Information, claims, and debates about CBD oil have infiltrated the internet over the past decade and the tide continues to rise. Consumers are confused, and practitioners are pressured to take a position on the claims and concerns surrounding this compound. Is it safe? How is it different from marijuana? Is it psychoactive? Will it fuel drug addictions? Are there ethical concerns? Is it a medical breakthrough? Is it legal? Before making a logical decision regarding which side of the fence to land on, a basic understanding of CBD oil, its claims and its concerns, are in line. “Just the facts, ma’am” is what we will explore here.

What is CBD Oil?

CBD is cannabidiol – a cannabinoid compound extracted from the cannabis plant. Various Cannabis species supply over 100 cannabinoids but medicine has focused primarily on either tetrahydrocannabinol (THC) or cannabidiol (CBD).

Cannabis Sativa L. is a taller and more narrow species, relatively low in THC (approximately 0.3%) but rich in CBD, which is harvested from the seeds and stalk fibers. This species is traditionally known as hemp.

Cannabis Indica is short and densely populated with broad leaves. This species is often referred to as marijuana since it contains up to 30% of the psychoactive cannabinoid, THC, which can be harvested from its flowering tops. Cannabis Indica contains very little CBD, which is considered to be an antagonist to the psychotropic effects of THC.

What are the Claims?

Interest in cannabinoids has surged in the last 20 years for their pharmacological effects on the neurological system and especially, as possible modulators of pain, inflammation, addiction, mood and psychosis, mental health disorders, and most recently, cancer.

Both CBD and THC act upon the endocannabinoid system of the human body, which is a signaling system laced throughout the central and peripheral nervous system. As a fairly new discovery, the complex nature of this system is still being researched; however, we know there are two primary receptor types, CB1 (located in the brain and peripheral tissue) and CB2 (located in the immune and hematopoietic systems), and two primary endogenous ligands, N-arachidonoylethanolamine (anandamide) and 2-arachidonoylglycerol (2-AG). Phytocannabinoids such as THC and CBD exert their effects when they bind to the endocannabinoid receptors. Activated CB1 receptors are responsible for the psychotropic effects of THC, while activated CB2 receptors are linked to the health-promoting benefits of CBD, including pain management.

One of the larger areas of focus in cannabinoid research is as an analgesic, especially for chronic, neuropathic pain. In fact, “several CB2 agonists reached clinical Phase II for pain management and inflammation.” A systematic review of 13 randomized placebo-controlled trials involving cannabinoids for the treatment of chronic nonmalignant pain found cannabis-based medicinal extracts provide effective analgesia in various conditions. The mechanism behind the analgesic effect is not yet confirmed but, proposed hypotheses include: “effect on inflammatory cells, reduction of basal NGF tone, induction of beta-endorphin release from keratinocytes, direct action on nociceptors. Evidence in support of this last hypothesis comes from down regulation of capsaicin-induced CGRP release in spinal cord slices and Dorsal Root Ganglia (DRG) neurons in culture after treatment with CB2 selective agonists.”

CBD has also been studied as an antagonist for the psychotic effects of THC. This research has laid a foundation for studying the effectiveness of CBD in other psychotic and mental health conditions including schizophrenia. A systematic review of the antipsychotic effects of CBD in human subjects showed “the ability of CBD to counteract psychotic symptoms and cognitive impairment associated with cannabis use as well as with acute THC administration.” Further, it confirmed “the potential of CBD as an effective, safe and well-tolerated antipsychotic compound.” Another study “evaluated if repeated treatment with CBD (30 and 60 mg/kg) would attenuate the behavioral and glial changes observed in an animal model of schizophrenia based on the NMDA receptor hypofunction” and found “both the behavioral disruptions and the changes in expression of glial markers induced by treatment were attenuated by repeated treatment with CBD.”

CBD has been cited as an effective therapy in the management of various inflammatory conditions. In a review of various rat models, it has been found that CBD “reduces joint inflammation in collagen-induced arthritis (CIA) in mice and carrageenan paw edema in rats. CBD treatment also suppressed release of tumor necrosis factor (TNF)α from synovial cells isolated from the mice.” Furthermore, CBD inhibits iNOS in a beta-amyloid-induced murine model of neuroinflammation, reduces intestinal inflammation, and attenuates inflammation induced by high glucose in diabetic mice. More recently, transdermal application of CBD has been shown to be effective for inflammatory conditions since CBD is hydrophobic and has poor oral bioavailability.

CBD seems to offer hope for managing pain and inflammation that is resistant to other therapies. From neuropathic pain associated with multiple sclerosis, cancer, and diabetes, to chronic pain associated with inflammatory conditions, CBD offers a solution. However, it is important to also be informed about the controversies that swirl around the use of CBD because of its close relative, THC (widely known as “medical marijuana”), which also seems to offer some clinical benefits and especially when combined with its antagonist, CBD.

By Nicole Spear, MS, CNS