What is CBD? What does CBD treat? And how to use Cannabidiol

Cannabis / Culture
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Why CBD deserves a place in your medicine cabinet.

Steve Elliott
Feb 11, 2018

CBD: What You Need To Know About Cannabidiol

Cannabidiol is one of more than 400 compounds found in the cannabis plant, more than 60 of which are unique to cannabis itself. Unlike tetrahydrocannabinol (THC), CBD is not psychoactive. But like THC, cannabidiol has a long list of medicinal benefits.

Until the 21st Century, THC didn’t have to share the spotlight. As the “active ingredient” (at least the psychoactive one), it got the lion’s share of scientific, media, and popular attention. But the medical potential of CBD oil has been in the spotlight for a couple of years now.

As the knowledge has spread, some states –especially those that are wary of passing a full medical marijuana law – have specifically legalized the oil in so-called “CBD only” legislation.

The rest of the 60 or so cannabinoids, including many that have already show medical promise, haven’t gotten much attention yet, partly because there’s not as much of them in cannabis. But that’s also partly because strict U.S. federal marijuana laws have, thus far, prevented much serious cannabis research from ever happening.

CBD Effects

While THC is psychoactive, CBD is not. Both are cannabinoids, but they interact with the body in different ways. THC directly engages the cannabinoid receptor 1 (CB1), which is concentrated in the human central nervous system.

Cannabidiol doesn’t engage CB1 in the same way as THC. “[CBD] doesn’t tend to bind directly to what’s called the orthosteric site [on cannabinoid receptors] where THC binds,” explains Dr. Ethan Russo in an interview with Project CBD. “Rather, it binds on what’s called an allosteric site, another site on the receptor, and so it alters the binding of both THC and the endogenous cannabinoids, the endocannabinoids.”

So cannabidiol and THC both bind to the CB1 receptors, but in different locations. Cannabidiol seems to have the capability to fine tune or regulate the interaction between THC and the CB1 receptor by attaching to a separate location on the same receptor. Cannabidiol, in essence, boosts some of the therapeutic effects of THC while at the same time reducing its psychoactive effects. That means it can be very useful for people using cannabis medicinally.

This is probably why common CBD effects include modulating the psychoactivity of THC. Say you’ve smoked some high THC weed, or maybe a bomb edible, and feel an anxiety attack coming on? Cannabidiol can help balance you out, at least according to anecdotal reports from the field. In fact, some CBD companies such as CannaRelief market the compound specifically for that purpose.

The evidence suggests that cannabidiol is safe, even at high doses.

Does CBD Get You High?

While cannabidiol can promote calm, it does not get you high, as does THC. The fact that high CBD strains of cannabis aren’t psychoactive, or are at least less psychoactive (when THC is also present) than other strains makes them a good option for patients looking for relief without feelings of consciousness alteration or lethargy.

The medicinal benefits of the compound make a difference in the body, reducing inflammation, helping to protect brain cells, dissipating depression, reducing pain, preventing tumors, and balancing moods.

As one of the cannabinoids, of which there are at least 80, CBD does originate inside the resin glands (trichomes) of female cannabis flowers, just as does THC. And like THC, CBD binds to the cannabinoid receptors found in the brain, the nervous system, the liver, the gut, and sprinkled almost everywhere throughout the human body. That’s one reason for its widespread, full-body medical benefits.

How Cannabidiol Works

The cannabinoids fit into the cannabinoid receptors like keys into locks. Consuming CBD, THC and other cannabinoid supplements mimic the naturally occurring endocannabinoids in the human body (that’s why the cannabinoid receptors are there in the first place). Plant-based cannabinoids like those found in marijuana are called phytocannabinoids, to distinguish from those naturally produced in the human body.

The body-wide system of endocannabinoids and their receptors are called the Endocannabinoid System (ECS). The ECS plays a crucial role in regulating body systems, appetite, mood, memory, sleep, immune function, and motor control.

The four primary functions of the ECS are neuroprotection, stress recovery, immune system balance, and homeostatic regulation. That last one is just a scientific way of referring to a system that works towards an optimum balance of physiological processes.

What Cannabidiol Treats

Cannabidiol is known as a “polypharmacological” compound because it can affect multiple systems in the body at once. While that can be great for your body, it also makes CBD difficult to study scientifically. That’s because it’s almost impossible to suss out the effects these different interactions have upon each other.

There is already preclinical evidence of CBD’s therapeutic efficacy as an:

While preclinical trials have shown much promise, much of the current evidence on cannabidiol is based on anecdotal reports from patients and families who often use the compound in the form of an oil. Even in the absence of strictly controlled human trials, many medical marijuana patients found relief with cannabidiol-rich strains and concentrated CBD oil.

oil resized What is CBD? What does CBD treat? And how to use Cannabidiol
Photo courtesy of thomasshaw9688/ via Flickr

Patients with chronic conditions including epilepsy and cancer use cannabis oil or “hemp oil” extracted from high-CBD strains of marijuana or hemp. Families’ stories of successfully managing the severe form of childhood epilepsy known as Dravet’s syndrome have gone a long way towards making CBD a household word. Researchers with the British Epilepsy Foundation in 2012 published a paper on cannabidiol’s anti-convulsant and anti-seizure potential. According to the paper, “evidence strongly supports CBD as a therapeutic candidate for a diverse range of human epilepsies.

A few of the most common reasons patients choose to use CBD oil include:

As we move farther into the exciting realm of cannabinoid science, working with THC, CBD and the rest of the cannabinoids (the “Entourage Effect“), the ability to alter the body’s “endocannabinoid tone” through supplementing with plant-based cannabinoids could be very beneficial for some medical conditions.

Dr. Russo in 2008 theorized that some illnesses could be triggered in people with an “endocannabinoid deficiency.” He speculated that just not having enough natural cannabinoids could be one of the culprits involved in migraines, irritable bowel syndrome (IBS), and fibromyalgia.

If future clinical trials of cannabidiol show positive results, the cannabinoid could turn out to be one of the most important therapeutic tools available for conditions related to the human endocannabinoid system.

Other Ways CBD Works

While we are still discovering things about cannabidiol on a regular basis, researchers have found that it does a lot more than just engage cannabinoid receptors. The positive effects of CBD are body-wide and far-reaching, including the following direct or indirect impacts:

  • Vanilloid receptors (involved in pain modulation)
  • Adenosine receptors (involved in the sleep-waking cycle)
  • Serotonin receptors (involved in mood and stress management)

Cannabidiol may also work for us by blocking a particular fatty acid known as fatty-acid amide hydrolase (FAAH), according to some rodent studies. FAAH is responsible for breaking down the naturally occurring endocannabinoid anandamide in the human body.

Anandamide, known as the “bliss molecule,” is the closest thing to a naturally occurring THC in the body. It helps regulate crucial functions like appetite, ovulation, memory, sleep, pleasure and reward, and pain. Since supplementing cannabidiol can result in less FAAH being available to break down anandamide, the theory is this can improve endocannabinoid tone.

How To Use Cannabidiol

High CBD Strains

If you want more CBD in your life, you can get ready-to-use CBD oil, or you can start with high CBD flowers for smoking, vaping, edibles or extracting your own oil.

Thanks to the growing use of cannabidiol as a therapeutic supplement, a decades-long trend among marijuana breeders of selecting only for high THC is finally being reversed. Now, high CBD strains are becoming among the most in-demand among in-the-know breeders, many of whom are themselves looking to devise that next famous strain.

Some of the most popular high CBD strains are:

trichomes charlottes web resize What is CBD? What does CBD treat? And how to use Cannabidiol
Macro shot of Charlotte’s Web Strain. Photo courtesy of Pelos Claros Image/ via Google images

Just because a strain is “high CBD” doesn’t mean it’s free of THC. Many patients, in fact, believe that a 1:1 ratio of CBD and THC is most effective for their conditions, and this ratio can still get you high (although the high will probably be a little more muted than the THC-only kind).

If you want to supplement CBD but don’t want to give up the cannabis high associated with THC, a strain like Critical Mass could be a good option. This fascinating strain typically has good levels of both CBD (5 percent) and THC (20 percent), making it a good choice for cannabidiol patients who also want to get stoned.

“CBD-rich” strains, according to Project CBD, have roughly equal amounts of CBD and THC, or more CBD than THC (usually at least 4 percent CBD). “CBD-dominant” strains, by contrast, are also CBD-rich but have very little THC content.

Well-stocked dispensaries typically carry CBD-infused coconut oil (which helps in absorption) and capsules.

Possible Side Effects of CBD

Small-scale studies looking at the safety of cannabidiol in adults have found that it is well tolerated across a range of doses. Cannabidiol in doses of up to 300 mg daily has been used safely for up to 6 monthsHigher doses of 1,200-1,500 mg daily have been used safely for up to 4 weeks.

No significant side effects have been noted on the central nervous system. Either light or heavy use hasn’t been seen to affect vital signs and mood among users.

The most common reported side effect is lassitude or a feeling of tiredness or drowsiness. Paradoxically, and underlining how individual reactions can vary, cannabidiol is a wake-inducing agent in most cases. A few people have noticed diarrhea and changes in weight or appetite. Other reported side effects include dry mouth, low blood pressure, and lightheadedness.

Cannabidiol has also been known to inhibit hepatic (liver) drug metabolism, decreasing the activities of p-glycoprotein and other drug transporters, according to an NCBI study.

According to some early research, taking cannabidiol in high doses may worsen tremors and muscle movements in Parkinson’s disease sufferers. But there are also studies that suggest cannabidiol is safe and well-tolerated by Parkinson’s patients. Parkinson’s patients should consult their physician before taking cannabidiol, and begin any regimen with small doses.

Cannabidiol Dosing

Adequate dosing is important; an important way to decide what’s adequate is your body weight. Also to be taken into account are factors such as age, nutritional deficiencies, and current medical challenges, according to Honey Colony. 

Customary dosage is around 25 mg per day, per 100 pounds of body weight. You can build the dosage from there, depending upon how much body fat you have. More body fat equals lower doses; lean muscle equals higher doses, according to the experts.

cbdforme resized What is CBD? What does CBD treat? And how to use Cannabidiol
Photo courtesy of Vaping360/ via Flickr

You should carefully monitor your body for a response to the CBD dose you’re taking. If you feel more energized 60-90 minutes after ingesting cannabidiol, take your dose in the morning. If instead, you feel relaxed or tired, then it’s probably better to take your dose at night before going to bed. If you don’t notice either effect, you’re free to take your dose at any time of the day.

Studies indicate that lower doses of cannabidiol promote alertness and energy. This can be accentuated by the reduction of anxiety typically accompanying cannabidiol usage. At higher doses, CBD at first has a gently calming effect, and if the dose is further increased, a relaxing, sedative effect.

Legality of CBD

In the United States, the legality of cannabidiol can depend on its source. CBD products derived from “hemp” and those derived from “marijuana” theoretically have the same compound, but with different legal definitions. Under the Farm Bill, “hemp” plants are cannabis plants with less than 0.3 percent THC.

According to the federal Drug Enforcement Administration, all cannabis products are considered Schedule I drugs under the Controlled Substances Act. The DEA, therefore, says CBD is illegal. Hemp industry experts question whether the DEA even has the legal right to include CBD under its definition of “marijuana.”

Products that contain only THC are currently often bypassing the legal ban on cannabis. Almost every state that doesn’t have a full medical marijuana law has a “CBD only” law on the books to allow cannabidiol products, sometimes with low amounts of THC, to be used for medicinal purposes. This handy map from Americans for Safe Access breaks down the legal information on cannabidiol by state and federal law.

Only six states — Idaho, Indiana, Kansas, Nebraska, South Dakota, and West Virginia — still officially consider everything about the cannabis plant, including CBD, to still be illegal.

Meanwhile, even with laws varying all over the place from state to state, and the DEA considering cannabidiol illegal under federal law, CBD products remain available for sale in many health supplement shops and organic food stores (although the CBD levels often aren’t as advertised), as well as online.

Beyond the U.S., the World Health Organization (WHO) has begun an examination of what level of international controls should be exercised on CBD distribution. WHO’s Expert Committee on Drug Dependence in December 2017 released its initial determinations regarding cannabidiol and plans for further review. CBD, for now, shouldn’t be subject to international drug scheduling, according to the committee. The WHO committee announced plans to undertake a more robust review of cannabidiol in 2018.

WHO said it made the move due to “increased interest from Member States in the use of cannabis for medical indications including for palliative care.”

“Recent evidence from animal and human studies shows that its use could have some therapeutic value for seizures due to epilepsy and related conditions. Current evidence also shows that cannabidiol is not likely to be abused or create dependence as for other cannabinoids […] The ECDD, therefore, concluded that current information does not justify scheduling of cannabidiol and postponed a fuller review of cannabidiol to May 2018, when the committee will undertake a comprehensive review of cannabis and cannabis-related substances.”

Currently, WHO lists the cannabis plant and its resin as Schedule I and Schedule IV substances, the two most restrictive classifications. The U.S. Health and Human Services agency are expected to delay making CBD recommendations of its own until WHO’s final determinations are submitted to the United Nations Commission on Narcotic Drugs.

Until the cannabis plant is unequivocally either reclassified or legalized at the federal level in the United States, overbearing restrictions on marijuana research will prevent us from realizing the full range of health benefits of cannabidiol itself, and more broadly, the entire plant.

Steve Elliott
Feb 11, 2018