Investigation of Cannabidiol for Reduction of NeuroInflammation in Chronic Back Pain

Inclusion Criteria:

• age ≥ 18 and ≤ 75;
• the ability to give written, informed consent;
• ongoing pain that averaged at least 4, on a 0-10 scale of pain during a typical week,and present for at least 50% of days during a typical week;
• fluency in English;
• on a stable pain treatment (pharmacological or otherwise) for the previous four weeks.
• Medical records confirming diagnosis of low back pain
• Chronic low back pain, ongoing for at least 6 months prior to enrollment.

Exclusion Criteria:

• outpatient surgery within 2 months and inpatient surgery within 6 months from the timeof scanning;
• elevated baseline transaminase (ALT and AST) levels above 3 times the Upper Limit ofNormal (ULN), accompanied by elevations in bilirubin above 2 times the ULN
• any interventional pain procedures within 6 weeks prior to scanning procedure or atany point during study enrollment;
• surgical intervention or introduction/change in opioid regimen at any point duringstudy enrollment
• contraindications to functional magnetic resonance imaging scanning and positronemission tomography scanning (including presence of a cardiac pacemaker or pacemakerwires, metallic particles in the body, vascular clips in the head or previousneurosurgery, prosthetic heart valves, claustrophobia);
• current or past history within the last 5 years of major medical illness not affectingthe central nervous system, other than chronic pain;
• implanted spinal cord stimulator (SCS) for pain treatment;
• any history of neurological illness or major medical illness affecting the centralnervous system, unless clearly resolved without long-term consequences;
• current or past history of major psychiatric illness;
• PTSD, depression, and anxiety are exclusion criteria only if the conditions were sosevere as to require hospitalization in the past year.
• pregnancy or breast feeding;
• history of head trauma requiring hospitalization;
• major cardiac event within the past 10 years;
• any use of recreational drugs in the past 3 months
• any marijuana use, medical or recreational, in the past 3 months
• an abnormal physical exam (e.g., peripheral edema);
• routine use of opioids ≥ 60 mg morphine equivalents;
• use of immunosuppressive medications, such as prednisone, TNF medications within 2weeks of the visit;
• current bacterial or viral infection;
• Any other contraindications to CBD administration noted by the study physician.
• If undergoing blood draws through an arterial line during scan, contraindications toplacement of arterial line, such as abnormal result on modified Allen's test on bothhands; Raynaud syndrome; bleeding disorder; use of anticoagulants such as Coumadin,Plavix or Lovenox