What Is CBD?
Cannabidiol or CBD is a non-psychoactive cannabinoid naturally found in cannabis. It is just one of about 113 identified phytocannabinoids naturally occurring in cannabis. The history of using the plant as a medicine goes back thousands of years. Researchers are quickly learning of the cannabinoid’s therapeutic potential as an effective pain reliever and anti-inflammatory.
Tetrahydrocannabinol (THC) is the popular phytocannabinoid that is responsible for producing the euphoric high after consuming cannabis. However, cannabidiol does not create an observable high or intoxication after consumption. CBD and THC do not interact with the body the same way, resulting in an apparent distinction between the two compounds.
Cannabidiol exerts a modulatory effect on the body, especially when combined with THC. It can also inhibit the adverse side effects caused by THC, such as paranoia and anxiety, depending on the amount of each substance consumed.
There is enormous therapeutic potential in cannabidiol as an analgesic, anxiolytic, muscle relaxant, anticonvulsant, antipsychotic, and neuroprotector.
Why Is CBD So Popular?
The Opioid Crisis
In the middle of a devastating opioid crisis, it makes sense that those suffering from pain are seeking alternative treatments to traditional painkillers, which are highly addictive. CBD has already demonstrated its therapeutic potential in treating conditions such as chronic pain, anxiety, depression, inflammation, epilepsy, and many more. Also, the passing of the 2018 Farm Bill federally legalized the growing and sale of hemp and its extracts like CBD oil.
Clinical research and an enormous growing body of personal anecdotes from patients and physicians believe that cannabidiol could be a viable treatment option for a variety of conditions involving autoimmune function, neuropathy, metabolism, the gut, the heart, the skin, and more.
Studies have already demonstrated CBD’s neuroprotective properties, and researchers are currently investigating its efficacy for treating cancer. In 2010, a California research team published a study that discovered cannabidiol’s ability to enhance THC’s inhibition of cancerous cell growth and survival — demonstrating that it synergizes with THC by enhancing the anticancerous effect. This is known as the “entourage effect” and describes the synergistic effects of compounds that would otherwise not occur or to a lesser degree when isolated.
Interestingly, a study published in 2018 found that CBD-rich cannabis extracts appear to possess more therapeutic potential for treating epilepsy than extracts containing only cannabidiol. Further research is needed to definitively determine whether the non-psychoactive cannabinoid is more effective when taken with THC but the current literature certainly suggests that it is.
To summarize, people are curious about cannabidiol after learning that it may help relieve symptoms relating to pain, inflammation, anxiety, and stress. Research remains limited but people and researchers alike are highly optimistic for the future of CBD and cannabinoids.
How Does CBD Work?
The Endocannabinoid System (ECS)
CBD’s pharmacological mechanism is not entirely understood as of now. However, we do know that it indirectly interacts with specific cannabinoid receptors of the endocannabinoid system (ECS). These cannabinoid receptors are found throughout the body and are called CB1 and CB2. CB1 receptors are primarily found in the central nervous systems and the brain, whereas CB2 receptors are in the peripheral nervous system and cells involved in immune function. The ECS is responsible for the regulation of numerous biological functions, including pain sensation, memory, appetite, sleep, mood, immune function, and more.
Think of CB1 and CB2 receptors as locks and endocannabinoids as keys. Endocannabinoids bind to these receptors and carry various information and instructions so once bound, cellular signaling takes place. These signals maybe something like “Woah, the stomach is too inflamed, let’s suppress inflammation.” Phytocannabinoids work by mimicking the actions of endocannabinoids, which the body naturally produces internally. Phyto- is the prefix for “plant.” For example, THC actually binds directly to CB1 receptors as if it were a natural endocannabinoid.
Understanding CBD’s Effects
Research also suggests that CBD binds to several serotonin receptors and inhibits the reuptake of noradrenaline, dopamine, serotonin, gamma-aminobutyric acid (GABA), and anandamide. Preventing the reuptake of these neurotransmitters may explain the effects of cannabidiol. Firstly, the elevated mood may be due to noradrenaline, dopamine, and serotonin. Decreased anxiety is likely from the increase in GABA. Finally, pain relief is likely from anandamide.
Inhibiting reuptake essentially means cannabidiol stops the body from breaking down these neurotransmitter molecules, causing an excess buildup. These neurotransmitters then enter the bloodstream and travel throughout the body, binding to their respective receptors.
Cannabidiol’s ability to prevent the degradation of anandamide, a naturally-produced endocannabinoid, is critical to explaining the analgesic properties. Anandamide is a neurotransmitter that’s similar to dopamine and serotonin. It’s most notably a potent antidepressant that produces a sense of bliss, acting as a natural mood lifter. Anandamide is released when the body feels pain, binding to CB1 receptors and relieving pain by slightly blocking the signals from reaching the brain. However, anandamide is quickly broken down by the body and only lasts a few minutes under normal circumstances. With CBD, anandamide may persist for longer to provide subtle pain relief.
A study from 2012 found that preventing the uptake of anandamide may contribute to cannabidiol’s antipsychotic effects, “potentially representing a completely new mechanism in the treatment of schizophrenia.”
To summarize, cannabidiol indirectly interacts with the endocannabinoid system by inhibiting the breakdown of several neurotransmitters. Scientists believe this contributes to CBD’s analgesic, antidepressant, anxiolytic, anticonvulsant, muscle relaxant, and antipsychotic effects.
2018 Farm Bill
The passing of the 2018 Farm Bill effectively federally legalized the growing and sale of hemp and hemp extracts. However, hemp and hemp extractions, especially CBD, cannot exceed a THC content of 0.3 percent. If the THC content exceeds this limit, the plant or product is now considered marijuana, which remains a Schedule 1 drug, according to the Drug Enforcement Administration (DEA). This can be a significant problem for hemp growers because THC-producing cannabis is commonly found in the wild, and the wind can carry its pollen for miles, pollinating otherwise THC-free hemp plants. Hemp growers must prevent cross-pollination with THC-producing cannabis to avoid running into trouble with the law.
Despite CBD’s enormous therapeutic potential, the FDA only recognizes cannabidiol as a treatment for epilepsy as a pharmaceutical drug called Epidiolex. The FDA also prohibits the sale of cannabidiol in any unapproved health product, dietary supplement, or food. So unless it is Epidiolex, it is not approved by the FDA.
Recently, Washington State issued a ban on hemp-derived CBD in food and beverage products, joining California and New York. However, products sold by cannabis dispensaries are not affected by the ban. While hemp-derived products are legal to buy as long as it doesn’t exceed a 0.3 percent THC content, check with your state and local laws for exact details surrounding the legality of cannabidiol. For example, in Virginia, CBD can only be purchased and possessed with a prescription.
CBD can be taken orally, applied directly to the skin, or inhaled. There are numerous products whos pros and cons vary. We’ll talk about a few of the most popular cannabidiol products and highlight both the benefits and drawbacks.
The most popular product, by far, is CBD oil. The natural oil is typically extracted from hemp or cannabis grown without the psychoactive cannabinoid, THC. It’s usually sold as a tincture with a dropper that’s either swallowed or placed under the tongue (sublingual) to be consumed orally. However, there’s a variety of ways to use cannabidiol oil, such as adding it to essential oil diffusers, tea, or using it as a skincare treatment.
Various kinds of oil contain different concentrations of terpenes and cannabinoids. These oils may also contain additional ingredients like omega-3 fatty acids, amino acids, essential oils, or vitamin oils. The following are the different types of high-quality CBD oil:
- PCR (phytocannabinoid-rich) CBD hemp extract — A high-quality, full-spectrum product that is rich in CBD and contains all the therapeutic compounds found in hemp.
- CBD concentrate or distillate — A processed full-spectrum concentrate where any undesired compounds are removed from the final product.
- CBD isolate — Purified CBD processed to remove all other beneficial terpenes and cannabinoids.
- PCR CBD oil — Full-spectrum CBD concentrate or oil combined with cannabidiol concentrate,
- Full-spectrum oil — contains high amounts of cannabidiol and other beneficial terpenes and cannabinoids found naturally in hemp except for THC.
There haven’t been studies on which type of oil is the most effective. However, one study from 2018 found that CBD-rich extracts appear to have more therapeutic potential than pure cannabidiol isolate when treating a population of patients with refractory epilepsy. This is likely attributed to the entourage effect considering the hundreds of terpenes and cannabinoids found in cannabis.
CBD-infused topical products include creams, salves, and balms. These products are infused with either pure isolate or full-spectrum oil. These topicals also often contain additional ingredients designed to provide a more significant benefit to the user. These ingredients may be vitamins, collagen, capsaicin, menthol, or seed oils. Salves often contain additional ingredients to increase its soothing effect, such as aloe. Topicals meant to provide pain relief may include a local anesthetic or ingredients that help the skin absorb the product.
Studies are limited on CBD topicals, but there a few that have concluded that they appear to be an effective treatment for knee pain from osteoarthritis and for inflammatory skin disorders. Zynerba Pharmaceuticals announced that their Phase 2 clinical trial results found that the cannabinoid produced significant improvement in pain symptoms compared to a placebo. Another study from March of 2019 found that the application of a CBD-enriched ointment was an effective and safe treatment for inflammatory skin disorders, improving the quality of life in the patients.
We still need more research conducted on topicals and their efficacy, but the literature suggests that they may be a suitable option for those with pain and inflammatory disorders.
CBD can also be inhaled through smoke or vaporization of CBD bud or distillate. Vape pens heat cartridges that contain CBD distillate to a specific temperature that doesn’t combust, preventing unwanted carcinogens found in combusted products from being inhaled. However, the CDC is currently investigating the unknown cause of a recent outbreak of hospitalizations and deaths from a pulmonary disease that may be associated with vaping.