During a winter run last year, Renee Metivier slipped on black ice and snapped her fibula in two places. She reached for a lotion infused with cannabidiol, a cannabis-derived compound, to help manage her pain. Metivier, a professional runner and trainer, is far from orthodox about how she interacts with pain and pain management.

During a recent surgery to reinforce her fibula with a metal plate, the now-36-year-old turned down general anesthesia to hasten healing (although she did accept a local nerve block). She still rubs a cannabidiol lotion around her calf and foot several times a day.

“I keep my body very clean, and I believe CBD is in line with that. For me, natural is really important,” Metivier said, adding that she does not stock ibuprofen or acetaminophen in her medicine cabinet.

At the height of a national opioid epidemic, Metivier is leery of some pain medications. She is also one of numerous athletes who are turning to CBD, the non-psychoactive compound that the World Anti-Doping Agency removed from its banned list last January. She feels that CBD turns down the volume on pain, but doesn’t mute it.

“You want some of those pain signals,” Metivier said. “If I don’t have those signals, I’m going to do something dumb, because I’m a Type A pro athlete. I mean, I was single-leg rowing on day five after surgery.”

Cannabis and the body

CBD, like tetrahydrocannabinol, or THC, is one of more than 100 compounds called cannabinoids, which are found in a variety of plants, but most mostly in cannabis, according to Dialogues in Clinical Neuroscience, a peer-reviewed medical journal. Bodies naturally produces some cannabinoids, which are called endocannabinoids. The endocannabinoid system helps regulate functions such as sleep, immune-system responses and pain. When CBD is consumed, it can reduce pain because it makes the body stop absorbing anandamide, a compound associated with regulating pain, according to a study published in The Journal of the American Society for Experimental Neurotherapeutics. If a person’s bloodstream has heightened levels of anandamide, a reduced amount of pain may be felt.

A budding industry

Nine states and the District of Columbia allow for the recreational and medical use of marijuana and its derivatives, like CBD. Thirty states allow for medical use only. In states where marijuana is prohibited, CBD derived from hemp is legal, according to the Drug Enforcement Administration’s website. Federally, however, marijuana and its derivatives remain a Schedule 1 controlled substance, on par with cocaine and heroin. In North America, retail cannabis sales grew to about $10 billion this year — up 33 percent since 2016, according to a several recent news reports.

Bend marijuana dispensary Tokyo Starfish has carried hemp- and marijuana-based CBD products since it opened in 2015, the year Oregon legalized recreational marijuana, said co-owner Gary Bracelin. CBD products account for 12 to 15 percent of business.

“CBD customers range from athletes (21) and older, all the way to older generations who are dealing with arthritis or surgeries,” Tokyo Starfish manager Everrett Novak said.

Prices range from about $10 for CBD-infused gummies or tonics that feature 15 milligrams of CBD to pricier 1,000-milligram tinctures, which cost $60.

“The CBD products out there are endless,” Bracelin said.

CBD users don’t need to visit marijuana dispensaries to restock on CBD products. Mother’s Juice Cafe can mix hemp-based CBD oil in 25-, 50-, and 75-milligram quantities into any smoothie for an additional $3 to $7 more. Metivier, who is also a co-owner of Recharge Sport, which opened in 2013, makes CBD readily available to her clients. In the studio’s reception area, two taps of hemp-sourced CBD carbonated drinks, made by a Bend company, stand next to several for kombucha.

After leading a recent workout, Metivier poured herself a half glass of Albis cranberry blood orange drink. Metivier speaks in full paragraphs when listing what she considers CBD’s numerous benefits: CBD reduces blood sugar levels, slows bacterial growth, which is handy while competing internationally. CBD reduces inflammation, suppresses muscle spasms and promotes bone growth. Multiple studies, including one published in the Journal of Experimental Medicine, suggest a link between CBD and these health benefits.

That hemp-sourced CBD carbonated drinks and other CBD products are available without any THC is important to Metivier, who said she has never used THC. Even though the World Anti-Doping Agency increased allowances of THC to permit non-competitive use, Metivier doesn’t want to risk it.

“I know a touch of THC would probably be amazing,” she said. “But until that rule is changed, I’m not going to challenge it.”

Bend cyclist David Caplan, 57, also began using CBD topically. He bought lotion from a marijuana dispensary that featured both CBD and THC. “It worked pretty well.”

Caplan uses the CBD topically before and after races or anytime he’s feeling soreness. Some CBD solutions feature arnica and other plant products mixed together, which makes Caplan wonder which compound is doing exactly what.

Caplan also finds CBD products “spendy” as much as he finds them increasingly trendy. Riding the CBD wave is Caplan’s wife, Cinda Strauch, an athlete and massage therapist. She owns Recharge Massage Therapy at NorthWest Crossing Chiropractic and Health Center, which she founded in 2000 (it is unrelated to Recharge Sport). Strauch has been using CBD lotions, salves and topicals on interested clients for a year.

“Usually it’s people with one area that has been giving them trouble,” Strauch said. “Some people have a lot of relief with this. Topicals are pretty good at isolating a small area.”

Strauch began treating her own pain with CBD topicals, lotions and salves. An active cyclist and runner, Strauch rubs CBD cream on her knees. She thinks CBD takes the pain down a couple notches.

“If I suspect I’m going to do a particularly challenging ride with lots of elevation gain, I’ll use it as a pre-emptive measure to counteract pain,” she said.

Strauch said using CBD is a good way to avoid addictive opioids.

“So many people have seen what the regular Western pharmaceutical companies have to offer, and they’re like, ‘No thanks,’” Strauch said. “(Opioids) mess with their heads as much as it helps with the pain. They can’t be productive in their everyday lives. A good chunk of us just wants the pain to not be the No. 1 thing that is stopping what we’re doing. That’s what I find with CBD — it doesn’t make pain go away,” Strauch said. “But if your pain is screaming at you at a 6 or 7, CBD might take it down to a 3 or a 4.”

Reporter: 541-617-7816, pmadsen@bendbulletin.com