As the recreational and medicinal use of cannabis products grows in popularity, CBD (cannabidiol) has also gained significant notoriety.
CBD is a chemical compound that found in cannabis. It does not produce the psychoactive effects that are associated with marijuana and other cannabis products. Those effects are produced by tetrahydrocannabinol (THC).
Currently, the medicinal uses of CBD are limited. Many products that are marketed as CBD contain small amounts of THC. While there are many advertised benefits of CBD, the research supporting its use is scant.
CBD is sold as CBD oils, soft gel capsules or tablets, powders, sprays that can be applied on the tongue, and in mixtures with alcohol (tinctures). CBD oils can be applied to the skin or taken orally.
CBD is believed to affect the endocannabinoid receptors that may be involved in mood, sleep, memory, and metabolic functions.
CBD is thought to act through many different pathways. Unlike THC, it is not believed to bind with the cannabinoid receptors in the brain (CB1 or CB2). It may interact with these receptors, but it may also act in other ways.
Supporters of medicinal cannabis products, including CBD, have tried to present the product as a sort of panacea that can cure nearly everything. Claims regarding the utility of CBD include its ability to treat or cure these conditions:
Nonetheless, there is not a great deal of research regarding many of the claims that its proponents make. There is some evidence to suggest that it might be beneficial for some conditions, but whenever any substance is advertised as a panacea, you should be suspicious. For instance, proponents of cocaine use, alcohol use, and even antidepressants have claimed these substances to be panaceas in the past.
In 2018, the Food and Drug Administration (FDA) approved the medication Epidiolex, made with CBD oil, for the treatment of seizures for two different types of epilepsy (for people who are over 2 years old). The approval of the drug was based on research findings suggesting that it was effective in the treatment of seizures for two rare forms of epilepsy: Dravet syndrome and Lennox-Gastaut syndrome.
This marked the first time any medication derived from cannabis products was formally approved by the FDA.
There are numerous other claims regarding the use of CBD and other cannabis products to treat seizures. It is very likely that other cannabis-based treatments will find approval for the treatment of different types of seizures.
Anxiety disorders are psychiatric disorders where the main feature of the disorder is dysfunctional anxiety. There is research to suggest that CBD may be able to address anxiety that occurs with certain anxiety disorders and other psychiatric disorders, like post-traumatic stress disorder and obsessive-compulsive disorder.
Much of the initial research regarding the benefits of CBD for the treatment of anxiety have to do with individuals who have social anxiety disorder, a type of anxiety disorder where people become very anxious and fearful in social situations. Researchers found that CBD reduces anxiety in these cases better than a placebo.
Unlike what many of the proponents of CBD claim, the medication will not cure the disorder. Instead, it can potentially help people with disabling anxiety to experience less anxiety. CBD should be combined with behavioral methods like psychotherapy to fully address the issues associated with these disorders.
An advantage to this treatment is that CBD does not produce physical dependence. It is also not a significant drug use in the same way that benzodiazepines are.
Medication-assisted treatments (MATs) for substance use disorders are common interventions that are combined with other treatments to address addictive behaviors.
Research suggests that CBD oil may be useful as a MAT in the treatment of numerous substance use disorders, including stimulant use disorders, opioid use disorders, and tobacco use disorders. CBD oil may block the effects of THC and may be useful in treating people who have cannabis use disorders.
Like its potential to address anxiety, CBD will not cure addictions. Instead, treatment for addictions should still be strongly based on behavioral interventions like therapy, group participation, and other similar therapies. Medications can assist with withdrawal symptoms, cravings, and other complications that occur when one stops using a drug of choice. Long-term abstinence from drugs or alcohol requires significant work, and the bulk of that work is done in therapy.
Studies with animals have suggested that CBD may facilitate the release of serotonin, a neurotransmitter that is considered crucial to the treatment of depression. Most of the antidepressant medications currently being prescribed have some effect on serotonin.
Some proponents of CBD oil call serotonin receptors the “happiness receptors.” Taking antidepressant medications that affect serotonin or using CBD will not make you giddy or “happy.” However, there may be potential for CBD to reduce some of the symptoms of depression.
Even though CBD may find treatment utility for addressing major depressive disorder, most people still require behavioral interventions and antidepressants. As with the previously mentioned disorders, CBD will not “cure” someone’s issues with major depressive disorder.
There are several research studies that have suggested that CBD may reduce muscle spasms in people who have multiple sclerosis. More research needs to be performed before the drug will find its way to the market, but the preliminary research is promising.
There are several animal studies that suggest that CBD may address pain. There are a few studies on human participants that suggest that CBD might be able to control pain in some people, but the methodology is flawed, and more research needs to be done.
Due to this mechanism of action, CBD may have useful applications in the treatment of pain, specifically chronic pain.
Related to chronic pain, CBD may have anti-inflammatory properties. This could lead to CBD being used to treat problems associated with inflammation, including chronic pain and other issues.
CBD may be useful in treating high blood pressure, particularly high blood pressure associated with stress. The research is preliminary, and more research needs to be done.
There are some other scattered research studies that look at the effect of CBD on other types of disorders and diseases, but the research is not well developed. There are no conclusions on CBD’s ability to treat these conditions:
Again, the only formally approved CBD medication to address any type of medical issue is Epidiolex, which may be used to treat rare forms of epilepsy. Numerous research studies are underway, and it is very likely that CBD will find more medicinal uses in the future.
Research indicates that these are the common side effects associated with CBD:
CBD may have untoward interactions with many different types of medications. Its use in pregnant woman may put the fetus at risk for developmental issues or other problems.
Some research studies have found that children with epilepsy who were treated with CBD had worse seizures.
Some CBD products may contain some THC, and this could lead to issues for some individuals.
Other than the one medication approved by the FDA, many of the CBD products on the market are not regulated by the FDA.
A study published in the Journal of the American Medical Association found that the vast majority of CBD products sold online were incorrectly labeled. These products have the potential to cause serious issues.
If you are thinking of using CBD for any purpose, first consult with your physician.
(November 2012) Acute effects of a single, oral dose of d9-tetrahydrocannabinol (THC) and cannabidiol (CBD) administration in healthy volunteers. Current Pharmaceutical Design. Retrieved August 2019 from https://www.ncbi.nlm.nih.gov/pubmed/22716148
(August 2018) Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels. Progress in Neuro-Psychopharmacology and Biological Psychiatry. Retrieved August 2019 from https://www.researchgate.net/profile/Amanda_Sales4/publication/325611730_Antidepressant-like_effect_induced_by_Cannabidiol_is_dependent_on_brain_serotonin_levels/links/5be83ea392851c6b27b73f3c/Antidepressant-like-effect-induced-by-Cannabidiol-is-dependent-on-brain-serotonin-levels.pdf
(October 2016) A personal retrospective: elevating anandamide (AEA) by targeting fatty acid amide hydrolase (FAAH) and the fatty acid binding proteins (FABPs). Frontiers in Pharmacology. Retrieved on his in 19 from https://www.frontiersin.org/articles/10.3389/fphar.2016.00370/full
(June 2014) Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia. Retrieved August 2019 from https://onlinelibrary.wiley.com/doi/full/10.1111/epi.12631
(June 2007) Alzheimer’s disease; taking the edge off with cannabinoids? British Journal of Pharmacology. Retrieved August 2019 from https://bpspubs.onlinelibrary.wiley.com/doi/pdf/10.1038/sj.bjp.0707446
(July 2014) Nonpsychotropic plant cannabinoids, cannabidivarin (CBDV) and cannabidiol (CBD), activate and desensitize transient receptor potential vanilloid 1 (TRPV1) channels in vitro: potential for the treatment of neuronal hyperexcitability. ACS Chemical Neuroscience. Retrieved August 2019 from http://centaur.reading.ac.uk/37398/1/cn5000524_final.pdf
(July 2018) FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. Food and Drug Administration. Retrieved August 2019 from https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
(January 2011) Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of psychopharmacology. Retrieved August 2019 from https://journals.sagepub.com/doi/abs/10.1177/0269881110379283
(May 2015) Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence. Substance Abuse: Research and Treatment. Retrieved August 2019 from https://doi.org/10.4137/SART.S25081
(August 2014) Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa. CNS & Neurological Disorders-Drug Targets. Retrieved August 2019 from https://www.ncbi.nlm.nih.gov/pubmed/24923339
(July 2012) Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial. Cmaj. Retrieved August 2019 from http://www.cmaj.ca/content/184/10/1143.short
(March 2018) Chronic pain treatment with cannabidiol in kidney transplant patients in Uruguay. In Transplantation Proceedings. Retrieved August 2019 from https://www.ncbi.nlm.nih.gov/pubmed/29579828
(September 2011) Cannabidiol as an emergent therapeutic strategy for lessening the impact of inflammation on oxidative stress. Free Radical Biology and Medicine. Retrieved August 2019 from http://www.sciencedirect.com/science/article/pii/S0891584911000116
(June 2017) A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI insight. Retrieved August 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470879/
(June 2019) CBD oil: Benefits, uses, side effects, and health. Very Well Health. Retrieved August 2019 from https://www.verywellhealth.com/cbd-oil-benefits-uses-side-effects-4174562
(November 2017) Labeling Accuracy of Cannabidiol Extracts Sold Online. Journal of the American Medical Association. Retrieved August 2019 from https://jamanetwork.com/journals/jama/fullarticle/2661569