What is CBD?

CBD is a health trend on the rise, but is it good for you?

If you haven’t noticed lately, CBD products are popping up in stores all over the country. CBD products are now sold gas stations, grocery stores, and online. You may have even heard the health claims and other purported healing properties from friends or family members. Now, you’re wondering if CBD could help you. It’s a good question.

Let’s get into it.

What is CBD made from?

Cannabis plants, which include hemp and medical marijuana, contain many chemical compounds called cannabinoids. The two main cannabinoids are tetrahydrocannabinol (THC) and cannabidiol. THC, the main cannabinoid in marijuana produces psychoactive effects, while cannabidiol does not.

CBD products derive from either hemp or marijuana. Hemp contains a high level of CBD and a low level of THC. Marijuana contains low levels of CBD, and its THC levels can vary.

The history

The history of cannabis in medicine is long and varied. The first medicinal use of cannabis dates back to 400 A.D., according to a report in Pharmacy & Therapeutics. It first appears in medical literature in the U.S. way back in 1850 [2].

In the U.S., federal restrictions on cannabis began in 1937, which stopped its use for medicinal purposes and academic research [2]. However, medical cannabis reemerged in 1996 when California approved the Compassionate Use Act [2]. This made California the first state to legalize the use of botanical cannabis for medical conditions [2].

Now, 46 states have adopted comprehensive medical cannabis programs or started to allow low-THC/high-CBD products for medicinal use [6].

Types of CBD-infused products

• Oils
• Tinctures
• Capsules
• Pills
• Sprays
• Lotions
• Creams
• Edibles/Gummies/Sodas/Waters
• Vape juices

Reported health claims of CBD

• Pain relief
• Anxiety relief
• Insomnia relief
• Anti-inflammatory properties
• Sleep enhancing properties
• Relief from post-traumatic stress disorder (PTSD) symptoms
• Relief from  schizophrenia symptoms
• Slowing of cancer cell growth
• Slowing of Alzheimer’s Disease
• Relief of nerve pain/fibromyalgia
• Curbing of withdrawal symptoms for people undergoing substance abuse treatment

Evidence supporting health claims

Advertisers claim that CBD products will improve a wide variety of health issues, but that isn’t the whole story. Research into cannabidiol is ongoing and inconclusive at this time. As of publication, there is strong scientific evidence of its benefits in treating certain forms of epilepsy. Research also shows that CBD can relieve the nausea and vomiting associated with cancer chemotherapy as well as the loss of appetite and weight loss related to HIV/AIDS. Further studies show how cannabidiol helps anxiety and insomnia as well as chronic pain and multiple sclerosis symptoms.

Research on cannabis and cannabinoids for other conditions is in its early stages. If you want to know more, visit the National Center for Complementary and Integrative Health to learn about the ongoing research into CBD’s benefits.

Possible side effects of CBD use

• Nausea
• Diarrhea
• Sleepiness
• Dizziness/Fainting
• Irritability/Cravings/Withdrawal
• Liver function abnormalities
• Possible interactions with medications (for example, the blood thinner coumadin)

Cautions

As with other supplements, regulation is a concern. CBD products are most often labeled as supplements, not medications. Therefore, the FDA does not regulate the safety and purity CBD containing products. It is important to do your research on the companies and products that you purchase. You cannot know for sure that the product you’re buying has active ingredients at the doses listed on the label. In addition, these products may contain other unknown elements or chemicals. Lastly, due to lack of scientific evidence, dosing can be difficult. Without extensive studies, it’s hard to say what doses are appropriate for different health conditions.

Recently, the FDA has stepped in. The agency has sent warning letters to companies making unfounded health claims on their supplemental products [7]. There is only one known and FDA-approved use for CBD, and that is curbing the symptoms of rare forms of epilepsy [7]. According to the agency, there is too little evidence to make firm conclusions about additional reported health claims at this time [7].

There are now additional concerns about vaping CBD oil. The practice has been linked to acute lung injury and death [5]. The Centers for Disease Control and Prevention recommends against the use of vaping or e-cigarette products.

On a positive note, the World Health Organization said in a study that “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 [10].”

Conclusion

Pending further research, CBD may prove to be an option for managing anxiety, insomnia, and chronic pain. The biggest potential barrier to effective use of cannabidiol in condition management at this time is dosing. Given the currently available research, dosing practices remain relatively unknown. Further, because CBD is currently mostly available as an unregulated supplement, it’s difficult to know exactly what you are getting even when taking a “recommended dose.”

A 2017 analysis of 84 CBD products sold online found that 26 percent contained substantially less CBD than the label indicated, and 43 percent contained substantially more [1]. If you decide to try CBD, talk with your doctor—if for no other reason than to make sure it won’t have an effect on other medications you are taking.

Take responsibility for your health. Talk with your health care providers about any alternative or complementary treatments you use. That way you can make well-informed decisions about your treatment.

References:

¹Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017;318(17):1708–1709. doi:10.1001/jama.2017.11909

²Bridgeman MB, Abazia DT. Medicinal Cannabis: History, Pharmacology, and Implications for the Acute Care Setting. P T. 2017;42(3):180–188. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/

³Medical Marijuana. UPMC. No date. Updated 2019 December 19. Accessed February 17, 2020. https://www.upmc.com/health-library/article?hwid=abl2153

⁴NIH to investigate minor cannabinoids and terpenes for potential pain-relieving properties [press release]. National Institutes of Health. 2019 Spetember 19. Accessed February 17, 2020. https://www.nih.gov/news-events/news-releases/nih-investigate-minor-cannabinoids-terpenes-potential-pain-relieving-properties

⁵Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products. The Centers for Disease Control and Prevention. No date. Updated 2020 February 11. Accessed February 17, 2020. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

⁶State Medical Marijuana Laws. National Conference of State Legislatures. 2019 October 16. Accessed February 17, 2020. https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx

⁷Warning Letters and Test Results for Cannabidiol-Related Products. U.S. Food and Drug Administration. No date. Updated 2019 November 26. Accessed February 17, 2020. https://www.fda.gov/news-events/public-health-focus/warning-letters-and-test-results-cannabidiol-related-products

⁸What is CBD oil? Facts about Cannabidiol oil. UPMC Health Beat. 2019, November 22. Accessed February 17, 2020. https://share.upmc.com/2019/11/health-facts-cbd-oil/

⁹World Health Organization (WHO). Cannabis (Marijuana) and Cannabinoids: What You Need to Know. No date. Updated December 5 2019. Accessed February 17, 2020. https://nccih.nih.gov/health/marijuana-cannabinoids#hed7

¹⁰World Health Organization (WHO) (2017). Cannabidiol (CBD), Pre-Review Report. [online] Geneva: Expert Committee on Drug Dependence. Accessed February 17, 2020. https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf