Cannabidiol (CBD) has surged into the mainstream, becoming a hot topic in wellness circles. You might encounter it as a trendy addition to your post-workout smoothies or morning coffee, and even infused in everyday items like sports bras. But beyond the hype, what exactly is CBD? And why is it gaining so much traction?
Close-up of hemp flower and CBD oil
Decoding Cannabidiol: CBD Compared to Marijuana, Cannabis, and Hemp
CBD, short for cannabidiol, is recognized as the second most active component found in cannabis, also known as marijuana. While CBD is a vital element within medical marijuana, it’s crucial to understand that it is typically sourced directly from the hemp plant, which is related to marijuana, or it can be synthesized in a lab. Within the complex makeup of marijuana, which includes hundreds of compounds, CBD stands out because it does not, on its own, induce a “high.” This non-psychoactive characteristic is a key differentiator from THC (tetrahydrocannabinol), the primary psychoactive compound in marijuana.
The World Health Organization (WHO) has issued a report stating, “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.” Further supporting this, a recent study published in Neuropsychopharmacology concluded that “acute CBD alone is unlikely to significantly impair daily functioning or workplace performance,” suggesting it’s unlikely to hinder daily activities or work efficiency.
Legal Status of Cannabidiol: Is CBD Legal?
The legal landscape surrounding CBD in the United States is complex and has been evolving. While CBD is widely accessible across most of the country, its precise legal standing has been subject to changes and interpretations. Currently, all 50 states have enacted laws that legalize CBD to some extent, though the specific regulations and restrictions can vary significantly from state to state.
A pivotal moment came in December 2015 when the Food and Drug Administration (FDA) took steps to ease regulatory hurdles, making it simpler for researchers to conduct clinical trials involving CBD. This was followed by the 2018 Farm Bill, which federally legalized hemp in the U.S. This legislation had a profound impact on CBD legality because hemp is defined as cannabis with 0.3% or less THC content by dry weight. By legalizing hemp, it became exceedingly difficult to maintain a prohibition on CBD derived from hemp. To illustrate, it would be akin to legalizing oranges but outlawing orange juice – an illogical distinction.
The Farm Bill explicitly removed hemp-derived products, including CBD, from the Controlled Substances Act, which is the federal law that criminalizes drug possession. Essentially, this legal framework means that CBD is federally legal if it is derived from hemp. However, if CBD is extracted from cannabis (marijuana), it remains under a different legal classification, even though the CBD molecule itself is identical regardless of its plant origin. Despite these nuances, many consumers today can legally purchase CBD online without needing a medical marijuana license, a practice that is permitted in most states. It is important to note that while federal law provides a baseline, state laws can add further complexity and it’s advisable to check local regulations regarding CBD.
Unpacking the Potential Health Benefits of Cannabidiol
CBD has been promoted as a potential remedy for a broad spectrum of health conditions. However, it’s important to distinguish between anecdotal claims and evidence-based benefits. The most robust scientific evidence supporting CBD’s effectiveness is in the treatment of severe forms of childhood epilepsy, specifically Dravet syndrome and Lennox-Gastaut syndrome (LGS). These conditions are notoriously challenging to treat and often do not respond adequately to traditional antiseizure medications. Numerous studies have demonstrated CBD’s ability to significantly reduce the frequency of seizures in these patients, and in some instances, to stop seizures altogether. This evidence led to the FDA approval of Epidiolex, a prescription medication primarily composed of CBD. Epidiolex holds the distinction of being the first cannabis-derived medicine approved by the FDA, marking a significant milestone in the acceptance of cannabinoid-based therapeutics for these rare and severe epilepsy syndromes.
Beyond epilepsy, research, including animal studies, self-reported patient experiences, and human research, suggests CBD may offer benefits for a range of other conditions. These include:
- Anxiety Disorders: Some studies indicate CBD may help manage symptoms of various anxiety disorders, such as generalized anxiety disorder, social anxiety disorder, and panic disorder.
- Insomnia: CBD is being explored for its potential to improve sleep quality and duration, particularly for individuals struggling with insomnia.
- Chronic Pain Management: Research suggests CBD may have analgesic (pain-relieving) and anti-inflammatory properties, which could be beneficial in managing chronic pain conditions like arthritis and back pain.
- Inflammation: CBD’s anti-inflammatory effects are being investigated for their potential in addressing conditions characterized by chronic inflammation.
- Addiction Management: Preliminary studies suggest CBD may play a role in managing cravings and withdrawal symptoms in substance use disorders.
It’s crucial to note that while these areas show promise, the level of scientific evidence varies. For many of these conditions, research is ongoing, and more rigorous clinical trials are needed to fully establish CBD’s efficacy and optimal usage.
CBD Safety Profile and Potential Side Effects
When considering CBD, understanding its safety profile is essential. While generally considered safe, CBD can have side effects in some individuals. Reported side effects may include nausea, fatigue, and irritability. One significant aspect of CBD is its potential to interact with other medications. CBD can affect how the body processes certain drugs by competing for liver enzymes that are responsible for breaking down these medications. This interaction can lead to increased levels of blood thinning medications and other drugs in the bloodstream. A well-known example of a similar interaction is grapefruit, which can also interfere with the metabolism of certain medications.
This potential for drug interaction is particularly important for individuals taking specific types of medications, such as blood thinners (anticoagulants), anti-epileptic drugs, or immunosuppressant medications. Maintaining stable levels of these medications in the blood is crucial for their effectiveness and safety. If you are taking any of these medications, it is vital to discuss CBD use with your doctor to assess potential risks and adjust medication dosages if necessary.
Furthermore, high doses of CBD have been associated with abnormalities in liver-related blood tests in some individuals. It’s worth noting that many over-the-counter medications, such as acetaminophen (Tylenol), can also have this effect. If you are using CBD regularly, it is advisable to inform your physician so they can monitor your liver enzymes periodically as part of routine check-ups.
A significant safety concern in the CBD market is that many products are marketed and sold as supplements rather than regulated medications. Currently, the FDA does not oversee the safety and purity of dietary supplements with the same rigor as prescription drugs. This lack of strict regulation means that the CBD market is, to a large extent, unregulated. Consequently, consumers cannot always be certain that a product contains the active ingredients at the dose listed on the label. Independent testing has revealed instances where CBD products contained significantly less CBD than advertised or even contained undisclosed contaminants.
To mitigate these risks, if you decide to purchase CBD products, it is strongly recommended to ensure that the product has undergone independent third-party laboratory testing. Reputable CBD products should be accompanied by a Certificate of Analysis (COA). A COA is a document from an accredited laboratory that verifies the product’s CBD and THC content and confirms that it has been tested for contaminants like heavy metals, pesticides, and solvents. Always look for a COA from a product’s manufacturer to help ensure you are getting a safe and accurately labeled product.
Ways to Take CBD: Exploring Different Forms
CBD is available in a variety of forms, offering different methods of administration to suit individual needs and preferences. Common forms of CBD include:
- Oils and Tinctures: These liquid forms are typically taken sublingually (under the tongue) for relatively fast absorption into the bloodstream.
- Capsules and Pills: CBD capsules and pills offer a convenient and precise way to consume CBD, similar to taking any other oral supplement.
- Topical Preparations: CBD-infused creams, lotions, balms, and salves are designed for application directly to the skin. These are often used for localized relief of muscle and joint pain or inflammation.
- Patches: CBD patches are adhesive patches applied to the skin that allow for a sustained release of CBD over an extended period.
- Vape Products: CBD vape oils are inhaled using a vaporizer. Vaping provides a rapid onset of effects but raises concerns about potential respiratory risks associated with vaping in general.
- Edibles: CBD-infused edibles, such as gummies and chocolates, offer a palatable way to consume CBD, but absorption through the digestive system can be slower and less efficient compared to sublingual or inhaled methods.
If your goal is to target inflammation and alleviate muscle and joint pain, topical CBD products like oils, lotions, creams, or even bath bombs may be a suitable option as they can be applied directly to the affected area. For systemic effects, CBD patches or sublingual tinctures and sprays, which are designed to be placed under the tongue, allow CBD to enter the bloodstream more directly. Medical professionals generally advise against smoking or vaping any substance, including CBD, due to respiratory health concerns.
Outside of the United States, the prescription drug Sativex, which contains CBD along with THC, is approved in several countries for the treatment of muscle spasticity associated with multiple sclerosis and for cancer pain. Within the U.S., as mentioned earlier, Epidiolex is approved for specific types of epilepsy and tuberous sclerosis. These prescription CBD products undergo rigorous testing and quality control, ensuring consistent dosages and purity, unlike many unregulated over-the-counter CBD products.
The Takeaway Message on Cannabidiol
It’s important to approach claims about CBD with a critical eye. Some CBD manufacturers have faced regulatory scrutiny for making unsubstantiated and exaggerated claims, such as promoting CBD as a cure-all for serious diseases like cancer or COVID-19. It is crucial to understand that CBD is not a proven cure for these conditions.
While more research is definitely needed, CBD is emerging as a potentially helpful and relatively safe option for managing conditions like anxiety, insomnia, and chronic pain. However, the current state of research leaves some key questions unanswered. We still need more high-quality evidence from human studies to definitively determine effective dosages for various conditions. Furthermore, because much of the CBD available to consumers is sold as an unregulated supplement, it can be challenging to ascertain the exact composition and purity of products, which can hinder both personal use and scientific research.
If you are considering trying CBD, it is essential to source your products from reputable manufacturers that provide third-party testing and Certificates of Analysis. Most importantly, it is always advisable to discuss your intention to use CBD or any other supplement with your doctor. This is crucial to ensure that CBD will not interact negatively with any other medications you are currently taking and that it is an appropriate option for your specific health needs. Consulting with a healthcare professional can help you make informed decisions about CBD and integrate it safely and effectively into your wellness plan.
