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Cannabidiol (CBD)

History

Cannabis is a group of flowering plants that contain numerous substances including tetrahydrocannabinol (THC) and cannabidiol (CBD), which are the two most well known components. THC is a chemical that can induce feelings of euphoria and is therefore sought after for recreational use. On the other hand, CBD is non-hallucinogenic and has gained recent popularity for its proposed therapeutic effect on various conditions such as pain. Although the current view of cannabis is that it’s a recreational drug, in 1851 medicinal compounds composed of cannabis were in fact registered with the United States Pharmacopeia, which is a list of medications for approved therapeutic use. However, after the passage of the Marijuana Tax Act of 1937, cannabis was removed from the US Pharmacopeia. In 1971, due to its rising recreational use, cannabis was re-classified as a Schedule I drug, which is defined as no accepted medical use as well as a high potential for abuse.

Bottle of CBD oil on a Cannabis leaf

Legal considerations

Recently, several states have passed medical marijuana legislation to allow for the sale and use of cannabis-derived products for medical therapy. However, irrespective of state laws, on the federal level the US government and DEA still consider products derived from cannabis controlled substances. The exception to this is pharmaceutical grade CBD oil. Due to this federal classification, studies using cannabis are restricted, so there exists a paucity of high quality research as to the therapeutic benefit of CBD, a component of cannabis.

Clinical uses

Some of the strongest research involving CBD’s therapeutic use is with medication refractory epilepsy. There have been three clinical trials that have demonstrated improvement in seizure control in patients started on CBD. There have also been studies that suggest CBD may be helpful in treating anxiety and insomnia. Additionally, some early research suggests that CBD has inherent anti-inflammatory properties and may be used in a similar manner to Non-Steroidal Anti-Inflammatories such as ibuprofen. If this research proves true, there may be a role for CBD in the treatment of osteoarthritis and some skin conditions such as eczema.

“As with other health supplements, please first seek the advice of your physician before starting it as a treatment and together you can address any questions or concerns.”

Brent Nathan, MD

Side effects

With regards to safety profile, current research suggests that CBD is safe. There have been no reported overdoses. However, on the biochemical level, CBD can interact with other medications and supplements by way of increasing or decreasing the activity of those drugs so it could be unsafe for certain people to use it.

The bottom line

At this time, the future of CBD is uncertain. There are currently several preparations of CBD products available to the public. Topical creams and ingestible oils are the most frequently used formulations. Oil was chosen as a standard preparation because it is odorless and dosing can be estimated by counting drops. Although CBD is currently available for purchase and at home use, at this point there is not enough conclusive medical evidence to speak for its safety and efficacy in order to make recommendations for or against its use. However, if one chooses to use CBD, they should remain skeptical of the source and do their best to ensure the purity of the product. Since it’s not regulated by the FDA, questionable or unsafe additives may be present in certain formulations. As with other health supplements, please first seek the advice of your physician before starting it as a treatment and together you can address any questions or concerns.


Works Cited

Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. doi: 10.7812/TPP/18-041. PubMed PMID: 30624194; PubMed Central PMCID: PMC6326553.

Samanta D. Cannabidiol: A Review of Clinical Efficacy and Safety in Epilepsy. Pediatr Neurol. 2019 Jul;96:24-29. doi: 10.1016/j.pediatrneurol.2019.03.014. Epub 2019 Mar 22. Review. PubMed PMID: 31053391.

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