From bath oils and soft drinks to skin creams and coffee bars, everywhere you look, you can see what looks like the next hot product: CBD oil.
CBD, or cannabidiol, oil is a member of the cannabinoid family of molecules found in marijuana and plants closely related to marijuana, such as hemp. Although CBD has been around since the 1940s, CBD’s popularity has dramatically increased along with the legalization of medical and recreational marijuana across the United States.
There are over 100 different cannabinoids found in marijuana and hemp plants. CBD and tetrahydrocannabinol (THC) are the most commonly studied cannabinoids. CBD oil is extracted from the buds and flowers of marijuana and related plants, such as hemp. But, unlike THC, which is psychoactive marijuana derivative oil, CBD does not produce a “high” or intoxicated feeling.
CBD does have medicinal benefits, however. Proponents of CBD claim that it can treat a variety of conditions including seizures, pain, anxiety, inflammation, insomnia, acne and other skin diseases, and even some forms of cancer.
Experts are not quite as enthusiastic because solid scientific research has not verified most of these claims, yet. That has not stopped marketers and producers. In addition to CBD-infused products popping up in bath and body stores and local coffee shops, many malls now have “CBD stores” dedicated to selling a variety of products containing CBD oil. You can even search “CBD oil” on Amazon.com and well over 1,000 products are displayed – all touted to treat a wide variety of health concerns.
Read on to learn more about the different types of cannabinoids and safety and effectiveness of CBD.
Three types of cannabinoids
These compounds, like CBD, are found in plants like marijuana and hemp.
These are found in the human body, discovered as a result of studying phytocannabinoids. They are derivatives of a chemical called arachidonic acid. Many tissues and organs contain receptors for endocannabinoids, which are released by human tissues in times of pain and inflammation. It is well-documented that receptors for endocannabinoids are located throughout the human body, including skin cells and the nervous system and brain.
The endocannabinoids in the skin can regulate cell growth which can be used in cancer treatments. The endocannabinoids in the nervous system and brain may affect thinking and understanding, memory, body movements, and pain control.
These are man-made cannabinoids used for research purposes and in some currently available products. They may eventually be employed in pharmacologic preparations and drug treatments used for cannabinoid-responsive conditions.
The rest of this column will focus on the phytocannabinoid, CBD.
Is CBD safe?
Unfortunately, most CBD is being produced without regulation. As a result, purity and quality can vary greatly.
In a recent study, 70 percent of products evaluated contained a different amount of CBD than listed on the label. Most products examined had less CBD, but some had more. Also, about 15 percent of CBD-containing products had measurable amounts of THC. This derivative can cause anxiety, just the very thing CBD is reported to calm, and THC should not be in CBD products.
Additionally, CBD is poorly absorbed. Only about 20 percent of CBD gets absorbed, so the quality and purity of CBD products are critical for their effectiveness.
Some studies have shown that CBD can have adverse effects on the liver. This seems to be the case in about five percent of all people. Other studies need to be done to see how CBD affects a person if the person consuming CBD is taking other medications. This is extremely important.
In general, there are relatively few side effects. So, the downside in using CBD-containing products is relatively low, but liver and other possible drug interactions must be considered.
Is CBD legal?
This is really a grey and ever-changing area. It appears to be legal in the 30+ states where marijuana is legal, but the overall national legal status has not been challenged yet, and the FDA has taken a very quiet and conservative stance.
Recently, a farm bill was proposed and is expected to pass that will make hemp-derived CBD legal. Keep in mind that just because something is legal does not mean that it is FDA-approved to treat anything or everything that is printed on the label.
Is CBD effective?
There are CBD receptors in our bodies. In the presence of bound CBD, our bodies can produce physiologic responses. In fact, CBD is FDA-approved to treat certain epileptic seizures in children.
There is emerging research that CBD may be useful in treating anxiety, and there are countless anecdotal reports that it helps muscle aches, joint pain, depression, psychiatric conditions, and insomnia. The number of human trials for other diseases is small but promising.
In fact, CBD’s use as an anti-inflammatory may be the next area for future FDA investigation and approval. As mentioned, many cells in our bodies have CBD receptors, so it stands to reason that CBD can have other physiologic effects in humans, such as on pain, inflammation, anxiety, and sleep.
Unfortunately, due to the murky legal status of CBD, research to uncover these physiologic responses has been sparse. As for other health claims, much more research, especially on humans rather than animals, needs to be done. Unfortunately, due to lack of regulation, manufacturers of products that contain CBD can print just about any health claim that they want on the product label, and buyers, desiring a relatively inexpensive, natural treatment, may just believe it.
As the new farm bill clears, legality issues over research should move forward at a much faster pace. Additionally, the best method of CBD delivery (oral, topical or inhaled) should be studied for the best treatment results.
Should I use CBD?
CBD is a promising product for a variety of challenging medical conditions, but more research needs to be done. If one is considering the use of CBD when other tried-and-true treatments are not working, don’t just buy something off the shelf because the label says it will help you.
I would strongly suggest using CBD-containing products with the guidance and care of a physician knowledgeable about and familiar with CBD-containing products. The future appears bright for CBD-containing products, but its ultimate success will depend on the production of high-quality products with safe, proven and approved results.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He received his M.D. and Master’s Degree in Molecular Biology and Genomics from the Mayo Clinic. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine. Dr. Crutchfield was recognized by Minnesota Medicine as one of the 100 Most Influential Healthcare Leaders in Minnesota. He is the team dermatologist for the Minnesota Twins, Vikings, Timberwolves, Wild and Lynx. Dr. Crutchfield is an active member of both the American and National Medical Associations, and president of the Minnesota Association of Black Physicians.