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CBD

CBD Products

CBD is a herbal product with a long history of use around the world. Recent research has uncovered potential health benefits ranging from anxiety to inflammatory bowel disease. This article explains CBD basics, answers frequently asked questions, and takes a look at what the medical community has to say about this popular supplement.

What is CBD?

CBD is short for cannabidiol, a natural compound from the plant Cannabis sativa. CBD is part of a group of similar chemicals that scientists call cannabinoids.

CBD interacts with the endocannabinoid system in the human body. The endocannabinoid system is a signalling network concentrated in the brain and nerve endings. While other cannabinoids have limited medical use because of their mind-altering effects, CBD does not cause a “high”. The medical community is investigating CBD to treat conditions like anxiety, epilepsy, and chronic pain.

The History of CBD

While modern medicine has only recently taken an interest in CBD, ancient practitioners were using it as early as 2700 B.C.

Prescriptions from the age of the pharaohs recommended cannabis for fever and infection. Around the same time in India, Ayurvedic texts described cannabis remedies for anxiety, pain and sedation. In China, early physicians often used cannabis as a general anaesthetic in surgery and childbirth.

It was only in the mid-19th century that physician William Brooke O’Shaughnessy brought cannabis to Europe and North America. Clinicians adopted it for nausea, nerve pain and tremor, but its popularity was short-lived. By the early 19th century, more practical and effective synthetic drugs had replaced traditional herbal medicines.

How Does CBD Work?

CBD looks a lot like the body's endocannabinoid messaging molecules, anandamide and 2-AG. This allows it to mimic their actions and alter processes such as nerve signalling.

To communicate with different body systems, CBD binds to sites called cannabinoid receptors. Researchers discovered large numbers of these receptors in parts of the brain that regulate pain, seizures, and memory. Experts believe that cannabinoids may be able to suppress pain and treat other conditions rooted in these areas.

What is CBD Used For?

Research into CBD is ongoing; scientists are discovering evidence for new benefits every year. Currently, a small number of medicines containing CBD are available on prescription to treat certain conditions.

  • Epilepsy - CBD research is most advanced for seizure disorders. Trials centre on rare childhood disorders such as Dravet Syndrome and Lennox-Gastaut Syndrome. Clinical trials suggest that CBD may be effective in these conditions where other therapies have failed. “Charlotte’s Web” is a high-CBD strain of medical cannabis named after a girl with Dravet Syndrome whose parents successfully used it to control her seizures. The US Food and Drug Administration (FDA) has licensed one prescription medicine containing CBD for this purpose.[1] Some specialist doctors in the UK can prescribe it under certain circumstances.
  • Multiple Sclerosis (MS) - UK authorities have licensed a product containing CBD for spasticity in MS where regular treatment has failed.[2] Spasticity is a type of muscle stiffness and involuntary movement that causes pain from MS. Scientists believe that cannabinoids can improve symptoms by acting on the nerve terminals.

The medicines above are prescription-controlled, but you can also buy CBD products over-the-counter in pharmacies and health stores. These products are not licensed medicines but food supplements, therefore they cannot make any specific health claims.

Nonetheless, public interest in early-phase CBD trials is stronger than ever.

Below are some indications for which CBD may be useful as a medicine in the future. Studies into the effects of CBD on the conditions below are still ongoing, and scientists will need more high-quality human studies to determine if CBD is safe and effective for these conditions.

  • Anxiety - In a 2015 review, a team of experts looked at 49 studies and found evidence to “strongly support” CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.[3] Furthermore, a report from World Health Organisation (WHO) on CBD also highlighted results from animal trials showing CBD’s ability to reduce muscle tension, restlessness, fatigue and problems in concentration from anxiety.[4] Scientists don’t yet fully understand how CBD works in anxiety, but it may be related to the endocannabinoid system’s role in fear responses.
  • Depression - Trials in mice show that CBD may have antidepressant properties. A number of conventional medicines treat depression by balancing serotonin levels. Serotonin is a chemical messenger strongly linked to mood and happiness. Experts have theorized that CBD may interact with serotonin receptors in the brain to enhance feelings of well-being.[5]
  • Chronic Pain - Endocannabinoid receptors in the brain’s pain centres suggest that CBD may be able to reduce nerve pain. A 2017 review of 43 studies supports this theory - researchers determined that CBD could reduce chronic pain in human participants above and beyond placebo.[6]
  • Addiction - A small number of preclinical investigations indicate that CBD may be useful against opioid, cocaine, and nicotine addiction. This could be due to the endocannabinoid receptors in brain areas responsible for psychological reward.
  • Insomnia - CBD seems to have a calming effect on the nervous system. As well as relieving anxiety, a rodent study found that CBD had the ability to prevent sleep disturbances.[7] CBD may be useful as a treatment for insomnia in the future.
  • Psychosis - Preclinical trials have shown that CBD has positive effects in animal simulations of psychosis. One human study of 88 participants with schizophrenia found that CBD reduced psychotic symptoms by significantly more than the placebo.[8]
  • Neurodegenerative diseases - Lab studies have shown that CBD can protect brain cells in models of neurodegenerative conditions such as Alzheimer's disease, Parkinson's disease and stroke.[9] The WHO report also noted improvements in psychiatric rating and reduction of agitation, nightmares and aggressive behaviour from CBD in patients with Parkinson’s disease.[4]
  • Inflammatory bowel and Crohn’s diseases - In cell studies, scientists have observed a reduction in inflammation and disease activity in Crohn's patients taking CBD. Researchers propose that CBD may be useful as a treatment for this and other inflammatory bowel disorders in the future.[10]
  • Cancer - Research is still in the very early stages, but results so far indicate that CBD could possibly have anti-tumour effects. In preclinical studies, cannabinoids inhibited cancer cell migration, invasion and metastases formation, as well as stimulating cancer cell death. While these initial results are promising, drugs often act differently in human patients compared to their effects in cell and animal models. More research is needed before we can come to any conclusions about the effects of CBD in cancer.

Frequently Asked Questions About CBD

  • Is CBD legal? Yes, CBD products are completely legal in the UK as long as no psychoactive cannabinoids are present. THC is a psychoactive cannabinoid which is illegal to possess and supply under the Misuse of Drugs Act 1971.
  • What does “full-spectrum” mean? Full-spectrum products contain all the natural compounds in the cannabis plant. As well as CBD, THC, and other cannabinoids, you’ll get a variety of compounds called terpenes. These ingredients work together synergistically in a phenomenon called “the entourage effect”. Broad-spectrum CBD is almost the same as full-spectrum, but without any THC.
  • Will CBD make me high? No. THC is the cannabinoid responsible for the high from cannabis. CBD has no mind-altering properties. As part of the “entourage effect”, CBD may actually counteract the psychoactive effects of THC.
  • Is hemp oil the same as CBD oil? No. Hemp oil comes from a different variety of the Cannabis sativa plant with very few cannabinoids and no medical value. Hemp oil is a culinary ingredient similar to olive oil, whereas CBD oil is a medicine or health supplement.
  • Is CBD addictive? Animal studies have found no evidence that CBD causes addiction. In fact, CBD is being investigated as a treatment for opioid, cocaine, and nicotine addiction.
  • Does CBD have any side effects? CBD is generally well-tolerated, and side effects, if they occur, are usually mild. However, drug-drug interactions between CBD and other medications are possible. People with ongoing medical conditions should consult a health care professional before using a CBD product. CBD is not safe for children, and pregnant or breastfeeding women.

Which CBD Product Should I Choose?

Products marketed as food supplements generally contain less than 5% CBD, but some offer up to 20%. Although the risk of side effects is very low, each person has a different sensitivity to CBD, so it’s best to start at the lowest dose and increase slowly.

The most widespread CBD products are oils and capsules to take by mouth. Some vendors also sell liquids designed for inhalation with a vaporizer.

Topical solutions containing CBD are also becoming increasingly popular. CBD creams and CBD ointments

  • CBD Oils - Oral CBD oils come in a spray bottle or with a dropper to release a fixed dose. Directions vary between manufacturers, but most recommend holding the dose under the tongue for around 60 seconds before swallowing.
  • CBD Creams – CBD creams and ointments are topical solutions that can be used to provide temporary relief for acute injuries and pains such as sprains and knocks sustained during sporting activities.
  • CBD Tinctures - Like oils, tinctures are taken by mouth with a spray or dropper. Tinctures come as an alcohol-based liquid rather than an oil.
  • CBD Pills - CBD pills are generally soft gel capsules filled with CBD oil and swallowed whole.
  • CBD Liquids for Vaporization - Dosing is less precise with vapourised CBD liquid as it depends on a person’s inhalation technique. Using a vaporizer is also less discrete and is likely to cause respiratory side effects.

References

  1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/210365lbl.pdf
  2. http://www.mhra.gov.uk/home/groups/par/documents/websiteresources/con084961.pdf
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
  4. https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf
  5. https://cbd-b.be/wp-content/uploads/2018/09/2014-Antidepressant-Like-and-Anxiolytic-Like-Effects-of-Cannabidiol.pdf
  6. https://www.ncbi.nlm.nih.gov/pubmed/28934780
  7. https://www.sciencedirect.com/science/article/pii/S0028390811003467
  8. https://www.ncbi.nlm.nih.gov/pubmed/29241357
  9. https://www.researchgate.net/profile/Mario_Abate/publication/314080489_Cannabidiol_State_of_the_art_and_new_challenges_for_therapeutic_applications/links/59cf63284585150177eadb08/Cannabidiol-State-of-the-art-and-new-challenges-for-therapeutic-applications.pdf
  10. https://www.ncbi.nlm.nih.gov/pubmed/22815234

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