propagating neurotransmitters in the brain and spinal cord via a similar G-protein-coupled mechanism. Researchers believe there is an intimate connection between cannabinoids and opioids in the modulation of pain perception. Further, a growing body of studies shows that cannabinoids, when co-administered with opioids, have a stronger analgesic effect than when opioids are administered alone. This effect may enable lower opioid doses to achieve the same level of pain relief when used in conjunction with cannabinoids.

The cannabinoid Cannabidiol, or CBD, especially in the form of full spectrum hemp oil has the potential to be a natural alternative or adjunct to pain medications. In spite of limited clinical research, many people, including myself, report using hemp oil and CBD body butter as an effective form of pain management. In fact, according to a recent study of Cannabidiol oil users, 62% use it to treat a medical condition. Of the 62% who use CBD medicinally, the majority of individuals reported using it for chronic pain as well as arthritis and joint pain.

Plant-based cannabinoids such as those extracted from hemp and marijuana can simulate the actions of our body’s own endocannabinoids, leading to analgesia or pain relief. THC appears to mimic the endocannabinoid anandamide by binding to our body’s own cannabinoid receptors. CBD, on the other hand, appears to inhibit the body from breaking down anandamide.

Anandamide, also known as the bliss molecule, is what is released when we smile or hug. It is the endocannabinoid behind the runner’s high we experience during physical exercise. Anandamide is associated with regulating pain, happiness, and much more. Researchers theorize that CBD and THC may reduce the amount of pain a person feels by increasing levels of anandamide in the bloodstream.

Hemp Oil For Chronic Pain

There are two types of chronic pain: neuropathic pain and inflammatory nociceptive pain. Studies suggest that cannabinoids can help alleviate both of these. In fact, although clinical studies are still in their early days, a 2019 survey of 1,321 participants found that approximately 80% reported substituting cannabinoids for traditional pain medications. Of those 80% who substituted pharmaceuticals with cannabis, 53% of respondents reported substituting cannabis for opioids and 22% for benzodiazepines.

Despite being the most studied plant in human history, cannabis research remains limited and most existing human studies tend to examine the joint effects of THC and CBD. These are just two cannabinoids of the approximately 120 total cannabinoids identified in the cannabis plant. Like our endogenous, or body made, cannabinoids, these plant-based cannabinoids interact with our body’s endocannabinoid system which receives and translates their signals. Researchers believe that cannabinoids work together to create greater effects when they are consumed as full-spectrum botanicals than they do when they are consumed in isolation. This effect is known as the entourage effect.

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Much of the information we have about full spectrum CBD and pain relief in humans is anecdotal like this story from Amelia, who shares how Ned’s Natural Cycle Kit put an end to a decade of excruciating menstrual pain, changing her life for the better. Experts believe that menstrual pain is related to hormonal fluctuations. It is possible that full-spectrum CBD oils may help balance hormonal production as well as downregulate pain and cramping. Interestingly, according to the Natural Encyclopedia of ancient scholar Pliny the Elder, cramping was one of the symptoms treated with hemp during Roman times.

Hemp Oil For Neuropathic Pain

The glutaminergic system, a major excitatory neuronal pathway, is largely responsible for creating and sustaining neuropathic pain. CBD appears to inhibit the release of inflammatory agents such as glutamate, which makes it neuroprotective and very good at diminishing the tingling, prickling and burning sensations that characterize neuropathic pain.

One study of patients experiencing opioid resistant cancer pain showed that THC and CBD administration resulted in statistically significant improvements over placebo whereas the THC only group was similar to placebo.

Hemp Oil For Inflammatory Pain

Although it is related to neuropathic pain, inflammatory pain is not limited to neurons. Examples of inflammatory pain include headaches, cramps, muscle aches and pains, all types of arthritis, and some autoimmune diseases such as Crohn’s and ulcerative colitis.

Some researchers theorize that endocannabinoid deficiency underlies the pathophysiology of migraines, irritable bowel syndrome, fibromyalgia and other functional conditions characterized by inflammation and alleviated by cannabinoids. One study from the University of Colorado which examined the effect of medical cannabis on migraine headaches showed that the frequency of migraine headaches decreased with cannabis use.

Traditional anti-inflammatory drugs work by inhibiting COX-1 and COX-2 receptors, a process that may lead to an increased risk of developing gastrointestinal ulcers or heart attacks. Unlike these drugs, cannabidiol or CBD has an anti-inflammatory mechanism that is unique to the cannabis plant and studies have shown that when compared to NSAIDs like Ibuprofen, cannabinoids such as THC and CBD are up to twenty times more potent anti-inflammatory agents.

A 2015 study involving a rat model of arthritis showed that transdermal CBD gel significantly reduced pro-inflammatory biomarkers and joint swelling, suggesting the therapeutic potential of CBD oil in relieving arthritis-related pain and inflammation. Another mouse study by Malfait et al showed that orally administered CBD decreased inflammation and effectively blocked the progression of arthritis.

Unlock the Power of Your Endocannabinoid System with Hemp Oil Cannabinoids

If you are suffering from pain, supplementing your lifestyle with plant-based cannabinoids in the form of full-spectrum CBD oil or topically applied salve may help to manage or even alleviate your symptoms.

When paired with whole foods, adaptogenic herbs, and endocannabinoid inducing practices such as acupuncture, yoga, meditation, and exercise, hemp oil can help soothe and tone your endocannabinoid system for optimal performance. Together these practices can enable you to control inflammation, relieve pain, improve sleep, and achieve whole-body balance.

CBD and Tramadol – March 2022

Does CBD Oil interact with Tramadol & other analgesics?

  • CBD oil lessens Tramadol’s high dosage analgesic effects (1 ) .
  • A National Institutes of Health research showed that using CBD in high doses with Tramadol may considerably lessen Tramadol’s analgesic effectiveness. It does not state CBD’s effect with low doses of Tramadol (2 ) .
  • A prospective cohort study stated that CBD could significantly lessen opioid use and improve chronic pain and sleep quality among patients who use opioids to manage pain (3 ) .
  • However, a study made by The American Society for Pharmacology and Experimental Therapeutics concludes that using CBD may inhibit the liver enzyme CYP2DC responsible for metabolizing Tramadol in the body (4 ) .
  • With not enough studies regarding specific drug dosage interaction between CBD oil and Tramadol, it is still best to consult a physician before use.

Can CBD Oil Be Taken with Tramadol?

Tramadol has been used as a pain reliever for years. However, because of its potential for abuse, it may not be for everyone. Veterinarians also use Tramadol for dogs in pain.

CBD and tramadol may be useful pain relievers. However, using them in combination brings about adverse effects and is, therefore, not recommended.

Many drug interaction reports between CBD oil and Tramadol do not state specific dosage interaction, except for the National Institutes of Health research which stated that CBD oil could lessen the analgesic efficacy of high dosage Tramadol (5 ) .

Tramadol is an analgesic that modulates moderate to severe pain by traveling within the central nervous system through metabolite binding to specific opioid receptors (6 ) .

The primary mu-opioid receptors (muORs) mediate the analgesic effects of opioids (7 ) .

A prospective cohort study stated that the use of full-spectrum cannabidiol, which has psychoactive effects, could significantly lessen opioid use and improve chronic pain and sleep quality among patients who use opioids to manage pain (8 ) .

However, a study made by The American Society for Pharmacology and Experimental Therapeutics concluded that the use of CBD might inhibit the liver enzyme CYP2DC responsible for metabolizing Tramadol and other opioids, such as codeine which is commonly used as an alternative to Tramadol when pain is mild to moderate, in the body (9 ) . By inhibiting the drugs’ metabolisms, there would be higher levels of both tramadol and codeine in the system and so the analgesic effect of CBD could be from that mechanism alone, rather than from the direct effects of CBD.

Can another analgesic be a substitute for Tramadol so that CBD Oil can be taken?

There is no established alternative to Tramadol so that CBD oil can be taken.

Tramadol relieves acute and chronic pain with moderate to severe intensity. It is used in the pain management of osteoarthritis, acute myocardial infarction, acute myocardial infarction, and Brugada syndrome (10 ) .

It is also used for dental, post-operative, chronic cancer, back pain, and acute renal pain relief (11 ) .

However, Tramadol can cause common side effects like headaches, constipation, and dry mouth (12 ) .

The more severe side effects are breathing difficulty or short, shallow breathing, hallucinations, urinary difficulty, seizures, confusion, and the low blood pressure symptoms of dizziness, exhaustion, and lack of energy (13 ) .

Severe allergic reaction (anaphylaxis) also happens, but rarely (14 ) .

Other analgesics can be used as a replacement for Tramadol that have fewer side effects when compared to Tramadol.

A 2005 experimental study in rats concluded that metoclopramide is a viable low-cost alternative to Tramadol in treating post-operative pain because it offers fewer side effects commonly linked to Tramadol, such as nausea, tremor, and vomiting (15 ) .

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Since there are no studies currently available about drug interactions between metoclopramide and CBD oil, consulting a doctor before use is highly recommended.

According to a February 2020 JAMA medical journal research, Tramadol had a higher mortality risk compared to the anti-inflammatory medications naproxen, diclofenac, and etoricoxib (16 ) .

More clinical trials are needed to confirm the research because it did not attribute the result to specific causes. Several external factors may have led to the conclusion (17 ) .

An NIH study stated that naproxen is not recommended to use with CBD products from the cannabis plant because naproxen’s CYP2C8/9 enzyme substrate interacts with CBD oil (18 ) .

The study has advised avoiding administering CBD oil with naproxen, decreasing the naproxen dose, or monitoring for adverse effects and toxicity to minimize side effects (19 ) .

It is also not recommended to take CBD oil while taking diclofenac because there are indications that CBD decreases its metabolization because CBD may inhibit the hepatic enzyme CYP2C9 (20 ) .

Take caution in using CBD products like cannabis oil with etoricoxib and corticosteroids because of possible drug interaction even if there is no published report (21 ) .

Drug interactions between ibuprofen, over-the-counter medications, and other NSAIDS with cannabinoids have not yet been demonstrated.

Can CBD replace Tramadol?

CBD can help relieve pain similarly addressed by prescribing Tramadol.

Pain associated with cancer, neuropathy, and central pain such as multiple sclerosis can be suitably managed with CBD (22 ) .

A study proves that CBD subdues inflammatory and neuropathic pain (23 ) .

CBD’s anti-inflammatory properties are expounded in the Journal of Pharmacology and Experimental Allergic Contact Dermatitis (24 ) .

CBD may also relieve muscle weakness, which is a significant symptom of neuropathy (25 ) .

CBD can also be used to manage pain that does not respond well to other treatments like optimized opioid therapy in conditions such as intractable cancer pain and chronic musculoskeletal pain (26 ) .

The University of Michigan Health Lab published an article declaring that the benefits of opioids like Tramadol and cannabinoids are similar, but that opioids are not as useful for chronic pain even though physicians prefer to use opioids over the use of cannabis, primarily due to its Schedule 1 status. (27 )

  • numbness, prickling, and tingling in hands and feet
  • sharp, burning, or throbbing pain
  • touch sensitivity
  • muscle weakness
  • paralysis (rare)

The endocannabinoid system plays an important role in the central nervous system.

Cannabinoids are preferred for neuropathic and centralized pain conditions like fibromyalgia (29 ) .

Other conditions with neuropathic and centralized pain conditions are allodynia, where the pain is experienced with ordinary touch, chronic pain syndrome, and neurological injuries such as stroke and spinal cord injury (30 ) .

Although their benefits are comparable, the article expressed that both opioids and cannabinoids should not be used as primary therapies for chronic pain because the benefits are minimal (31 ) .

The article suggested that physicians are reluctant to prescribe cannabis because the appropriate formulation and dose has not been determined (32 ) .

It also advised pharmaceutical companies to stop marketing opioids for a broad range of conditions until studies confirm opioids’ extensive scope of efficacy (33 ) .

Tramadol vs. CBD

Tramadol was not yet classified as an opiate in 1995. However, the FDA identified Tramadol as a controlled substance in 2014 due to widespread abuse and addiction to it. It is Schedule IV, lower risk of abuse than OxyContin, a Schedule II drug (34 ) .

Contrary to Tramadol and some similar prescription medications, CBD is non-addictive according to a 2015 research conducted by Nora Volkow (35 ) .

However, Wayne Hall of the Society for the Study of Addiction stated in 2018 that it was premature to expand access to medical cannabis to solve the U.S. opioid crisis of addiction (e.g., to Xanax) and overdose (36 ) .

What To Look for in a CBD Oil When You Are Taking Tramadol

Obtain medical advice before taking CBD products in the form of oils or tinctures.

  1. Although CBD products with hemp oil are legal in the U.S. federal system, verify the laws regarding the sale, possession, and use of CBD products in the state of purchase.
  2. Read online reviews before buying in the website store. Confirm whether the clinics and brick-and-mortar and stores you buy from are authorized to sell CBD products. Buy only from reliable and legitimate brands.
  3. Select pure CBD oils falling under the crystalline isolate category over full-spectrum oils that retain tetrahydrocannabinol (THC) and other cannabinoids that cause a high sensation.
  4. Check for additional ingredients. MCT oils and melatonin are safe and beneficial. Beware of high-risk ingredients like vegetable glycerin and propylene.
  5. Determine appropriate dosing by corresponding the dose for the condition it is used for.

Trust the advice of an experienced medical professional specializing in CBD from hemp plants instead of searching online in Google to avoid risks and side effects like withdrawal symptoms. Proper medical guidance is needed in corresponding use, dosage, and administration concerning a patient’s health condition and maintenance medications.

CBD can interact with other compounds that are metabolized in the body by cytochrome P450 or CYP3A4 enzymes (37 ) .

These CYP450 and CYP3A4 enzymes break down substances such as drug medications and toxins that are formed within the cells.

Since CBD competes for these enzymes, CBD products limit the metabolism of drugs, heightening the concentration levels of drugs in the bloodstream.

CBD can increase the blood levels when taken with the blood thinner Coumadin, and it can raise levels of certain other medications in your blood by the same mechanism that grapefruit juice does.

Important Facts About Tramadol

The pain medication Tramadol was discovered and synthesized in 1962 by the German company Grunenthal GmbH. It was introduced in the market under the name Tramadol in 1977. It became available in the U.S. after 1995 (38 ) .

Tramadol has severe drug interactions with alvimopan, procarbazine, rasagiline, and selegiline. It has severe interactions with approximately 49 drugs and moderate interactions with around 269 drugs (39 ) .

  • marijuana
  • sage
  • asenapine
  • brimonidine
  • darifenacin
  • eucalyptus
  • naloxone
  • nilotinib
  • dextroamphetamine
  • maraviroc
  • ziconotide
  • paroxetine
  • lidocaine

As a prescription drug, oral doses of Tramadol come in tablets, reconstituted suspension, and extended-release capsules (41 ) .

Veterinarians are in consensus that Tramadol is the most common painkiller for dogs because of the minimal risk of side effects and addiction (42 ) .


CBD could significantly lessen opioid use and improve chronic pain and sleep quality among patients who use opioids such as oxycodone to manage pain.

Using CBD with high doses of Tramadol can lessen its analgesic effects. The effect when Taking Tramadol in lower doses is unknown.

Using CBD with Tramadol may slow the drug’s metabolism in the body and increase the high levels of Tramadol in the bloodstream, which appears to contradict the statement above. If the metabolism of tramadol is slower, then higher levels of tramadol (in the face of CBD) would mean a higher analgesic effect. Thus, the end result is that we do not have all the answers, yet.