Mailbag: Treating Pain With CBD and Why Hangovers Get Worse With Age

I was blown away by the responses I got to my essay on all-natural painkillers.

Readers were eager for more tips on how to treat their pain without nasty side effects, like nausea and increased heart attack risk.

Though looking at the numbers… I suppose I shouldn’t have been surprised.

According to a study conducted by the National Center for Complementary and Integrative Health (NCCIH), roughly 40 million adults live with severe levels of pain.1

An estimated 126 million adults reported experiencing some type of pain within the three months leading up to the NCCIH’s study.

Clearly chronic pain is a huge issue in the U.S.

And Manward readers, rightly, want to know what they can do about it.

Fortunately, I can help.

A Bright Future for Cannabidiol (CBD)

Do you have any knowledge about CBD oil and its use for chronic pain – in particular lower back pain and swelling from rheumatoid arthritis? In states where it may be legal for medical purposes, how much would be taken and would you most likely need a prescription? Mary R.

The growing body of research surrounding CBD is fascinating.

A review of decades’ worth of studies published in Therapeutics and Clinical Risk Management found that CBD is effective not only in pain management but also as an antidepressant and antipsychotic, as well as a treatment for insomnia.2

The authors of the study concluded that “the future for cannabinoid therapeutics appears very bright, indeed.”

But to Mary’s point… what about topical applications of CBD for pain?

The results are quite exciting. CBD has proved in several studies to have powerful anti-inflammatory and pain-relieving properties.

One animal trial detailed in the European Journal of Pain determined CBD “has therapeutic potential for relief of arthritis pain‐related behaviours and inflammation without evident side effects.”3

Now that the 2018 Farm Bill has passed, I expect to see a lot more human trials confirming what most of us already know…

CBD derived from hemp is a miraculous alternative to dangerous modern pain meds.

There is no set recommended dosage for internal or external use of CBD. Whether you live in a spot where CBD is technically legal or not, I’d recommend talking to your doctor about your options.

Laws are changing fast. And I have yet to hear of anyone getting arrested over the possession of a CBD supplement.

If you’re concerned about the risks of taking too much CBD… don’t be.

According to research published in Current Drug Safety, high daily doses of CBD – up to 1,500 milligrams – have been taken with no significant side effects.4

I personally prefer something that’s derived from organically grown hemp and contains no THC.

Now let’s shift gears to a different type of pain…


“Is This Normal?”

I’m sure this condition will apply to several senior individuals… As I get older, drinking one or two glasses of wine creates a headache the next day. Is this normal? Can I do anything to prevent this? Love my wine! Jim J.

I hear you, Jim. You’re definitely not alone.

Many adults – not just seniors – experience more extreme hangovers as they age. I’ve heard from folks as young as 30 claiming that they can’t “drink like they used to.”

There are lots of contributing factors here: Fewer liver enzymes, lifestyle and diet choices – not to mention what you prefer to drink – play major roles. But generally speaking, the simple truth is…

The older we get, the harder it is for our bodies to metabolize alcohol.

According to research published in Current Opinion in Clinical Nutrition and Metabolic Care, over time, it takes longer and longer for our systems to distribute and eliminate even just a few glasses of pinot.5

“[Aging] organs such as brain and liver are more sensitive to the toxicity of alcohol,” the study concluded. “For these reasons, alcohol should be used in moderation, especially among those of older age.”

Your doctor may have a different opinion about what “moderation” means for you. The Centers for Disease Control and Prevention defines it as up to two drinks per day for men and one drink per day for women (sorry, ladies).6

The good news is there are some things you can do to reduce your risk of next-day headache and grogginess.

First and foremost: Stay hydratedand never drink on an empty stomach.

The vast majority of hangover symptoms stem from dehydration. Most people know this, but once the wine starts flowing, they tend to forget to chase every glass with at least 8 ounces of water (ideally more).

You should also make sure to eat something before you start drinking (not after). A full belly helps your body process alcohol easier.

And drink slowly. It takes your liver roughly one hour to metabolize every ounce of alcohol. So the more you imbibe over a short period, the worse you’re going to feel in the morning.

Lastly, you should consider the type of alcohol you drink.

If you’re a wine drinker, like Jim, you could switch to a bottle with a lower alcohol by volume (ABV).

The average ABV in wine is 11.6% – more than twice what you get from most beers. Shave off a few percentage points and your body will surely notice the difference.

There’s also evidence that clear and light-colored alcohols can reduce your hangover risk. Dark liquors, like whiskey, dark beers and red wine contain higher concentrations of congeners – chemicals produced during the fermentation process.

Congeners add flavor to many people’s favorite drinks. Unfortunately, as a Brown University study recently showed, they also make hangovers much more severe.7

If you can stomach the change from bourbon to vodka or malbec to sauvignon blanc, it could mean less pain the next day.

Just remember…

Drinking too much alcohol is serious business – especially as you get older.

If you’re experiencing regular and painful hangover symptoms, it may mean it’s time to hop on the wagon for good.

Keep the questions and comments coming. Email me at


Dr. Sanjay Jain, MD, MBA