Cannabidiol molecule model for health benefits
Cannabidiol (CBD) has become a prevalent topic, frequently featured in the media and marketed as a beneficial addition to everything from post-workout smoothies to morning coffee. CBD-infused products, including even sports bras, are increasingly available. But what does CBD actually do? And what’s behind its surging popularity?
Understanding CBD: How It Differs from Marijuana, Cannabis, and Hemp
CBD, short for cannabidiol, is the second most abundant active compound found in cannabis (marijuana). It’s a crucial component of medical marijuana but can also be sourced directly from the hemp plant, a botanical cousin of marijuana, or produced synthetically in a laboratory. CBD is just one of over a hundred different compounds known as cannabinoids found in the cannabis plant. Unlike tetrahydrocannabinol (THC), the primary psychoactive cannabinoid in marijuana, CBD itself does not induce a “high.”
The World Health Organization (WHO) has stated in a report that, “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.” This distinction from marijuana and lack of psychoactive effects are key to understanding what CBD does and why it’s gaining attention for potential wellness applications.
The Legality of Cannabidiol: Navigating the Legal Landscape
The legal status of CBD in the United States has been evolving, but it is largely accessible across the country. While the specifics of CBD legality can vary by state, all 50 states have enacted laws that legalize CBD to some extent. In a significant move in December 2015, the Food and Drug Administration (FDA) relaxed certain regulatory hurdles to facilitate CBD research trials. The 2018 Farm Bill further shifted the landscape by legalizing hemp at the federal level.
This Farm Bill effectively removed hemp-derived products, including CBD, from the Controlled Substances Act, which criminalizes drug possession. Essentially, this means CBD derived from hemp is federally legal, whereas CBD derived from cannabis (marijuana), while chemically identical, exists in a more complex legal gray area depending on state and local laws. Despite these nuances, many individuals can legally purchase CBD products online without needing a medical marijuana license in most states. Understanding the legal framework is crucial for consumers seeking to understand what CBD does and access its potential benefits.
What Does CBD Do For Your Health? Exploring the Potential Benefits
CBD has been promoted for a wide spectrum of health conditions. However, the most robust scientific evidence supporting what CBD does lies in its effectiveness in treating severe forms of childhood epilepsy, specifically Dravet syndrome and Lennox-Gastaut syndrome (LGS). These conditions are notoriously difficult to manage and often do not respond adequately to traditional antiseizure medications. Numerous studies have demonstrated CBD’s ability to significantly reduce seizure frequency, and in some instances, completely halt seizures in these patients. Epidiolex, a medication primarily composed of CBD, holds the distinction of being the first cannabis-derived drug approved by the FDA. It is specifically indicated for the treatment of these rare and severe epilepsy syndromes.
Beyond epilepsy, ongoing research, including animal studies, self-reported patient experiences, and human research, suggests CBD may also play a role in managing a variety of other conditions. These include:
- Anxiety Disorders: CBD may have anxiolytic (anxiety-reducing) properties. It is thought to interact with serotonin receptors in the brain, which play a crucial role in mood regulation and anxiety. Some studies suggest CBD could be beneficial for generalized anxiety disorder, social anxiety disorder, and panic disorder. What CBD does in this context is potentially modulate the brain’s response to stress and fear.
- Insomnia and Sleep Disorders: Many individuals use CBD to improve sleep. While research is still developing, CBD may influence sleep cycles by reducing anxiety and promoting relaxation. Understanding what CBD does for sleep is an area of active investigation, with potential benefits linked to its calming effects.
- Chronic Pain Management: CBD interacts with the body’s endocannabinoid system, which is involved in pain regulation, inflammation, and immune responses. Research indicates that CBD may help reduce chronic pain, including neuropathic pain, inflammatory pain, and pain associated with conditions like arthritis. What CBD does for pain is thought to involve reducing inflammation and altering pain perception.
- Inflammation: CBD exhibits anti-inflammatory properties. By interacting with the endocannabinoid system and other pathways, CBD may help reduce inflammation throughout the body. This anti-inflammatory action is relevant to many of the potential benefits of CBD, including pain management and neuroprotection. What CBD does to reduce inflammation is a key area of research.
- Neuroprotective Properties: Early research suggests CBD may have neuroprotective effects, potentially protecting brain cells from damage. This is relevant to conditions like Alzheimer’s disease, Parkinson’s disease, and stroke. What CBD does for neuroprotection is still under investigation, but it holds promise for future therapeutic applications.
It’s important to note that while these areas show promise, much of the research is still preliminary, and more rigorous clinical trials are needed to fully understand the extent of what CBD does for these conditions and to establish optimal dosages and treatment protocols.
Is CBD Safe? Understanding Potential Side Effects and Risks
While generally considered safe, CBD can have side effects in some individuals. Reported side effects of CBD may include:
- Nausea: Some users may experience mild nausea, particularly at higher doses.
- Fatigue: CBD can cause drowsiness or fatigue in some people.
- Irritability: Although less common, irritability has been reported as a side effect.
A significant consideration regarding what CBD does is its potential to interact with other medications. CBD can interfere with liver enzymes, specifically cytochrome P450 enzymes, which are responsible for metabolizing many drugs. This interaction can lead to increased levels of certain medications in the blood, potentially increasing their effects or side effects. This is particularly important for individuals taking:
- Blood thinners (anticoagulants): CBD may enhance the effects of blood thinners, increasing the risk of bleeding.
- Anti-epileptic medications: While CBD itself is used for epilepsy, it can interact with other anti-seizure drugs, potentially altering their levels.
- Immunosuppressant medications: CBD interactions could affect the levels of immunosuppressants, which are critical for transplant recipients and individuals with autoimmune conditions.
This interaction is similar to how grapefruit can affect certain medications. It is crucial to inform your doctor if you are using CBD, especially if you are taking any prescription medications.
Additionally, high doses of CBD have been associated with abnormalities in liver function tests. Many over-the-counter medications, such as acetaminophen (Tylenol), can also cause similar effects. Regular monitoring of liver enzymes may be advisable for individuals using CBD regularly, especially at higher doses.
A significant safety concern in the CBD market relates to regulation. Currently, in many regions, CBD products are primarily marketed and sold as supplements, not as medications. Dietary supplements often have less stringent regulatory oversight compared to pharmaceuticals. The FDA, for example, does not currently regulate the safety and purity of dietary supplements in the same way it regulates drugs. This lack of rigorous regulation means there is no guarantee that a CBD product contains the active ingredients at the dose listed on the label.
Furthermore, unregulated CBD products may contain contaminants or undisclosed ingredients. To mitigate these risks, if you choose to use CBD, it is strongly recommended to ensure that products undergo independent third-party laboratory testing. A Certificate of Analysis (COA) should be available for every CBD product, verifying its contents and purity. Understanding these safety considerations is vital when considering what CBD does and whether it is right for you.
How Can CBD Be Taken? Exploring Different Forms and Uses
CBD is available in a variety of forms, offering different routes of administration and intended uses. Common CBD product types include:
- Oils and Tinctures: These are liquid forms of CBD, often taken sublingually (under the tongue) for relatively rapid absorption into the bloodstream.
- Capsules and Pills: CBD capsules and pills provide a convenient and precise dosage. They are ingested and absorbed through the digestive system.
- Topical Preparations: CBD-infused lotions, creams, balms, and salves are applied directly to the skin. Topical CBD is often used for localized relief of muscle and joint pain or inflammation.
- Patches: CBD patches are applied to the skin and deliver a sustained release of CBD over time.
- Vapes: CBD vape products involve inhaling CBD vapor. Vaping allows for rapid absorption, but concerns exist regarding the safety of vaping in general. Medical professionals generally advise against smoking or vaping any substance, including CBD.
- Edibles: CBD-infused edibles, such as gummies or chocolates, are ingested and absorbed through the digestive system.
The best method of taking CBD depends on the desired effects and individual preferences. For localized pain and inflammation, topical CBD preparations may be suitable. For systemic effects, such as anxiety or sleep support, sublingual oils, capsules, or patches may be preferred.
Outside of the United States, the prescription medication Sativex, which contains CBD as an active ingredient along with THC, is approved in several countries for treating muscle spasticity associated with multiple sclerosis and for cancer pain. Within the US, Epidiolex is approved specifically for certain types of epilepsy and tuberous sclerosis. These prescription CBD-based medications highlight the therapeutic potential of what CBD does under medical supervision.
Conclusion: What CBD Does and What We Still Need to Learn
While some CBD manufacturers have faced regulatory scrutiny for making unsubstantiated claims, such as CBD being a cure-all for cancer or COVID-19, it’s crucial to recognize that CBD is not a panacea. However, research is increasingly indicating that CBD is a potentially helpful and relatively non-toxic option for managing conditions like anxiety, insomnia, and chronic pain.
Despite the promising findings, more high-quality research, particularly in human clinical trials, is needed to fully elucidate what CBD does, establish effective dosages for various conditions, and understand long-term effects. The current regulatory landscape, where CBD is often available as an unregulated supplement, makes it challenging to ensure product quality and conduct rigorous research.
If you are considering trying CBD, it is essential to source products from reputable manufacturers that provide third-party testing and Certificates of Analysis. Most importantly, discuss CBD use with your doctor, especially if you have underlying health conditions or are taking other medications, to ensure it is safe and appropriate for you and to monitor for potential interactions. Understanding what CBD does is an evolving field, and informed, cautious exploration is key to harnessing its potential benefits responsibly.
About the Author
Peter Grinspoon, MD, Contributor; Editorial Advisory Board Member, Harvard Health Publishing
Dr. Peter Grinspoon is a primary care physician, educator, and cannabis specialist at Massachusetts General Hospital; an instructor at Harvard Medical School; and a certified health and wellness coach. He is the author of Seeing Through the Smoke: What We Really Know About Marijuana. See Full Bio
View all posts by Peter Grinspoon, MD
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