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It’s not a stretch to say that CBD (cannabidiol) is one of the most exciting and promising compounds currently being studied by the medical and scientific communities.
Although government regulatory agencies have not yet ruled on the use of CBD to treat many of the symptoms and conditions it’s currently being investigated for, the FDA did make headlines recently for approving the first CBD-derived medication to treat certain forms of severe epilepsy.
In the meantime, misinformation and confusion about CBD still abounds due to the relatively recent emergence and widespread awareness of this fascinating compound. Let’s take a deep dive into what cannabidiol (CBD) is, and exactly what it does — and doesn’t — do.
CBD is simply short for “cannabidiol”, the second-most abundant cannabinoid molecule produced within the cannabis (hemp) plant. The most abundant molecule, of course, being THC: the psychoactive chemical famous for making users feel “high” (note that CBD does not have this effect).
Keep in mind that your body already has an endocannabinoid system, an extremely important molecular system that your body uses to regulate and perform various critical functions.
CBD binds to receptors in this system; our bodies were designed to interface with cannabinoids from the very beginning — we even naturally produce them!
- CBD does not get you “high” (non-intoxicating)
- Comes from hemp or cannabis plants
- Is being studied for potential anti-seizure and anti-inflammatory properties
- Indirectly interacts with CB1 and CB2 cannabinoid receptors
- CBD is totally legal to buy and own in all 50 states
As we stated earlier, your body already has a wildly complex endocannabinoid system that affects several different areas and functions.
That system is rife with “receptors,” sites that await cannabinoid molecules presence.
When the cannabinoid nears, the receptor will bind it to itself, creating a sophisticated chemical interaction that modern science is only just beginning to scratch the surface of understanding.
Does CBD actually work?
Perhaps you’ve heard a lot of people are using CBD.
The chemical compound, naturally occurring in cannabis plants, doesn’t get you high, but does have a wide swath of other purported effects making it very popular.
Although clinical studies haven’t necessarily proven those results, many Americans are testing CBD (which stands for “cannabidiol”) for themselves.
All over the US, people are rubbing CBD balm onto aching joints, dropping CBD tinctures under tired tongues, popping CBD gummies, and puffing on CBD oil-filled vaporizers in hopes of chilling out.
On Quartz’s behalf, Harris Poll recently surveyed more than 2,000 people in the US about their experience, knowledge, and opinions regarding CBD and found that more than 85% of Americans have heard of CBD, and of those, more than one in five have tried it.
What are all these people using CBD for?
More than half of the CBD-users surveyed—some 55%—said they use it to relax. Half reported using it to reduce stress and anxiety, and the proportions of people who use CBD to improve their sleep and relieve pain (including muscle, chronic, and joint pain) were not far behind. Also on the list were relief from migraines, menstrual symptoms, nausea, and sexual enhancement.
Is there proof that CBD works for all this?
In short: not much.
“There really isn’t very much evidence in humans with respect to its effectiveness,” says Ziva Cooper, the research director at the University of California-Los Angeles Cannabis Research Initiative.
“And when I say evidence in humans, I’m really talking about rigorous, double-blind placebo-controlled studies.” On the other hand, Cooper says, there’s also not much research showing that cannabidiol doesn’t work for things.
“There is just a general lack of studies—period.”
Beyond pain relief and mental health: The science behind CBD oil
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CBD’s introduction into the mainstream began with medical applications in more serious cases. When patients with epilepsy responded well to CBD oil, significant scientific arguments were made and continue to be made for its use in treating people that suffer from seizures. From there, initial studies suggested that CBD oil could be beneficial in managing chronic pain and stress and anxiety.
However, as CBD has made its way from the fringes to the mainstream, more medical studies are suggesting its applications in the following areas:
- Sleep apnoea
- Dry skin
As the list of possible benefits of using CBD oil and CBD products increases, the discussion regarding exactly what CBD is and how it works is an important one to consider. If you would be interested in speaking with Dr David Dawit on this subject, please do not hesitate to get in touch.
Dr David Dawit, Chief Scientific Officer of Eos Scientific:
“There are 4 main methods used to produce or extract CBD from hemp, whole plant extraction, isolate extraction, CO2 extraction and alcohol extraction.
Whole Plant Extraction
The entire hemp plant forms part of the extraction and is one of the more favoured methods. This is because it is believed to be the most effective way to capture the entire cannabinoid spectrum as close to the natural endocannabinoid system as possible
CBD isolates are pure CBD compounds extracted, with their effectiveness dependent on the quality of hemp from which they are derived.
This is when CO2 is forced through the plant to extract the oil, the most complex methods currently available but does allow for the individual cannabinoid compounds to be separated effectively.
This is the original extraction method used, by soaking the hemp in a solvent to remove the oils after which the solvent is evaporated to leave the CBD oil.
CBD is regarded as a food supplement that helps to bring balance to our bodies and minds by complementing or ‘topping up’ the endocannabinoid system which most are unable to create enough of therefore causing imbalance.
The human body naturally creates cannabinoids, which are used by the endocannabinoid system to maintain balance/homeostasis within the body.
The endocannabinoid system has been long regarded as the most important system in the body for maintaining long term health.”
Simon Manthorpe, CEO of Eos Scientific:
“CBD is one of over 100 cannabinoids found in the cannabis plant.
Although CBD has been known to help a myriad of people with different ailments sadly we are unable to promote its health benefits unless it has been tested and approved as a medicinal product.
There are a few products on the market that have this approval such as Epidolex that can be used to treat children with Epilepsy. So far CBD is known to help with not only epilepsy but also anxiety, inflammation, pain relief and sleeping issues.
We are at the beginning of a seismic shift in respect of this plant on a global scale. People who would quite comfortably go to health and wellbeing stores such as Holland & Barrett to buy vitamins are suddenly being presented with cannabinoid products that range from conventional oils to cosmetics.
Elsewhere, cafés, bars and spas are incorporating this exciting new ingredient into the products and services they offer. Over the next 12-24 months we’re going to see an even more dramatic explosion of CBD products, in the same way that people take vitamins and supplements to improve their wellbeing.
The Science and Sourcing Behind CBD
Credit: Public Domain.
CBD has been a phenomenon in the world of health and medicine recently with more studies linking this cannabinoid to several health benefits.
Cannabidiol (CBD) is one of the dozens of cannabinoid compounds found in the cannabis plant. CBD oil can be made from both marijuana or hemp cannabis plant, and can be extracted in a number of ways. However, in order for CBD products to be considered legal, it must come from a hemp plant and have low (0.03%) or no THC levels.
CBD is stimulating a lot of interest among scientists in recent years, and while a lot has been discovered about this compound, research continues.
Research has uncovered a myriad of benefits that CBD has on the mind and the body including alleviating pain, inflammation, anxiety, and seizures. It is also linked with improving sleep, mental clarity, heart health, muscle recovery, regulated blood pressure and helping to decrease the risk of developing cancer.
Clearly, there are a number of advantages that CBD brings to the table, but what’s the science behind it?
CBD and The Endocannabinoid System
CBD’s effects all come down to the body’s endocannabinoid system, which is a network of 5-HT receptors that are activated and play a role in maintaining homeostasis in the body. Homeostasis affects pain, mood, and appetite among others other factors.
CBD interacts with the receptors of the endocannabinoid system, predominantly the CB1 and CB2 receptors that are found mainly in the brain and immune cells.
While the body already has its own set of cannabinoids, introducing CBD to the body enhances the efficacy of the endocannabinoid system.
While CBD does not actually bind directly with these receptors, it interacts with them indirectly and modulates many non-cannabinoid receptors and ion channels. The endocannabinoid system determines how the body processes and utilizes cannabinoids.
How Does CBD Take Effect in The Body?
CBD’s therapeutic effect on the body occurs in several ways including the following:
5-HT1A Serotonin: CBD has been shown to activate 5-HT1A serotonin receptors in the body, which can help alleviate anxiety, reduce nausea and vomiting, regulate appetite and improve sleep. They’re found in the central and peripheral nervous systems and stimulate many different chemical messages, which can either produce an excitatory or inhibitory response.
TRPV1 Receptors: CBD binds to TRPV1 receptors in the endocannabinoid system, which helps to reduce pain and inflammation, and regulate body temperature.
GPR55 Protein Receptors: cannabidiol acts as an antagonist to GPR55 protein receptors. By blocking it, CBD can help to hinder bone reabsorption associated with osteoporosis and modulate blood pressure. It can also help to reduce the spread of cancerous cells throughout the body as GPR55 has been associated with the proliferation of cancer cells.
PPARs: CBD plays a role in activating PPARs, which have been associated with reducing the effects of Alzheimer’s Disease and even have anti-cancer effects. PPARs are located on the surface of the cell’s nucleus. By activating the PPAR-gamma receptor, CBD has an anti-proliferative effect on cancer cells.
The activation of PPAR-gamma also diminishes amyloid-beta plaque, which is associated with the onset of Alzheimer’s disease. This is why CBD can be an effective agent for Alzheimer’s patients.
Further, diabetics can find much use for CBD and its activation of PPAR receptors because they regulate genes involved in insulin sensitivity.
The types of CBD formulas typically fall under one of two categories: full spectrum and isolate.
Full spectrum CBD formulas: these products include all the cannabinoids found in the cannabis plant. Every cannabinoid found in the plant offers different health benefits for a wide range of ailments.
CBD certainly offers plenty of health benefits on its own, but all other cannabinoids also have something to offer.
Many people debate whether CBD products that contain the full spectrum of cannabinoids are more effective.
Isolate CBD formulas: these products contain CBD that has been isolated from other cannabinoids in the cannabis plant. Because of this, these formulas may not provide the same amount of relief as full spectrum formulas.
That said, CBD isolates can be used to effectively treat several different ailments, and, in many cases, CBD isolate is the preferred formula type.
For some, it may not always be necessary to take advantage of full spectrum CBD and sometimes, other cannabinoids can even cause negative reactions.
Both full spectrum and isolate CBD formulas have their place in the world of medicine and can provide the precise effects that users want.
CBD Oil Sources
As mentioned earlier, CBD that’s extracted from marijuana plants contains THC, while CBD that’s derived from the hemp plant contains very little to no THC. It’s the latter of the two that is legal in the US at the federal level, though this is still the topic of much debate.
Generally speaking, hemp-derived CBD formulas are more easily accessible because of their legal status. They’re also more highly favored among those who prefer not to experience the mind-altering effects of cannabis while still taking advantage of its medicinal and therapeutic effects.
Hemp-derived CBD is considered safer for certain people to take, such as children, the elderly, and even pets because of its low THC content. CBD oil that is extracted from hemp is just as potent as marijuana-derived CBD on a molecular level after it has been extracted.
Knowing exactly where the CBD comes from is very important for users, especially those who wish to avoid THC and its psychoactive effects as well as those who want to remain compliant with the law.
It’s also important to conduct some research on the manufacturers who produce CBD. Some products that are marketed as hemp-derived CBD can still contain higher levels of THC than the legal limit.
There are some manufacturers who produce CBD products that contain more THC and less CBD than what they claim.
Once you’re satisfied with a certain manufacturer, you might want to order bulk CBD oil in order to offset costs associated with long-term treatment.
This is why it’s vital that consumers research the manufacturers that they’re buying their CBD oil from, read product labels and review third-party lab reports.
There is plenty of research out there to back up the efficacy of CBD on the mind and body.
And as cannabis products become more widely accepted, more studies investigating CBD’s properties on human health will be carried out.
Understanding how CBD works in the body and doing some research into the manufacturers who source and produce CBD products are important factors for consumers to consider before making a purchase
Cannabidiol (CBD) – Use, Effects and Safety — UPA
The medical benefits of CBD have been the subject of many recent studies. Likewise, research suggests there are many possible uses for this compound.
In the medical field, new compounds are first screened in lab experiments using animal cells, then tested in live animals, and finally in humans. The final phase of testing in humans is called a clinical trial.
Human studies are considered the best level of evidence for the safety and efficacy of a medical compound. Recent studies conducted in humans seem to support the use of CBD for the following conditions:
Epilepsy – The efficacy of CBD in treating epilepsy is perhaps the best studied use of pure cannabidiol. A pharmaceutical-grade drug called Epidiolex®, comprised of almost pure CBD oil, has been approved for research by the Food and Drug Administration.
Epidiolex® has been studied in 214 patients with severe forms of epilepsy that did not respond to other medications. At doses between 25 and 50 mg/kg a day, Epidiolex® was found to lower seizure frequency by 50% in a 12-week clinical trial.
In addition to this carefully controlled study using a pharmaceutical-grade product, there are numerous reports of epilepsy patients showing reduction in seizure frequency after taking a CBD oil preparation.
Anxiety – In one study, 24 patients with social anxiety disorder were allocated to receive either 600 mg of CBD or placebo.
A simulated public speaking test was performed to assess the patients’ signs and symptoms of anxiety. The CBD-treated group did better than the placebo-treated group.
On measures of cognitive impairment, discomfort, and alertness, the CBD-treated group did just as well as a healthy cohort who did not have social anxiety disorder.
Parkinson’s disease – In one study, 21 patients with Parkinson’s were randomized to receive placebo, CBD at 75 mg/day or CBD at 300 mg/day.
Patients rated their quality of life at baseline after receiving treatment. The group taking 300 mg/day of CBD scored significantly higher than the group on placebo for overall quality of life.
However, in another study, CBD at doses over 300 mg/day exacerbated Parkinsonism.
Schizophrenia – In one study, 29 patients with first-break paranoid schizophrenia were given either 600 mg of CBD or a placebo for 14 days. After the 14 day period, patients switched treatments from CBD to placebo and vice versa. CBD was found to significantly improve psychotic symptoms.
Dystonia – In one study, 5 patients with dystonic movements disorders were given 100-600 mg/day of CBD over a 6 week period, along with their usual medications. Dystonia improved in all patients by the end of the study.
Graft versus host disease (GVHD) – In a study of 48 patients who underwent bone marrow transplant to treat a type of blood cancer, 300 mg/day of CBD was given orally from 7 days before transplant to 30 days after transplant. Compared to a group of similar patients who did not receive CBD, the CBD-treated group were less likely to develop graft versus host disease, a severe and serious complication of bone marrow transplant.
Nicotine addiction – In one study, 24 smokers were randomised to receive an inhaler of CBD or placebo for one week.
They were instructed to use the inhaler whenever they felt a craving to smoke.
Over the course of one week, those receiving the placebo inhaler did not decrease the number of cigarettes they smoked while those taking the CBD inhaler reduced their number of cigarettes smoked by 40%.
THC impairment and withdrawal – One of the most important properties of CBD is its ability to modulate the effects of THC. In one study, patients were first given THC, followed by CBD.
CBD was found to reverse some of the known psychoactive effects of THC, including anxiety.
The pharmaceutical drug Sativex®, a 1:1 combination of CBD and THC, has also been found to be helpful in treating cannabis withdrawal in at least one other study.
- Animal Studies
- While the medical benefit of a compound can only be truly proven in a clinical trial, data from laboratory and animal studies are still useful to guide future clinical studies.
- Laboratory and animal studies have found CBD to have beneficial effects in the following conditions:
How CBD Works
Cannabidiol (CBD), a non-intoxicating component of the cannabis plant, has generated significant interest among scientists and physicians in recent years—but how CBD exerts its therapeutic impact on a molecular level is still being sorted out. Cannabidiol is a pleiotropic drug in that it produces many effects through multiple molecular pathways. The scientific literature has identified more than 65 molecular targets of CBD.
Although CBD has little binding affinity for either of the two cannabinoid receptors (CB1 and CB2), cannabidiol modulates several non-cannabinoid receptors and ion channels.
CBD also acts through various receptor-independent pathways—for example, by delaying the “reuptake” of endogenous neurotransmitters (such as anandamide and adenosine) and by enhancing or inhibiting the binding action of certain G-protein coupled receptors.
Here are some of the ways that CBD confers its manifold therapeutic effects.
Jose Alexandre Crippa and his colleagues at the University of San Paulo in Brazil and King’s College in London have conducted pioneering research into CBD and the neural correlates of anxiety.
At high concentrations, CBD directly activates the 5-HT1A (hydroxytryptamine) serotonin receptor, thereby conferring an anti-anxiety effect.
This G-coupled protein receptor is implicated in a range of biological and neurological processes, including (but not limited to) anxiety, addiction, appetite, sleep, pain perception, nausea and vomiting.
5-HT1A is a member of the family of 5-HT receptors, which are activated by the neurotransmitter serotonin. Found in both the central and peripheral nervous systems, 5-HT receptors trigger various intracellular cascades of chemical messages to produce either an excitatory or inhibitory response, depending on the chemical context of the message.
CBDA [Cannabidiolic acid], the raw, unheated version of CBD that is present in the cannabis plant, also has a strong affinity for the 5-HT1A receptor (even more so than CBD). Preclinical studies indicate that CBDA is a potent anti-emetic, stronger than either CBD or THC, which also have anti-nausea properties.
CBD directly interacts with various ion channels to confer a therapeutic effect. CBD, for example, binds to TRPV1 receptors, which also function as ion channels. TRPV1 is known to mediate pain perception, inflammation and body temperature.
vanilloid cannabinoid receptor
TRPV is the technical abbreviation for “transient receptor potential cation channel subfamily V.” TRPV1 is one of several dozen TRP (pronounced “trip”) receptor variants or subfamilies that mediate the effects of a wide range of medicinal herbs.
Scientists also refer to TRPV1 as a “vanilloid receptor,” named after the flavorful vanilla bean. Vanilla contains eugenol, an essential oil that has antiseptic and analgesic properties; it also helps to unclog blood vessels. Historically, the vanilla bean has been used as a folk cure for headaches.
CBD binds to TRPV1, which can influence pain perception.
Capsaicin—the pungent compound in hot chili peppers—activates the TRPV1 receptor. Anandamide, the endogenous cannabinoid, is also a TRPV1 agonist.
Whereas cannabidiol directly activates the 5-HT1A serotonin receptor and several TRPV ion channels, some studies indicate that CBD functions as an antagonist that blocks, or deactivates, another G protein-coupled receptor known as GPR55.
GPR55 has been dubbed an “orphan receptor” because scientists are still not sure if it belongs to a larger family of receptors. GPR55 is widely expressed in the brain, especially in the cerebellum. It is involved in modulating blood pressure and bone density, among other physiological processes.
GPR55 promotes osteoclast cell function, which facilitates bone reabsorption. Overactive GPR55 receptor signaling is associated with osteoporosis.
GPR55, when activated, also promotes cancer cell proliferation, according to a 2010 study by researchers at the Chinese Academy of Sciences in Shanghai. This receptor is expressed in various types of cancer.
CBD is a GPR55 antagonist, as University of Aberdeen scientist Ruth Ross disclosed at the 2010 conference of the International Cannabinoid Research Society in Lund, Sweden. By blocking GPR55 signaling, CBD may act to decrease both bone reabsorption and cancer cell proliferation.
PPARs – nuclear receptors
CBD also exerts an anti-cancer effect by activating PPARs [peroxisome proliferator activated receptors] that are situated on the surface of the cell’s nucleus. Activation of the receptor known as PPAR-gamma has an anti-proliferative effect as well as an ability to induce tumor regression in human lung cancer cell lines. PPAR-gamma activation degrades amyloid-beta plaque, a key molecule linked to the development of Alzheimer’s disease. This is one of the reasons why cannabidiol, a PPAR-gamma agonist, may be a useful remedy for Alzheimer’s patients.
PPAR receptors also regulate genes that are involved in energy homeostasis, lipid uptake, insulin sensitivity, and other metabolic functions. Diabetics, accordingly, may benefit from a CBD-rich treatment regimen.
CBD as a reuptake inhibitor
Cannabidiol (CBD) — what we know and what we don’t – Harvard Health Blog – Harvard Health Publishing
Cannabidiol (CBD) has been recently covered in the media, and you may have even seen it as an add-in booster to your post-workout smoothie or morning coffee. What exactly is CBD? Why is it suddenly so popular?
How is cannabidiol different from marijuana?
CBD stands for cannabidiol. It is the second most prevalent of the active ingredients of cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, which is a cousin of the marijuana plant.
While CBD is a component of marijuana (one of hundreds), by itself it does not cause a “high.” According to a report from the World Health Organization, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential….
To date, there is no evidence of public health related problems associated with the use of pure CBD.”
Is cannabidiol legal?
CBD is readily obtainable in most parts of the United States, though its exact legal status is in flux.
All 50 states have laws legalizing CBD with varying degrees of restriction, and while the federal government still considers CBD in the same class as marijuana, it doesn’t habitually enforce against it.
In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials. Currently, many people obtain CBD online without a medical cannabis license.
The government’s position on CBD is confusing, and depends in part on whether the CBD comes from hemp or marijuana. The legality of CBD is expected to change, as there is currently bipartisan consensus in Congress to make the hemp crop legal which would, for all intents and purposes, make CBD difficult to prohibit.
The evidence for cannabidiol health benefits
CBD has been touted for a wide variety of health issues, but the strongest scientific evidence is for its effectiveness in treating some of the cruelest childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), which typically don’t respond to antiseizure medications.
In numerous studies, CBD was able to reduce the number of seizures, and in some cases it was able to stop them altogether. Videos of the effects of CBD on these children and their seizures are readily available on the Internet for viewing, and they are quite striking.
Recently the FDA approved the first ever cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.
CBD is commonly used to address anxiety, and for patients who suffer through the misery of insomnia, studies suggest that CBD may help with both falling asleep and staying asleep.
CBD may offer an option for treating different types of chronic pain. A study from the European Journal of Pain showed, using an animal model, CBD applied on the skin could help lower pain and inflammation due to arthritis.
Another study demonstrated the mechanism by which CBD inhibits inflammatory and neuropathic pain, two of the most difficult types of chronic pain to treat.
More study in humans is needed in this area to substantiate the claims of CBD proponents about pain control.
Is cannabidiol safe?
Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level in your blood of the blood thinner coumadin, and it can raise levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does.
A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other (unknown) elements.
We also don’t know the most effective therapeutic dose of CBD for any particular medical condition.
The bottom line on cannabidiol
Some CBD manufacturers have come under government scrutiny for wild, indefensible claims, such that CBD is a cure-all for cancer, which it is not. We need more research but CBD may be prove to be an option for managing anxiety, insomnia, and chronic pain.
Without sufficient high-quality evidence in human studies we can’t pinpoint effective doses, and because CBD is currently is mostly available as an unregulated supplement, it’s difficult to know exactly what you are getting.
If you decide to try CBD, talk with your doctor — if for no other reason than to make sure it won’t affect other medications you are taking.
What Are the Benefits of CBD?
Continue reading the main story
The CBD industry is flourishing, conservatively projected to hit $16 billion in the United States by 2025. Already, the plant extract is being added to cheeseburgers, toothpicks and breath sprays.
More than 60 percent of CBD users have taken it for anxiety, according to a survey of 5,000 people, conducted by the Brightfield Group, a cannabis market research firm.Chronic pain, insomnia and depression follow behind. Kim Kardashian West, for example, turned to the product when “freaking out” over the birth of her fourth baby.
The professional golfer Bubba Watson drifts off to sleep with it. And Martha Stewart’s French bulldog partakes, too.
Cannabidiol, or CBD,is the lesser-known child of the cannabis sativa plant; its more famous sibling, tetrahydrocannabinol, or THC, is the active ingredient in pot that catapults users’ “high.” With roots in Central Asia, the plant is believed to have been first used medicinally — or for rituals — around 750 B.C., though there are other estimates too.
Cannabidiol and THC are just two of the plant’s more than 100 cannabinoids. THC is psychoactive, and CBD may or may not be, which is a matter of debate. THC can increase anxiety; it is not clear what effect CBD is having, if any, in reducing it. THC can lead to addiction and cravings; CBD is being studied to help those in recovery.
Cannabis containing 0.3 percent or less of THC is hemp. Although last year’s Farm Bill legalized hemp under federal law, it also preserved the Food and Drug Administration’s oversight of products derived from cannabis.
CBD is advertised as providing relief for anxiety, depression and post-traumatic stress disorder. It is also marketed to promote sleep. Part of CBD’s popularity is that it purports to be “nonpsychoactive,” and that consumers can reap health benefits from the plant without the high (or the midnight pizza munchies).
Just as hemp seedlings are sprouting up across the United States, so is the marketing. From oils and nasal sprays to lollipops and suppositories, it seems no place is too sacred for CBD. “It’s the monster that has taken over the room,” Dr.
Brad Ingram, an associate professor of pediatrics at the University of Mississippi Medical Center, said about all the wild uses for CBD now.
He is leading a clinical trial into administering CBD to children and teenagers with drug-resistant epilepsy.
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“It’s promising in a lot of different therapeutic avenues because it’s relatively safe,” said James MacKillop, co-director of McMaster University’s Michael G. DeGroote Center for Medicinal Cannabis Research in Hamilton, Ontario.
Last year, the F.D.A.
approved Epidiolex, a purified CBD extract, to treat rare seizure disorders in patients 2 years or older after three randomized, double-blind and placebo-controlled clinical trials with 516 patients that showed the drug, taken along with other medications, helped to reduce seizures. These types of studies are the gold standard in medicine, in which participants are divided by chance, and neither the subject nor the investigator knows which group is taking the placebo or the medication.
While there is hope for treating other conditions with the plant extract, Epidiolex remains the only CBD-derived drug approved by the F.D.A.
Most of the research on cannabidiol has been in animals, and its current popularity has outpaced science.
“We don’t have the 101 course on CBD quite figured out yet,” said Ryan Vandrey, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.
For students with generalized social anxiety, a four-minute talk, with minimal time to prepare, can be debilitating. Yet a small experiment in the journal Neuropsychopharmacology found that CBD seemed to reduce nervousness and cognitive impairment in patients with social anxiety in a simulated public speaking task.
However, a double-blind study found healthy volunteers administered CBD had little to no change in their emotional reaction to unpleasant images or words, compared to the placebo group.
“If it’s a calming drug, it should change their responses to the stimuli,” said Harriet de Wit, co-author of the study and a professor in the University of Chicago’s department of psychiatry and behavioral neuroscience. “But it didn’t.”
Many soldiers return home haunted by war and PTSD and often avoid certain activities, places or people associated with their traumatic events. The Department of Veterans Affairs is funding its first study on CBD, pairing it with psychotherapy.
“Our top therapies attempt to break the association between reminders of the trauma and the fear response,” said Mallory Loflin, an assistant adjunct professor at the University of California, San Diego and the study’s principal investigator. “We think that CBD, at least in animal models, can help that process happen a lot faster.” While large clinical trials are underway, psychologists say there isn’t compelling evidence yet as to whether this is a viable treatment.
Up in the wee hours of the night, stuck watching videos of puppies? CBD may be promising as a sleep aid; one of the side effects of the Epidiolex trials for epilepsy was drowsiness, according to Mr. MacKillop, a co-author of a review on cannabinoids and sleep. “If you are looking for new treatments for sleep, that may be a clue,” he said.
But he cautions that the side effects could have been because of an interaction with other medications the children were taking to control the seizures. So far, there hasn’t been a randomized, placebo-controlled, double-blind trial (the gold standard) on sleep disorders and CBD.
[Stressed-out parents are giving it a shot.]
A recent chart review of 72 psychiatric patients treated with CBD found that anxiety improved, but not sleep. “Over all, we did not find that it panned out as a useful treatment for sleep,” said Dr. Scott Shannon, assistant clinical professor of psychiatry at the University of Colorado, Denver and the lead author of the review in The Permanente Journal.