Plantar Fasciitis is ligamentous inflammation that causes pain on the bottom of the heel. About 2 million people are treated for plantar fasciitis yearly. CBD Oil For Plantar Fasciitis: Does It Help With Foot Problems? Some people experience excruciating pain in their heels or in the bottom of their feet. This uneasiness usually increases as we put Hemp-derived CBD oil interacts directly with receptors in our endocannabinoid system. Also known asthe ECS, the endocannabinoid system is a network of receptors responsible for regulating vital functionssuch as sleep cycles, inflammatory response, and stress levels.
Best CBD Oil for Plantar Fasciitis – August 2022
Cannabidiol (CBD) is a non-psychoactive cannabinoid that exerts multiple pharmacological effects, including antioxidant and anti-inflammatory properties (5) .
It interacts with the human body ’s ECS ( endocannabinoid system ), responsible for regulating pain and inflammation (6) .
The ECS consists of two cannabinoid receptors that are found in different parts of the body. For instance, CB1 receptors are located in the brain and the central nervous system (7) .
CB1 interacts with tetrahydrocannabinol ( THC ) , which causes a person to experience a euphoric feeling (8) .
Meanwhile , CB2 receptors are located in the immune system (9) . When CB2 is activated, it stimulates a response against inflammation, reducing pain and minimizing damage to tissues (10) .
Cannabinoids help regulate how a person thinks and feels by interacting with the endocannabinoid system ’s CB1 and CB2 receptors (11) .
Meanwhile, phytocannabinoids like THC and CBD obtained from hemp plant s also stimulate these receptors (12) .
A study from the journal Current Neuropharmacology hypothesized that cannabinoid receptor agonists stimulate CB1 receptors . Th is stimulation may provide therapeutic effects on chronic pain (13 ) .
In 2009, the British Journal of Pharmacology published a study that showed how CBD may act as a CB1 agonist and antagonist despite its low affinity for the receptors (14) .
These findings may contribute to CBD’s documented anti-inflammatory properties (15) .
How CBD Works to Help With Plantar Fasciitis
There are no known studies on how CBD oil works to help with plantar fasciitis . However, CBD’s anti-inflammatory and pain-relieving properties may benefit people diagnosed with the condition.
The Benefits of CBD for Plantar Fasciitis
Pain is manifested through chronic and acute inflammation that often challenges people with plantar fasciitis (16) .
A 2020 study stated that THC may also offer anti-inflammatory and pain-relieving benefits (17) .
Therefore, plantar fasciitis sufferers who use full-spectrum CBD oil with traces of THC and other cannabinoids may benefit from it.
According to a 2004 study, about 7% of people over 65 reported tenderness in the heel. In the U.S., diagnosi s and treatment for such a condition accounted for over one million visits to healthcare providers per year (18) .
Reduced ankle dorsiflexion , the backward bending of the foot , and obesity are recognized risk factors for plantar fasciitis (19) .
Most studies on cannabidiol ’s therapeutic potential demonstrated tests on joint condition s such as osteoarthritis and other rheumatic diseases (20) .
Like joints, the plantar fascia is vital in bodily movement. It is a thin ligament or a band of connective tissue that supports the arch of the foo t (21) .
However, researchers have yet to examine how CBD may affect inflammation and pain targeting the plantar fascia .
Plantar fasciitis is a disabling condition that impact s millions of people in the world. While most people with such a condition respond to conservative management most of the time, about 1% of patients still undergo surgery (22) .
A 2015 animal study posted in the European Journal of Pain showed how transdermal CBD administration reduced inflammation. The researchers observed improved limb posture and pain rating scores among rat models (23) .
Transdermal administration involves applying CBD through the skin, enabling it to be gradually absorbed into the body.
Based on the study, topical CBD application has therapeutic potential for alleviating arthritis pain and inflammation without detrimental side effects (24) .
Still, more comprehensive studies on how CBD may help alleviate pain and inflammation in human ligaments are necessary.
Types of CBD for Plantar Fasciitis
The cannabis plant ’s composition is complex. It has major compounds such as cannabidiol (CBD) and delta-9- tetrahydrocannabinol ( THC ), which have opposing effects (25) .
THC is the main psychoactive constituent in marijuana, while CBD is the non-psychoactive component of the cannabis plant (26) .
CBD or hemp oil is produced from the hemp plant (27) . Extraction methods, such as carbon dioxide extraction, create high-quality CBD products (28) .
The hemp extracts may be categorized as full-spectrum CBD , broad-spectrum CBD , and CBD isolates (29 ) .
CBD oil is classified as full-spectrum if all extracts of the cannabis plant, such as CBD, terpenes , flavonoids, essential oils, and other cannabinoids , are used. In addition, the THC concentration should be less than 0.3% (30 ) .
The best CBD products that have been formulated to treat pain are available on the market. These products range from CBD oil , tinctures , and gummies .
Topical CBD products , such as salve , lotions , and creams, may be used for pain relief .
Taking CBD Oil for Plantar Fasciitis
A person diagnosed with plantar fasciitis may opt to use CBD oil topically for pain management . Other CBD topical products like CBD creams may also be a good choice.
However, note that different ingestion types have varying rates of bioavailability. It is the extent to which a substance is absorbed and used by the body (31) .
A person may feel the effect s of topical CBD products for two to four hours (32) . For those who use vape pens to inhale CBD, the substance may enter their bloodstream as quickly as 30 seconds or less (33 ) .
Although using vape pens is the fastest way to benefit from cannabidiol , this method may irritate a person’s lungs (34) . Thus, consumers should practice it with caution.
People diagnosed with plantar fasciitis may also use CBD oil by taking it sublingually. Taking CBD under the tongue ensures prompt delivery of the substance into the body (35 ) .
Cannabidiol is not yet approved by the U.S. Food and Drug Administration ( FDA ) as a medication. Therefore, there are no official dosage guidelines for CBD.
However, a standard dose of CBD ranges from 10mg to 100mg of CBD per dose each day (36) .
Safety and Side Effects
Controlled CBD use may be safe based on recent developments in CBD administration in humans. However, further studies are needed to learn more about its possible side effects (37) .
Comparing CBD Oil to Alternative Treatments for Plantar Fasciitis
Most plantar fasciitis patients usually recover in a few months after conservative treatment (38 ) .
Nonsteroidal anti-inflammatory drugs ( NSAIDs ) or pain relievers may ease the inflammation and pain caused by plantar fasciitis (39-40) .
However, most people may not tolerate the possible side effects of these medications. Meanwhile, others may find physical therapy expensive and time-consuming.
Therefore, some people are turning to alternative treatments to manage foot and heel pain .
A natural remedy for plantar fasciitis is massaging the affected area using lavender essential oil.
Lavender is a known alternative treatment for its anti-inflammatory properties . It also contains antioxidant and antimicrobial elements (41) .
Individuals with p lantar fasciitis may also use CBD oil as a massaging agent. Like lavender, CBD also has antioxidative and anti-inflammatory properties (42) .
People may also use ointments , menthol creams, aloe vera gel, and peppermint massage oil for plantar fasciitis pain .
Some individuals may also benefit from strengthening programs. Engaging in such activities may correct functional risk factors, such as weakness of the intrinsic foot muscles (43) .
Wearing orthopedic shoes with sufficient arch support may also be beneficial for people with foot conditions .
The Pros and Cons of CBD Oil for Plantar Fasciitis
- A 2017 study acknowledged that CBD is generally safe for human consumption (44) .
- A 2015 research from the European Journal of Pain demonstrated how the transdermal application of CBD helped in reducing pain in target areas (45) .
- CBD may help improve sleep quality, which may benefit people dealing with sleep issues due to chronic pain and discomfort (46) .
- The World Health Organization (WHO) acknowledged CBD as a substance that is “generally well tolerated with a good safety profile (47) .”
- CBD products are poorly regulated. People are encouraged to research before choosing a CBD brand.
- Most existing studies about CBD’s efficacy are done on animal subjects.
- The FDA warned the public that extremely high doses of CBD may cause liver injury (48) .
- CBD may cause adverse interactions with other drug s such as ibuprofen, commonly used for plantar fasciitis (49) .
CBD Usage for Plantar Fasciitis and Other Medical Condition s
CBD’s anti-inflammatory properties may be used to help with medical conditions involving the feet , such as Achilles tendonitis or inflammation of the tendon (50) . It is also promising in managing inflammatory arthritis or other joint pains , skin irritations, neuropathic pain , plantar fasciitis , and other ailments related to foot pain .
Research also suggested that CBD is a therapeutic compound helpful in treating painful diabetic neuropathy due to its ability to activate serotonin (5-HT1A) receptors (51) .
Activation of serotonin receptors has been involved in the mechanism of action of antidepressant and antipsychotic medications (52) .
Cannabidiol (CBD) has also been shown to ease anxiety behaviors relevant to numerous disorders (53) . A person with anxiety may experience a temporary spike in blood pressure during an episode (54 ) .
1. What is plantar fasciitis?
Th is degenerative condition is the most common cause of heel pain . It appears when a band of tissue that supports the arch of a person’s foot becomes inflamed and irritated (55) .
The plantar fascia is a narrow ligament that lies beneath the skin on the bottom of a person’s foot (56) .
2. What are the symptoms of plantar fasciitis?
Symptoms include pain on the base of the foot near the heel, discomfort after a long rest, and severe pain after physical activities .
3. Are there specific studies about CBD’s benefits on plantar fasciitis?
No research has been done on the benefits of CBD specifically for this condition. However, CBD’s anti-inflammatory and pain-relieving properties may help with pain caused by plantar fasciitis .
4. Is CBD oil better than CBD cream for treating plantar fasciitis?
The best CBD oils for plantar fasciitis are available in different concentrations and potenc ies . It is best to speak with a doctor versed in cannabis use, especially if one considers taking CBD orally.
On the other hand, CBD creams are topical CBDs that people may use to target specific pain-affected body areas. However, CBD creams are not absorbed into the whole body (57) .
Considering how little is known about CBD’s long-term effects, CBD topicals like creams may be a more manageable option.
5. Is CBD Legal?
In 2018, the United States Farm Bill permitted the commercial use of industrial hemp derivatives as long as the THC levels are 0.3% or lower (58) .
CBD may be a promising substance that appears to be safe. However, further studies are still recommended to understand its full potential and long-term effects on wellness and medical conditions like plantar fasciitis.
CBD Oil For Plantar Fasciitis: Does It Help With Foot Problems?
Some people experience excruciating pain in their heels or in the bottom of their feet. This uneasiness usually increases as we put weight on our feet. The pain may be because of different health issues, but sometimes it is due to plantar fasciitis. Plantar fasciitis is simply the technical term for the most common type of heel pain.
Prolonged pain can significantly reduce our energy and productivity levels. If the pain is not managed efficiently, it can eventually lead to severe side effects. CBD is a potential treatment for pain and discomfort. This amazing compound has the ability to interact with our body at the molecular level and can help it perform better even in the face of pain caused by plantar fasciitis.
What Is Plantar Fasciitis?
Plantar fasciitis is known to be the most common type of heel pain that may occur due to various reasons. The heel bone is connected to our toes through a band of tissues. Inflammation in this thick band can cause stabbing pain, especially during the first step in the morning. The pain usually goes away as we take a few steps. However, it may return if we sit or stand for a prolonged period of time. Plantar fasciitis is a common condition for runners and for people who are overweight.
What Are the Symptoms of Plantar Fasciitis?
Plantar fasciitis is typically associated with excruciating pain near the heel area of the foot. The pain can get worse after a workout session or excessive physical activity. The stabbing pain is usually experienced shortly after a long rest period.
What Are the Causes of Plantar Fasciitis?
The arch of our foot is supported by a bowstring called the plantar fascia that absorbs the shock we experience as we walk. Excessive stress and tension of the bowstring can cause a tear which will cause inflammation and irritate the muscles in your foot. Risk factors of plantar fasciitis include age, obesity, foot mechanics, and the types of exercises you participate in.
What Is CBD?
CBD, or cannabidiol, is one of the most popular exogenous cannabinoids extracted from the Cannabis Sativa plant or from industrial hemp. Unlike its chemical cousin, THC or tetrahydrocannabinol, CBD is non-psychoactive and does not cause euphoric effects. Research has shown that CBD is quite effective in improving the overall health of the human body as it can promote homeostasis and help in maintaining overall balance. CBD products with less than 0.3 % THC are legal federally in the United States and can be used for various purposes. It is available in a wide range of products that can be used according to personal preferences and your needs.
What Is CBD Used for?
CBD works by interacting with the human endocannabinoid system, which is responsible for maintaining homeostasis. The endocannabinoid system carries out a long list of physiological processes that are essential in keeping the body working in its optimal state. CBD can interact with the CB2 receptors of the endocannabinoid system. CB2 receptors are usually concentrated in the peripheral nervous system. CB2 receptors perform some of the most basic physiological functions that include managing inflammation, pain, neurological activity, and immune function.
CBD can be used to promote the activity of CB2 receptors and reduce pain and inflammation, and neurological dysfunction. It can also help in boosting overall mental health by reducing your stress and anxiety levels.
Benefits of CBD for Plantar Fasciitis
Many studies show that CBD can be helpful for chronic pain or medical conditions that cause pain in muscles and joints. However, there are no studies that directly explain the effect of CBD on plantar fasciitis. But CBD can be helpful in reducing pain and discomfort caused by a damaged bowstring in your foot. The interaction of CBD with CB2 receptors helps in relieving pain and reducing inflammation. Since inflammation is directly related to pain, a decrease in inflammation also reduces discomfort and uneasiness and allows you to walk in a much more comfortable manner.
The most prominent symptom of plantar fasciitis is stabbing pain in the heel or in the bottom of the foot. CBD can decrease pain perception because of its nociceptive effects.
Even though inflammation is a positive and helpful response of the body towards any injury, excess inflammation can cause potential damage to the body. CBD can suppress the response of immune cells and reduce inflammation to help the damaged cells heal quickly and eventually make you feel more at ease.
Obese people have a higher risk of damaged muscles. Some people may have obesity because of an underlying health condition, but many people suffer from this condition because of overeating or in taking unhealthy calories. Research has shown that CBD can also help in reducing your appetite, which can be extremely valuable in weight management.
Swelling and redness are the most common effects of inflammation. Since CBD is quite helpful in reducing inflammation, it can also significantly reduce the physical effects of the body’s natural response, including swelling and redness. This promotes easier movement, better sleep, and a more natural appearance.
How Does CBD Work for Foot Pain?
Research has shown that CBD is quite effective in reducing localized pain in different parts of the body, including the feet. Topical or transdermal application of CBD can reduce the symptoms of inflammation such as swelling, redness, and pain. Rubbing CBD products directly on the affected area helps it to heal the damaged cells quickly.
Oral CBD doses are also effective but may produce the desired results only after a few hours of its intake. Topical application of CBD usually produces instant results, and you can feel relief with a few minutes of application.
Side Effects of CBD
CBD is generally safe and does not cause any severe side effects.
The most common side effects caused by CBD include:
- Reduced appetite
- Dry mouth
These side effects usually fade off on their own and do not require any medical attention. CBD is also known to interact with some over-the-counter medications, such as blood thinners. It is important to avoid using CBD with most prescription medications. Always consult your healthcare practitioner before taking CBD if you are already on some medicines. Also, your CBD products should be reliable and pure so that there are no contaminants in the product which can cause harmful effects on your health and body, particularly if you are already taking other medication.
How to Use CBD for Plantar Fasciitis?
CBD is available in different types of products that can be used for relief from chronic pain caused by an injured heel. Here are some of the most common types of CBD products available on the market today.
CBD vapes are very common these days and can be used for relief from the symptoms of plantar fasciitis. Vaping is safer than smoking and produces quicker results as compared to other CBD delivery methods. However, if you are already suffering from any lung-related or breathing issues, it is recommended to avoid using CBD vapes and switch to other types of CBD products.
CBD topicals are the most effective types of CBD products that can be used to seek relief from the symptoms of plantar fasciitis. You can easily find CBD topical products, such as balms, creams, lotions, and salves. Our skin possesses CB2 receptors, so your CBD dose can directly interact with these receptors in the skin and produce quicker results.
CBD oil is another popular way to intake CBD. Since CBD you ingest will have to go through metabolic processing in the body, it usually takes 4 to 5 hours before producing the desired result.
CBD gummies may be the tastiest and most convenient way to take your daily CBD dose. Each gummy contains a specific quantity of CBD, which can be taken with other vitamin supplements. These CBD gummies have different flavors like orange, strawberry, and mango, among many others in the market today.
There is no universal dose of CBD that is equally helpful for everybody. Each one of us has to find the dose that is best for our health condition. In the process of finding the right dosage, we should be very careful and observant about any positive and negative changes occurring in our bodies. It is recommended to begin with the smallest dose possible and increase it gradually if it does not seem to produce the desired results. You can begin with taking 5mg of CBD per day and increase it as necessary. Note that our body can tolerate up to 1500 mg of CBD per day.
Key Takeaways on Using CBD Oil for Plantar Fasciitis
CBD is undoubtedly helpful for reducing pain caused by plantar fasciitis. However, be careful if you are already taking any other medicines. It is important to remember that CBD should not be considered as a sole treatment option and if your condition worsens, consult your doctor immediately.
Make sure to go for safe CBD products that come with a certificate of analysis showing the exact ingredients and their quantity. All premium CBD products should be third-party lab tested. So, play it safe and choose quality products from established companies for the best results in easing the pain from plantar fasciitis.
- Crivelaro do Nascimento, G., Ferrari, D. P., Guimaraes, F. S., Del Bel, E. A., Bortolanza, M., & Ferreira-Junior, N. C. (2020). Cannabidiol increases the nociceptive threshold in a preclinical model of Parkinson’s disease. Neuropharmacology, 163, 107808. 
- Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154. 
Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.
The 7 Ways CBD Oil Helps Foot Problems
Pain is pain no matter what part of the body is affected by it. But when pain originates in the foot, it can be life-altering by affecting your mobility and preventing you from enjoying routine daily activities, such as shopping, taking your kids to the park and exercising.
According to a recent American Podiatric Medical Associates study, nearly 80 percent of adult Americans have experienced a foot problem. Sources of foot pain range from bunions and ill-fitting shoes to more severe ailments, such as Achilles tendonitis, arthritis and diabetic neuropathy.
Regardless of its source, almost 50 percent of people with foot ailments choose over-the-counter products for relief, while 25 percent do nothing. One increasingly popular alternative to chasing away foot pain is with cannabidiol (CBD) products. Recent studies have found that transdermal (topical) CBD significantly reduced joint swelling and pain without adverse side effects. That’s great news for those managing foot pain but how does it work?
How CBD Oil Works Against Pain and Inflammation
Hemp-derived CBD oil interacts directly with receptors in our endocannabinoid system. Also known as the ECS, the endocannabinoid system is a network of receptors responsible for regulating vital functions such as sleep cycles, inflammatory response, and stress levels.
The action of CBD oil on the ECS has a full-body effect that may also help manage foot problems due to its anti-inflammatory and pain-reducing properties. Hemp-derived CBD also has the added benefit of providing temporary relief without the psychoactive properties inherent with products containing THC. In fact, hemp-derived CBD oil must have 0.3 percent or less THC content as mandated by law.
Although all high-quality CBD oils have anti-inflammatory properties and can be effective in treating a variety of symptoms related to foot pain, certain administration likely yields the fastest results when used for seven common foot problems.
7 Common Foot Problems
There are hundreds of conditions that can be classified as foot problems, and this list is far from exhaustive, but some of the most common are described below along with recommended CBD products that may help alleviate pain and inflammation.
1. Achilles Tendinitis and other forms of Tendonitis– is an injury of the Achilles tendon that connects the calf muscles of the lower leg to your heel bone. It’s a common injury among runners who overdo it during training and among people who run moderately but are in not-so-good shape.
Achilles tendinitis pain typically begins as a dull ache in the calf and or the back of the leg. At times, it can intensify if there is not enough time given for the injury to heal or if the tendon tears, which would then require special medical attention. The properties of hemp-derived CBD oil to reduce pain and inflammation may help this type of injury.
2. Diabetic neuropathy- is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerves throughout your body. Diabetic neuropathy most often damages nerves in your legs and feet. It develops gradually and is comprised of four main types of this condition:
- Peripheral neuropathy-feet and legs affected first followed by hands and arms
- Autonomic neuropathy-affects neural system controlling heart, lungs bladder, etc.
- Proximal neuropathy- also called diabetic amyotrophy, this condition is more common in people who have type 2 diabetes and in older adults
- Mononeuropathy-comes on suddenly and involves damage to a specific nerve, causing pain in the foot, thigh or anywhere else in the body
Diabetic neuropathy can cause a wide range of serious foot problems, such as ulcers, infections, deformities, and bone and joint pain. Diabetic neuropathy is a serious complication of diabetes that affects up to 50 percent of people with the condition.
Besides people who have diabetes, those who are substantially overweight, smoke or who have kidney disease are also at risk for diabetic neuropathy. Hemp-derived CBD oil can help with pain management, inflammation management and neuroprotection of the foot.
3. Gout- is a form of arthritis resulting from a buildup of excess uric acid in the bloodstream. Uric acid crystals eventually form in the joints, especially around the big toe and cause swelling and intense pain.
The tendency to experience a gout attack can be an inherited trait but it can also be brought on by high blood pressure, diabetes, obesity, surgery, chemotherapy, stress and certain medications. Limiting consumption of certain foods and drinks may reduce your chances of getting gout. Limiting or avoiding shellfish, organ meats (kidney, liver, etc.), red wine, beer, and red meat are good ways to start.
Hemp-derived CBD oil can help with pain management, inflammation management and neuroprotection of the foot and joints. Recommended CBD products include CBD with capsaicin, Pain Cream with CBD & Lidocaine, Warming CBD Salve, CBD Pain Patch
4. Degenerative Hallux Disorders-In addition to its tendency for getting stubbed, your big toe (great toe or hallux in medical terminology) is susceptible to a number of painful conditions including:
- degenerative arthritis (hallux rigidus)
- bunions (hallux valgus)
- traumatic conditions (sesamoiditis or turf toe)
Pain and inflammation management often calls for cold or heat compresses, change of diet or surgery. When symptoms are mild or easily managed, a high-quality CBD oil topical may provide temporary relief without the side effects of OTC analgesics or prescribed medications.
5. Heel Pain, Plantar Fasciitis- Plantar fasciitis is one of the most common causes of heel pain. Almost one third of US adult respondents to a recent survey cited heel pain as the primary source of their foot pain. Heel pain happens when inflammation occurs with a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia).
Plantar fasciitis most commonly occurs in people with high arches or flat feet. It can also happen to people who spend long hours on their feet without the proper supportive footwear.
Anti-inflammatory and pain relieving properties of CBD may help to manage the symptoms as well as to suppress the inflammation that causes the pain.
6. Neuroma – is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes. It brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot. The most common cause of neuroma is wearing ill-fitting shoes, high heels or shoes with a tapered toe box.
The good news is that mild neuromas can be managed with padding, orthopedic devices or modifying your activities that put pressure on your feet. CBD oil can help with pain management, inflammation management and neuroprotection.
7. Tarsal Tunnel Syndrome-Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot. In layman’s terms, if you have tarsal tunnel syndrome, you have painfully swollen ankles and feet.
Tarsal tunnel syndrome is similar to carpal tunnel syndrome, which occurs in the wrist. CBD oil can help with pain management, inflammation management and neuroprotection.
Our feet have 25 percent of all the bones in our bodies – 52 bones in all. With 33 joints, 107 ligaments, and 19 muscles and multiple tendons holding everything together, the foot is susceptible to a variety of injuries and ailments likely to cause pain and immobility. Hemp-derived CBD oil has been shown to have beneficial properties lessening the severity of inflammation and pain.
When pain and inflammation can’t be alleviated by taking off shoes and kicking your heels up, CBD oil products may provide relief in a more holistic, natural way without the side effects of over the counter and prescribed medications.