This article will look at what CBD is, how it might benefit a person’s health, how to use it, any possible risks, and its legal status in the United States.Everything you need to know about Cannabidiol CBD oil,How to use CBD-What is CBD oil,Benefits,Legality,Risks and Side effects

What Is the Evidence for CBD Oil? - Keep Kids Healthy

CBD is often extracted from the cannabis sativa plant in oil form and mixed with an inert carrier oil like hemp seed oil for consumption. In recent years, CBD oil has skyrocketed in popularity thanks to its purported calming effects. It can now be found in a range of products from simple oil tinctures to CBD-infused potato chips.

Better known as CBD, it is one of more than 100 chemical compounds called cannabinoids that are found in the cannabis plant, Cannabis sativa (Source).

QUICK FACTS ABOUT CANNABIDIOL (CBD) OIL

Some studies suggest that CBD may help with substance abuse disorders, mental health disorders, and certain types of cancers. However, we need more research in humans to find out more about these potential effects.

In June 2018, the Food and Drug Administration (FDA)Trusted Source approved the prescription use of Epidiolex, a purified form of CBD oil, for treating two types of epilepsy.

Cannabis contains a wide range of compounds, with varying effects. Some — but not all— are useful as a treatment. Similarly, some forms — but not all — are legal in some states.

Cannabidiol is a popular natural remedy used for many common ailments.

How is cannabidiol different from marijuana, cannabis and hemp?

  • 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.”
  • Tetrahydrocannabinol (THC) is the main psychoactive cannabinoid found in cannabis, which means it causes the sensation of getting high that’s often associated with cannabis. However, unlike THC, CBD is not psychoactive.
  • This quality makes CBD an appealing option for those who are looking for relief from pain and other symptoms without the mind-altering effects of cannabis or other side effects related to some pharmaceutical drugs.
A person adds CBD oil to a mug of tea with a dropper.Vane Nunes/Shutterstock

Is CBD legal?

  • Hemp-derived CBD products (with less than 0.3% THC) are legal on the federal level but are still illegal under some state laws.
  • Cannabis-derived CBD products are illegal on the federal level but are legal under some state laws.
  • Check your state’s laws and those of anywhere you travel.
  • And keep in mind that nonprescription CBD products are not FDA-approvedTrusted Source and may be inaccurately labeled.

The evidence for cannabidiol health benefits

CBD Oil Vs Hemp Oil - What Are The Differences And Why They Matter
The evidence for cannabidiol health benefits

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.

This article covers 10 evidence-backed health benefits of CBD, as well as potential side effects and safety concerns related to CBD products.

CBD research is growing, too. Here are Top 10 ways cannabidiol studies suggest CBD oil could benefit your health.

1. Offset Anxiety and Depression

A 2017 study in the Brazilian Journal of Psychiatry tested the anxiety levels of 57 men in a simulated public speaking test. Some received a placebo while others received either 150 milligrams, 300 milligrams or 600 milligrams of CBD before their speeches. Those who received 300 milligrams of CBD experienced significantly reduced anxiety during the test compared to those who received the placebo. Interestingly, participants who received either 150 or 600 milligrams of CBD experienced more anxiety during the test than the 300 milligrams group.

Meanwhile, at least one study in mice revealed CBD had effects similar to the antidepressant imipramine. Human trials are needed, though, to confirm whether CBD can induce this same antidepressant reaction in our bodies.

CBD use has been shown to improve some symptoms related to anxiety disorders. Researchers are currently investigating how CBD may be used in the treatment of other mental health disorders.

2. Treat Select Epilepsy Syndromes

In some instances, CBD can be used to treat epileptic seizures.

In 2018, the Food and Drug Administration (FDA) approved the use of CBD under the brand name Epidiolex to treat seizures resulting from Lennox-Gastaut syndrome and Dravet syndrome—two rare forms of epilepsy—in patients at least 2 years old.

Three well-vetted studies provide the basis of support for the FDA’s decision. In these trials, 516 patients with Lennox-Gastaut syndrome or Dravet syndrome received either Epidiolex or a placebo. Epidiolex, when taken along with other prescribed medications, decreased the frequency of participants’ seizures compared to the placebo.

3. Reduce PTSD Symptoms

In a small 2018 study in the Journal of Alternative and Complementary Medicine, 11 people with post-traumatic stress disorder (PTSD) received CBD along with routine psychiatric care for eight weeks in an outpatient psychiatric clinic. Ten of the 11 experienced a decrease in their PTSD symptoms. CBD was generally well tolerated, the researchers write.

Margaret Rajnic, a doctor of nursing practice experienced in medical cannabis and CBD, emphasizes the importance of using therapy in tandem with any type of cannabis or CBD for PTSD. “There is an amount of therapy that is needed for PTSD,” she says. “But CBD will give you that little bit of decreased anxiety.”

Four other human trials from 2012 to 2016 suggest CBD reduces PTSD symptoms, although some include THC, or tetrahydrocannabinol, the main mind-altering element in cannabis. When THC and CBD work together, they create what’s called an “entourage effect,” complementing each other’s benefits and potency. For example, taking the same dose of THC and CBD together tempers the “high” from THC, while just a little THC paired with more CBD enhances the effects of the CBD.

4. Treat Opioid Addiction

In one such study, researchers administered CBD to people with heroin use disorder. Over the course of a week, CBD significantly reduced heroin users’ cue-induced cravings, withdrawal anxiety, resting heart rate and salivary cortisol levels. No serious adverse effects were found.

Other studies find CBD helpful in reducing various psychiatric and medical symptoms like anxiety, insomnia and pain in patients with substance use disorders, indicating that CBD may be an effective treatment for opioid addiction. However, further studies are necessary.

5. Alleviate ALS Symptoms

Amyotrophic lateral sclerosis (ALS) is a disease that causes nerve cells in the brain and spinal cord to deteriorate, resulting in loss of muscle control that worsens over time. It’s not yet understood exactly why ALS occurs, although it can be hereditary in some cases. There’s no known cure, and there are only two FDA-approved medications to help treat ALS symptoms.

Research suggests people with ALS can benefit from the entourage effect created by the combination of THC and CBD, similar to people with PTSD. In a 2019 study, patients received a combination of THC and CBD in varying doses depending on their needs and preferences. Those with mild, moderate or severe spasticity (muscle tightness and stiffness) due to ALS reported high levels of satisfaction with the treatment, and those with moderate to severe spasticity reported higher satisfaction rates than those with mild spasticity.

6. Relieve Unmanageable Pain

In 2005, Canada approved the use of Sativex, an oromucosal (absorbed in the lining of the mouth) spray with equal proportions of THC and CBD, for the treatment of multiple sclerosis-related central neuropathic pain. In 2007, Canada approved the medicine’s use again for cancer pain that proved unresponsive to other medications.

Meanwhile, continued studies in the U.S. indicate CBD is effective in treating chronic, non-cancer pain. In one 2020 study, researchers administered CBD topically to a group of patients with symptomatic peripheral neuropathy (a result of brain nerve and spinal cord nerve damage) while another group with the same condition received a placebo. Results showed a significant reduction in intense, sharp pains and cold, itchy sensations in those who used the topical CBD compared to those who used the placebo. No participants reported adverse side effects.

When introduced topically, CBD oil doesn’t affect the systemic issue as it might if it were introduced directly into the bloodstream. Instead, topical CBD is more localized and treats pain in a certain area. Since it’s more direct, it may have a more pronounced effect.

7. Ease Diabetic Complications

For starters, tests on human cells found that CBD helps reduce the effects of high glucose levels on other cells in the body, which typically precedes the development of diabetes and various complications. Researchers concluded that with further studies, CBD could have significant benefits when used in patients with diabetes, diabetic complications and plaque buildup in artery walls.

In another small study, 13 patients with type 2 diabetes who weren’t on insulin treatment were given both CBD and a placebo (in lieu of insulin). Researchers found CBD decreased their levels of resistin (which causes resistance to insulin, the protein that regulates sugar levels) and increased their levels of glucose-dependent insulinotropic peptide (a hormone that ensures a sufficient release of insulin from digested food) compared to their baselines before they started the test. These results suggest CBD could be a natural treatment for diabetes by helping the body regulate insulin-related hormone levels.

8. Protect Against Neurological Disease

Several preclinical studies suggest CBD can produce beneficial effects against Parkinson’s disease, Alzheimer’s disease and multiple sclerosis. Huntington’s disease and cerebral ischemia were also tested, although significant positive results were not recorded. Further clinical studies are needed to confirm CBD’s benefits when used as a treatment for these disorders.

9. Inhibit Arthritis Symptoms

A 2006 study found that Sativex—a CBD-based botanical drug approved in the United Kingdom in 2010—promoted statistically significant improvements in quality of sleep, pain during movement and pain at rest in patients with rheumatoid arthritis when compared to a placebo. It was the first controlled trial of Sativex as a treatment for rheumatoid arthritis, involving 58 patients. CBD was found to have a pain-relieving effect, as well as an ability to suppress disease activity.

In 2018, in a study of more localized treatment, researchers administered a synthetic CBD gel in either 250-milligram or 500-milligram doses daily or a placebo to patients with knee pain due to osteoarthritis. Patients also stopped taking any other anti-inflammatory medications or painkillers, with the exception of acetaminophen, before and during the study period.

The results were interesting, although not entirely conclusive. On one hand, those treated with CBD did not experience much change in pain when compared with placebo patients. On the other hand, there were statistically significant differences between the group receiving the 250-milligram dose and the placebo group when measuring the average weekly improvement of their worst pain levels and their WOMAC (Western Ontario and McMaster Universities Arthritis Index) physical function rating. Additionally, men seemed to benefit from CBD more significantly than women in this test.

10.May alleviate certain cancer-related symptoms

Though CBD may improve certain cancer-related symptoms in some people, research findings are currently mixed and more studies are needed to assess its effectiveness and safety.

CBD may help reduce some cancer-related symptoms and side effects related to cancer treatment, such as nausea, vomiting, and pain.

An older study looked at the effects of CBD and THC in 177 people with cancer-related pain who did not experience relief from pain medication.

Those treated with an extract containing both compounds experienced a significant reduction in pain compared with those who received only THC extract (Source).

A review of five studies found some evidence that Sativex may help reduce cancer-related pain in some people (Source).

Other health benefits of CBD Oil

  1. Antipsychotic effects. Studies suggest that CBD may help people with schizophrenia and other mental health conditions by reducing symptoms of psychosis (Source).
  2. Substance abuse treatment. CBD may be helpful for relieving anxiety and depression in people who have a dependence on certain drugs, including heroin (Source).
  3. Possible extension of life in those with glioblastoma. Recent studies suggest that treatment with a combination of CBD and THC may help extend the life of some people with an aggressive form of cancer called glioblastoma, yet research is limited (Source).
  4. Possible improvement in sleep. Some studies suggest that CBD might help improve sleep in people with certain sleep disorders, though more research is needed (Source).

 

How can CBD be taken?

  • 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.
  • 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.

Potential side effects of CBD products

Special Precautions and Warnings

Pregnancy and breast-feeding: It may be unsafe to take CBD if you are pregnant or breast feeding. CBD products can be contaminated with other ingredients that may be harmful to the fetus or infant. Stay on the safe side and avoid use.

Children: It is possibly safe for children to take a specific prescription CBD product (Epidiolex) by mouth in doses up to 25 mg/kg daily. This product is approved for use in children with certain conditions who are at least 1 year old. It isn’t clear if other CBD products are safe in children.

Liver disease: People with liver disease may need to use lower doses of CBD.

Parkinson disease: Some early research suggests that taking high doses of CBD might make muscle movement and tremors worse in some people with Parkinson disease.

Though CBD is generally well-tolerated and is considered safe, it may cause adverse reactions in some people.

Side effects noted in studies include

  • diarrhea
  • changes in appetite and weight
  • fatigue

Other side effects, including abnormal liver function test results, drowsiness, sedation, and pneumonia, have been reported in childhood epilepsy studies. But these effects could stem from CBD interacting with other medications, such as clobazam (Source).

In fact, CBD interacts with several medications, including pain medications, antidepressants, seizure medications, and diabetes medications. Before you try CBD oil, discuss it with a healthcare professional to assess safety and avoid potentially harmful interactions

Additionally, it’s important to note that the market is currently saturated with CBD products, many of which are low quality.

CBD is added to foods, beverages, dietary supplements, and body care products, and these items are often marketed as a way to improve stress, pain, and sleep issues.

However, this does not mean you should include any of these items in your diet or wellness routine.

Although some evidence suggests that CBD may be helpful for certain aspects of health, dosing varies widely in research studies. It’s difficult to determine what dose is most appropriate for treating specific health needs.

What’s more, many products contain a blend of ingredients, not just CBD. For example, dietary supplements that contain CBD plus a blend of herbal ingredients may not be safe for everyone, as many herbs have the potential to interact with commonly prescribed medications.

Before you use a CBD product, talk with a healthcare professional to discuss appropriate dosing and any other questions you may have.

If you do decide to use a CBD product, choose one that has been third-party tested for quality and purity.

 

SUMMARYAlthough CBD is generally considered safe, it can cause adverse effects such as diarrhea and fatigue in some people. It may also interact with certain medications, causing side effects that may be harmful.

The Bottom Line on Cannabidiol

If you decide to try CBD, make sure you are getting it from a reputable source. And talk with your doctor to make sure that it won’t affect any other medicines you take.

CBD oil has been studied for its potential role in easing the symptoms of many common health conditions, including anxiety and neurological disorders. Plus, it may benefit heart health and help relieve certain types of pain.

Keep in mind that some of these health benefits are related to the use of CBD combined with THC, not CBD alone.

Research investigating the effects of CBD on certain conditions is ongoing, and there is still much to be learned about the potential uses of CBD.

If you’re interested in trying CBD to manage a health condition or to support overall health, check with a healthcare professional first. They can help you decide whether adding a CBD product to your routine is appropriate and help you choose the best product.

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.

 

SOURCES:

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  2. Office of the Commissioner. FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. U.S. Food and Drug Administration. Accessed 5/13/2021.
  3. Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case SeriesThe Journal of Alternative and Complementary Medicine. 2019;25(4):392-397.
  4. Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human TrialsFrontiers in Neuroscience. 2018;12.
  5. Hurd YL, Spriggs S, Alishayev J, et al. Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled TrialAmerican Journal of Psychiatry. 2019;176(11):911-922.
  6. Hurd YL, Yoon M, Manini AF, et al. Early Phase in the Development of Cannabidiol as a Treatment for Addiction: Opioid Relapse Takes Initial Center StageNeurotherapeutics. 2015;12(4):807-815.
  7. Bilsland LG, Dick JR, Pryce G, et al. Increasing cannabinoid levels by pharmacological and genetic manipulation delay disease progression in SOD1 miceFASEB J. 2006;20(7):1003-1005.
  8. Meyer T, Funke A, Münch C, et al. Real world experience of patients with amyotrophic lateral sclerosis (ALS) in the treatment of spasticity using tetrahydrocannabinol:cannabidiol (THC:CBD)BMC Neurol. 2019;19(1):222.
  9. Russo EB. Cannabinoids in the management of difficult to treat painTher Clin Risk Manag. 2008;4(1):245-259.
  10. Xu DH, Cullen BD, Tang M, Fang Y. The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower ExtremitiesCurr Pharm Biotechnol. 2020;21(5):390-402.
  11. Weiss L, Zeira M, Reich S, et al. Cannabidiol lowers incidence of diabetes in non-obese diabetic miceAutoimmunity. 2006;39(2):143-151.
  12. Rajesh M, Mukhopadhyay P, Bátkai S, et al. Cannabidiol attenuates high glucose-induced endothelial cell inflammatory response and barrier disruptionAmerican Journal of Physiology-Heart and Circulatory Physiology. 2007;293(1):H610-H619.
  13. A Randomised, Double Blind, Placebo Controlled, Parallel Group, Pilot Study of 1:1 and 20:1 Ratio of Formulated GWP42003 : GWP42004 Plus GWP42003 and GWP42004 Alone in the Treatment of Dyslipidaemia in Subjects With Type 2 Diabetes. clinicaltrials.gov. Accessed 5/13/2021.
  14. Mannucci C, Navarra M, Calapai F, et al. Neurological Aspects of Medical Use of CannabidiolCNS Neurol Disord Drug Targets. 2017;16(5):541-553.
  15. Malfait AM, Gallily R, Sumariwalla PF, et al. The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritisProc Natl Acad Sci U S A. 2000;97(17):9561-9566.
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