Cannabidiol (CBD)-what we know and what we don’t
Cannabidiol (CBD) is often covered in the media, and you may see it touted as an add-in booster to your post-workout smoothie or morning coffee. You can even buy a CBD-infused sports bra. But what exactly is CBD? And why is it so popular?
How is cannabidiol different from marijuana, cannabis and hemp?
CBD, or cannabidiol, is the second most prevalent active ingredient in cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, a cousin of marijuana, or manufactured in a laboratory. One of hundreds of components in marijuana, CBD does not cause a “high” by itself. 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 has been in flux. All 50 states have laws legalizing CBD with varying degrees of restriction. In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials. In 2018, the Farm Bill made hemp legal in the United States, making it virtually impossible to keep CBD illegal – that would be like making oranges legal, but keeping orange juice illegal.
The Farm Bill removed all hemp-derived products, including CBD, from the Controlled Substances Act, which criminalizes the possession of drugs. In essence, this means that CBD is legal if it comes from hemp, but not if it comes from cannabis (marijuana) – even though it is the exact same molecule. Currently, many people obtain CBD online without a medical marijuana license, which is legal in most states.
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, stop them altogether. Epidiolex, which contains CBD, is the first cannabis-derived medicine approved by the FDA for these conditions.
Animal studies, and self-reports or research in humans, suggest CBD may also help with:
Studies and clinical trials are exploring the common report that CBD can reduce anxiety.
- Insomnia. Studies suggest that CBD may help with both falling asleep and staying asleep.
- Chronic pain. Further human studies are needed to substantiate claims that CBD helps control pain. One animal study from the European Journal of Pain suggests CBD could help lower pain and inflammation due to arthritis when applied to skin. Other research identifies how CBD may inhibit inflammatory and neuropathic pain, which are difficult treat.
- Addiction. CBD can help lower cravings for tobacco and heroin under certain conditions, according to some research in humans. Animal models of addiction suggest it may also help lessen cravings for alcohol, cannabis, opiates, and stimulants.
Is CBD safe?
Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level of blood thinning and other medicines in your blood by competing for the liver enzymes that break down these drugs. Grapefruit has a similar effect with certain medicines.
People taking high doses of CBD may show abnormalities in liver related blood tests. Many non-prescription drugs, such as acetaminophen (Tylenol), have this same effect. So, you should let your doctor know if you are regularly using CBD.
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 be 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.
How can CBD be taken?
CBD comes in many forms, including oils, extracts, capsules, patches, vapes, and topical preparations for use on skin. If you’re hoping to reduce inflammation and relieve muscle and joint pain, a topical CBD-infused oil, lotion or cream – or even a bath bomb — may be the best option. Alternatively, a CBC patch or a tincture or spray designed to be placed under the tongue allows CBD to directly enter the bloodstream.
Outside of the US, the prescription drug Sativex, which uses CBD as an active ingredient, is approved for muscle spasticity associated with multiple sclerosis and for cancer pain. Within the US, Epidiolex is approved for certain types of epilepsy and tuberous sclerosis.
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 or COVID-19, which it is not. We need more research but CBD may prove to be a helpful, relatively non-toxic 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 currently is typically available as an unregulated supplement, it’s hard to know exactly what you are getting.
If you decide to try CBD, make sure you are getting it from a reputable source. And talk with your doctor to make sure that it won’t affect any other medicines you take.
8 Medical Conditions That CBD Can Help Treat
It seems like everywhere you look, cannabidiol, better known as CBD, is being touted as a cure for, well, anything that might ail you. At last check, you can find CBD in hundreds of products meant to relieve all manner of pain and anxiety, and in lifestyle-enhancing products like sports-recovery balms, personal lubricants, sleeping aids, and energy boosters that might keep you up all night (yep, take your pick!).
What Is Cannabidiol (CBD) and Where Is It Found?
But first, what is CBD? Cannabidiol is a nonpsychoactive compound found in both cannabis and hemp plants, which are different varieties of the same plant species. Cannabis plants are often grown in order to cultivate tetrahydrocannabinol (THC), which is the component in marijuana that is responsible for the “high” feeling in people who smoke or ingest it. Many hemp plants, on the other hand, have had the THC largely bred out of them, according to a report published in November 2016 in Critical Reviews in Plant Sciences. These plants are grown for a variety of products, including textiles, insulation, food, paper, supplements, and skin-care items.
While headlines may lead you to believe that CBD — sold in oils, edibles, tinctures, creams, capsules, and more — is a cure-all, there are really just a handful of conditions that scientific studies suggest it can treat, according to a report published in 2018 by the World Health Organization. It’s important to know that CBD is treated by the Food and Drug Administration (FDA) the same way as dietary supplements — that is, like supplements, CBD products can go to market without scientific evidence that they actually work. It’s a “buyer beware” situation.
Can CBD Help With Post-Traumatic Stress Disorder?
What Conditions Is CBD Used For?
Here’s a look at what a handful of scientific studies have found in recent years concerning CBD’s medical usefulness, including some diseases and ailments for which the FDA has approved CBD products.
- Pain When CBD reaches a family of receptors, or cells that receive stimuli, called vanilloid receptors, the interaction results in lower inflammation and levels and pain perception, according to a study published in Current Neuropharmacology. And a study published in July 2016 in the European Journal of Pain found that CBD could help people with arthritis manage their pain. The animal study looked at whether using a CBD gel transdermally (on the skin) would reduce inflammation and signs of pain, and researchers concluded that the topical product did offer relief from pain-related behaviors without evidence of side effects.
- Anxiety and depression Hundreds of studies have looked at how cannabidiol might be used to treat various neuropsychiatric disorders. One of the most recent, published in October 2015 in Neurotherapeutics, concluded that topical CBD has “considerable potential as treatment for multiple anxiety disorders.” What’s more, a study review published in September 2015 in the Journal of the American Society for Experimental NeuroTherapeutics found that “preclinical evidence strongly supports CBD as a treatment for anxiety disorders,” including PTSD, generalized anxiety disorders, obsessive-compulsive disorder, and seasonal affective disorder.
- Epilepsy Anecdotal reports about CBD’s use as a treatment for epilepsy have been around for decades, and a handful of rigorous scientific studies seem to support these claims. One, published in May 2018 in the New England Journal of Medicine, showed CBD to be effective at reducing the number of seizures in people with a form of epilepsy called Lennox–Gastaut syndrome (LGS). And in 2018, the FDA approved an oral CBD formulation for LGS and another type of epilepsy called Dravet syndrome.
- Symptoms related to cancer treatment The focus on CBD for cancer treatment has been for its use in reducing the nausea and vomiting that often accompany chemotherapy and radiation treatments. Two cannabinoid drugs have been approved by the FDA to combat those side effects: Marinol (dronabinol) and Cesamet (nabilone). More recently, researchers have discovered CBD may slow the growth of cancer cells, according to the American Cancer Society.
- Acne and other skin issues A study published in July 2014 in the Journal of Clinical Investigation suggested topical CBD can be a potent antiacne agent, likely because of its anti-inflammatory properties. And a study published in July 2017 in the Journal of the American Academy of Dermatology found CBD (and THC) useful for reducing the itch and inflammation associated with eczema and psoriasis.
- High blood pressure Researchers in England studied the effects of CBD on a small group of healthy men ages 19 to 29 — all nonsmokers who had never used cannabis — and discovered a single dose of CBD reduced resting blood pressure by 6 millimeters of mercury (mmHg), which may ultimately also reduce the risk of stroke. The study, published in July 2017 in JCI Insight, concluded that the response may be due to CBD’s anxiolytic (anxiety-reducing) and analgesic (pain-reducing) effects.
- Addiction As ironic as it sounds, CBD — which technically is classified as a Schedule I substance by the Drug Enforcement Administration and as such is currently illegal in nearly half the United States — has shown a lot of promise in fighting addiction to everything from opioids and cocaine to alcohol and tobacco. In addition, a number of preclinical studies, including a study published in June 2017 in Cannabis and Cannabinoid Research, suggest CBD might be useful as a pain therapy in place of opioids.
- Diabetes A number of studies, including one published in February 2012 in the American Journal of Pathology, have suggested that CBD could play a role in improving outcomes for people with diabetes. Observational studies have shown that people who use marijuana have lower fasting insulin levels and measures of insulin resistance.
Is CBD Right for You, and What Are the Possible Side Effects?
If you’re suffering from any of the ailments or diseases on this list and are curious to see if CBD could help, you should also know about the side effects that some people experience when using CBD products. The most common are dizziness, dry mouth, mood changes, gastrointestinal issues — including nausea — and fatigue. And since research has shown that CBD can interact with a variety of medications, including warfarin (a blood thinner) and clobazam (used to treat epilepsy), it’s essential to discuss your use of CBD-containing products with your physician or other healthcare provider.
How Do You Know What’s in CBD Products?
The next challenge is finding products that are accurately labeled. According to research published in November 2017 in the Journal of the American Medical Association, many CBD products do not contain the amount of CBD their labels claim. The research, conducted at the University of Pennsylvania Perelman School of Medicine, involved testing 84 CBD products to see if they contained the amount of CBD listed. The researchers found 70 percent of CBD products are mislabeled, and “26 percent contained less CBD than labeled, which could negate any potential clinical response.”
Like any other product, from aspirin to zinc oxide, CBD is not for everyone. And even though it’s “natural,” it’s not necessarily safe, especially for people who are taking other medications. If you decide to try CBD products, make sure you know where the products are sourced from, how they’re manufactured, and how they’re meant to be used.