This article is part of Nature Outlook: Cannabis, an editorially independent supplement produced with the financial support of third parties. About this content.
Forty years on from Mechoulam’s initial work, extensive randomized controlled trials have decisively shown that this purified cannabinoid can profoundly benefit children with certain epileptic disorders. “Over those trials, we saw about a 26–28% reduction in frequency over placebo in all convulsive seizures for Dravet syndrome and drop seizures for Lennox–Gastaut syndrome,” says Devinsky, who has led several such studies 4 , 5 . “Some of the patients became, and remain, seizure-free.”
Preclinical data from rodent and cell-culture studies have hinted at the possible benefits of using CBD to help treat disorders that range from Parkinson’s disease to chronic pain. The range of conditions in which CBD is being tested might seem diverse, but it is a compound with far-reaching, if poorly understood, physiological effects. Antonio Zuardi, a psychiatrist at the University of São Paulo in Brazil, notes that something on the order of 20 possible mechanisms of action have been described to date for CBD. “These multiple pharmacological effects may justify the wide range of possible therapeutic activities.”
World Health Organization. Cannabidiol (CBD): Critical Review Report (World Health Organization, 2018).
Linares, I. M. et al. Braz. J. Psychiatry 41, 9–14 (2019).
Article 30 SEP 20
This flies in the face of current evidence. Numerous studies have shown that CBD is a safe and non-habit-forming substance that does not produce the ‘high’ associated with tetrahydrocannabinol (THC), the main psychoactive component of cannabis 1 . In 2018, the US Food and Drug Administration (FDA) determined that Epidiolex — a purified CBD product developed by GW Pharmaceuticals in Histon, UK — effectively reduces the frequency of seizures in certain rare forms of paediatric epilepsy. This approval has heartened the cannabinoid research community, which has long recognized the medicinal potential of CBD but come up against scepticism and regulatory constraints on the road to the clinic.
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.
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.
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.
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 can CBD be taken?
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.”
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.
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.
Is CBD safe?
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.
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.