What are they supposed to do?
You’ve probably noticed that there are CBD shops everywhere. CBD has become increasingly popular within the past few years. Why? What are the benefits of using it? Isn’t CBD from marijuana? So, how can these shops sell it since marijuana is still illegal in some areas?
The pain-relieving properties of marijuana have been known about since 2900 BC. It wasn’t until more recently that scientists discovered that certain parts of cannabis plant are responsible for this effect. Scientists have isolated 108 different types of cannabinoids in cannabis. The most well-known is Delta-9-tetrahydrocannabinol (THC), which is the chemical in marijuana that makes you high. Cannabidiol, CBD, is a different chemical compound from the cannabinoid family, but unlike THC, it doesn’t make you high and is thought to be one of the primary components in providing pain relief. Due to this, CBD is quickly acquiring support for its potential therapeutic benefits. Both CBD and THC work on your body’s endocannabinoid system. This is a regulatory system made up of naturally occurring cannabis-like molecules, called endocannabinoids. They work like neurotransmitters, which send and receive messages through your body to help maintain homeostasis. CBD and THC interact with the endocannabinoid system at two receptors: CB1 and CB2. CB1 receptors are for the most part located in the brain and are used to help with cognition, memory, motor skills and pain. CB1 receptors are also in the peripheral nervous system, liver, thyroid, uterus and more places throughout your body. When you take in THC, it attaches itself to these CB1 receptors, which inhibits the release of some neurotransmitters and might increase the release of others. Ultimately, this alters how your body functions. Initially, researchers thought that CBD did the same thing, but with CB2 receptors. These receptors are abundant in the immune system, gastrointestinal system and brain/nervous system. Now, scientists think CBD encourages your body to produce more of its own endocannabinoids. By doing this, it might help to reduce anxiety, pain and inflammation. In 2017, World Health Organization (WHO) reported that CBD, when in its pure state, is safe and well-tolerated by humans and animals. Also, they reported that it’s not likely to cause physical dependence or abuse. According to a study done by the National Institutes of Health (NIH), 1,500 mg of CBD has been safely taken by mouth daily for up to four weeks without any adverse events. However, there are some risks associated with taking CBD, including possible side effects, such as dry mouth, nausea, diarrhea, changes in appetite/weight, fatigue, irritability, low blood pressure, lightheadedness and drowsiness. In addition, across numerous studies, about 10% of people taking CBD had increases in liver enzymes, which would mean that they had possible liver damage.
While CBD may not be a cure-all, new research is showing promising results as far as the number of different potential uses. According to the WHO, depression is the single largest cause of disability worldwide and anxiety disorders are ranked sixth. Studies are showing that CBD might be a possible treatment for both of these due to its ability to act on the brain’s receptors for serotonin, a neurotransmitter that regulates mood and social behavior. Another area that researchers are evaluating is how CBD’s ability to act on the endocannabinoid system and other brain signaling systems may provide advantages in treating those with neurological disorders. Currently, one of the most studied uses for CBD is in the treatment of epilepsy and multiple sclerosis. It’s also being researched as treatment options for Parkinson’s disease and Alzheimer’s disease. Other studies are presenting CBD as a way to treat side effects related to cancer treatment, like nausea, vomiting and pain. They’re even finding that it may have cancer-fighting properties. CBD oil has been found to have anti-inflammatory properties as well. One area that this might be useful is in reducing acne, which is thought to be caused by genetics, bacteria, underlying inflammation and overproduction of sebum (an oily secretion made by sebaceous glands in the skin) In addition to reducing inflammation, CBD would be able to reduce the amount of sebum that is produced. Since acne affects more than 9% of the population this would be a welcomed use. Another area that CBD would be extremely helpful in treating is high blood pressure because it’s linked to higher risks of developing a wide variety of health conditions, such as stroke, heart attack and metabolic syndrome. Several studies indicate that it may be able to reduce high blood pressure, but it’s not clear if this is a result of CBD’s impact on the cardiovascular system or if it’s from the stress- and anxiety-reducing properties of CBD. It’s also being researched to see if it can help with antipsychotic effects, substance abuse treatment and diabetes prevention. There’s no question that more information is needed and since research is ongoing, new therapeutic uses are sure to be discovered. One of the things that will need to be overcome during pharmaceutical development is the fact that cannabinoid receptors are so widely distributed throughout the body. For example, if you’re trying to activate one receptor for a certain purpose, you might activate others unintentionally and cause unwanted effects.
Despite its increasing popularity, is CBD legal? Technically yes, CBD is legal, but the answer falls into a gray area. We know that the cannabis plant comes in many different varieties and for many years, the US Drug Enforcement Administration (DEA) had treated them all the same. They classify cannabis as a Schedule I substance, which means that it has “no currently accepted medical use and a high potential for abuse.” This makes it illegal to produce or possess any part of the cannabis plant in any form. However, the Agriculture Improvement Act of 2018, or Farm Bill, changed that. The Farm Bill legalized nationwide “hemp.” Under the legislation, it defined hemp as cannabis that contains no more than 0.3% THC. If it contains higher levels of THC, it’s referred to as “marijuana” and remains a Schedule I drug. So, under the new legislation, if a CBD product comes from a hemp plant, it’s legal. However, if it comes from a marijuana plant, it’s illegal federally. This is where it becomes an even more gray area because CBD is legal in 30 states where medicinal and/or recreational marijuana is legal and seventeen additional states have CBD-specific laws. One important thing to note is that even though hemp-derived CBD products are now legal on the federal level, they are still illegal under some state laws. It’s important to check your state’s laws and those of anywhere you plan on traveling to. Another key consideration is that even if a product does come from a hemp plant, there’s no guarantee it won’t contain THC. This is the result of things like cross-pollination and the absence of industry regulation.
Due to the legal murky nature of marijuana and CBD until recently, the Food and Drug Administration (FDA) had not stepped in to regulate CBD products. Now, they are currently trying to figure out how to do this because CBD is primarily marketed and sold as a supplement, not a medication and FDA does not regulate the safety and purity of dietary supplements. States where CBD products are legal have been struggling with regulation because they don’t have the financial resources of the federal government. Since cannabis was classified as a Schedule 1 drug for so long, it severely hampered American scientists’ ability to study CBD’s possible health benefits. Thankfully, before the Farm Bill, in December 2015, the FDA eased the regulatory requirements to allow researchers to start conducting CBD trials. This is where some of the study results are coming from. In fact, studies regarding CBD treatment for two rare and severe forms of epilepsy were so conclusive, that last year the FDA approved Epidiolex, a medication now used to treat Lennox-Gastaut and Dravet syndromes. It was the agency’s first approval of a cannabis-derived drug. The main concern about CBD being produced without any regulation is that results in products varying widely in quality and potential side effects. Since there are no standards in place for producing, testing or labeling products, it makes any type of federal oversight or quality control unattainable. Researches at Penn Medicine found that nearly 70% of products purchased from the internet contained either more or less CBD than was indicated on the label. This fluctuation could result in dangerous side effects or negate any potential benefits. In addition, they found that many products contained significant amounts of THC. All of these findings demonstrate need for nonprescription CBD products to be regulated, so they may be more accurately labeled. Due to these safety concerns, experts recommend buying CBD products from companies located in states, like Indiana and Utah, that require cannabis products to be tested for potency and purity.
CBD is extracted from the flowers and buds of marijuana or hemp plants and then diluted with a carrier oil like coconut or hemp seed oil. It comes in a variety of forms. The delivery method of CBD does impact how quickly it works and what kinds of effects it has on your body. Edibles are any products that you eat or drink. They can take anywhere from 20 minutes to four hours to take effect. Oils and tinctures are processed and concentrated forms of CBD. They are usually placed under the tongue using a dropper and then absorbed into the bloodstream. Pills and capsules are ingested orally and can look similar to the vitamins and/or drugs you’d find in a pharmacy. They typically contain CBD oil or CBD isolate. So far, several studies have found that CBD isn’t well absorbed in oral form. Topicals are CBD-infused oils, creams and lotions that are intended to be used directly on skin, hair or nails. They’re becoming increasingly popular to treat localized pain. Vaping, involves inhaling a vaporized liquid that contains CBD oil. Usually nicotine is not present if CBD is, but it’s possible to mix them. There are all sorts of CBD products, from rubs, pain creams and lip salves to caramels, chocolates and lollipops to tea bags, honey and olive oil. Also, there are candles infused with CBD that, once melted, could be used for massaging. These products are appearing on shelves at natural food stores, boutiques and clothing shops across the country. While the CBD industry’s growth has largely been a grassroots movement, large-scale consumer packaged goods or pharmaceutical companies are probably going to start selling CBD products to national retail chains. According to the Brightfield Group (a cannabis-focused research firm), the US market for CBD products grew by more than 80% in 2018, to about $591 million and sales for this year are expected to exceed $5 billion, which is a 706% increase over last year. They also estimate that the industry could reach $22 billion by 2022.
In light of this surge of CBD usage, there are several things to consider. The first is that CBD is known to interact with several medications and it may interfere with other medications as far as how quickly the body breaks them down, which can increase the risk of developing side effects. For example, CBD can increase the level in your blood of the blood thinner coumadin. Also, it can raise levels of certain medications in your blood in the same exact way that grapefruit juice does. It has been found to enhance the sedative properties of herbs and supplements. In addition, there’s not yet sufficient evidence about whether it’s safe to take CBD while you’re pregnant or nursing. So, before you start using CBD products, you need to discuss it with your doctor to be aware of any potentially harmful interactions. While there isn’t a large amount of evidence about CBD’s properties available yet, your doctor should have a basic understanding of CBD and how it interacts with certain medications. By collaborating with them, they can monitor and help you manage your health condition and other medications with your CBD usage. It’s important to keep in mind that due to the lack of studies, if you’re taking CBD to treat a particular ailment, you could be taking too much, too little or wasting your money completely.
Since there is currently no definitive way to compare different brands or types of CBD products, you need to do your own research before you start using them. Besides talk to your doctor, one of the first things you need to consider is researching whether or not CBD is been proven to be helpful in treating whatever disease or ailment you’re concerned about. Next, you need to check into a product’s quality and purity. A way to tell this is if the products are third-party tested. To find this out, look for a Certificate of Analysis, or COA, showing test results done by an independent laboratory. The manufacturer/retailer should be willing to share this information. Once you’ve vetted the safety of the product, you need to understand exactly how to use it. Is it an oil, pill or edible? How much of it are you supposed to take and for how long? What are the risks and benefits? Each product label should include the following: identity (like dietary supplement) to understand what it’s meant for, cannabinoid content (CBD from hemp contains only trace amounts of THC), net quantity (weight or numerical count), batch lot or control number, production or expiration date, instructions for use, dosing guidance (research on safe, appropriate dosing is still in early stages), appropriate warnings and contraindications for use and storage instructions. This information speaks to the product’s purity, quality, consistency and safe use. If you can’t find the answers to these questions, then you shouldn’t use the product. Also, check for FDA warning letters because they keep a list of firms (and their purchase websites) to which they’ve had to send warning letters about questionable CBD products. A key thing to remember is that federal regulations prohibit food or supplement products from being marketed to cure or treat any disease. So, beware of any hype that claims the product is a cure-all. Also, federal regulations require that product labels display information on how to contact the company. If this information is missing, don’t buy the product.
CBD products have the potential to be game changers in many areas of healthcare. The important thing to remember is that more research needs to be done to back these initial findings and products need to be better regulated to ensure their quality. In the meantime, if you’re planning on using CBD products, make sure you do your research first.