Care Triad

The skinny on CBD

It seems like everyone I know is taking CDB for something (insomnia, pain, anxiety, etc.) but what exactly is it and does it really work? And why is it so popular?

CBD stands for cannabidiol and it is one of over 100 chemicals (called cannabinoids) that are extracted from the cannabis plant. Hemp and marijuana are different types of cannabis. Marijuana causes a “high” because it contains a lot of tetrahydrocannabinol (THC) but hemp has more CBD and very little THC. Most CBD you can buy comes from the hemp plant and is legal (in most US states) as long as it contains less that 0.3 percent THC.

While CBD is often purchased as an oil that you put under your tongue with a dropper, it is also available as a pill, lotion or a vaping liquid. For now, CBD is considered to be a dietary supplement so it is not regulated by the Food and Drug Administration (FDA) and you do not need a prescription to get it. That’s the good news. The bad news is that without rules imposed by the FDA, the CBD you get from one company may be different from what you get from another company. We also don’t know if one form of CBD is better than another for different conditions.

How does it work?

Some scientists believe that CBD calms the immune system so that inflammation is kept under control. Inflammation is thought to be the underlying reason for lots of medical conditions (rheumatoid arthritis, inflammatory bowel disease, heart disease, etc.) so this could explain why CBD seems to work for so many different symptoms. As Moises Velazques-Manoff discusses in his recent NY Times article: Can CBD really do all that? there is evidence that CBD works on multiple different pathways in the brain and may act as a conductor (similar to a symphony conductor) by coordinating these different pathways.

Is it effective?

CBD has been well studied in 2 serious and rare forms of epilepsy that are seen in children, Lennox-Gaustaut syndrome and Dravet syndrome. In 2018, CBD was FDA approved for treatment of these 2 diseases in the US in the form of a drug called Epidiolex. 

There are also 2 FDA-approved drugs, dronabinol and nabilone, that contain a man-made form of THC. These drugs are approved to treat people with nausea caused by chemotherapy and to increase appetite in people with extreme weight loss caused by AIDS.

These FDA approvals are based on research studies looking at the effects of the drugs on specific conditions. More research is in progress but for now, CBD and THC have not been well studied in other conditions.

Why is it so popular?

Many people like that fact that CBD is easy to get (no prescription) and seems “natural”. It has the same appeal as other nutritional supplements that you can buy over-the-counter. Some people may also like the fact that it is related to marijuana.

The challenge is that those who take it, want to believe that it works and this can make it seem like it works better than it really does. This is referred to as the placebo effect. One of the reasons there is often a control group in research studies – people who receive a sugar pill instead of the drug being tested – is that there will always be people who get better even without treatment. The placebo effect is not a bad thing – it just reinforces the fact that the brain has a powerful influence over the body. And, if symptoms go away, that is great.

What’s the bottom line?

CBD may or may not work for most conditions but so far, it does not seem to be harmful. And it is probably best to buy it from a reputable source. Consumer Reports has published an in-depth guide to shopping for CBD that gives advice about how to read labels and how to choose a supplier (hint: Colorado has the most experience growing hemp for CBD products).