Cannabis and CBD self‑medication for chronic pain in deprived settings

Background

Chronic pain management occurs at the intersection of healthcare systems, consumer markets and informal economies. CBD products are promoted as remedies for pain despite clinical consensus that they are ineffective, while most cannabis use remains illegal. These dynamics are salient for people living with socioeconomic disadvantage, who experience higher pain burden and significant barriers to formal care. Yet informal cannabis and CBD use for pain remains under‑studied and real‑world practices do not align neatly with clinical trial evidence. This study explores how people with chronic pain navigate cannabis and CBD use within overlapping regulatory and commercial contexts.

Methods

A qualitative study was conducted in two socioeconomically deprived neighbourhoods in England. Adults experiencing long‑standing pain who reported using cannabis or CBD were recruited using purposive sampling (n = 25). Semi‑structured interviews examined experiences of pain management, encounters with prescribed analgesia, decisions to use cannabinoids, product sourcing and dosing, costs, perceived effects, legality and stigma. Interviews were analysed using reflexive thematic analysis.

Results

Participants described turning to cannabis or CBD after judging prescribed treatments to be ineffective, addictive or harmful. CBD was often framed as safer or more legitimate, even where participants expressed uncertainty about its effectiveness. Reported benefits centred on relief of pain and muscle tension, improved sleep and mood, and support for everyday coping rather than cure. Cannabis use was sometimes perceived as more effective but was shaped by stigma and fear of criminalisation.

Conclusions

Cannabis and CBD self‑medication reflects how chronic pain is managed under conditions of inequality. Unregulated markets and criminalisation transfer risk onto individuals already facing health and social inequalities.

Key messages

• Persistent informal cannabinoid use highlights a disconnect between clinical evidence, regulatory frameworks, and lived experiences of chronic pain.

• Qualitative evidence is crucial for understanding why pain self medication persists despite limited clinical support for cannabinoids.