CBD 101
What is CBD?
Cannabidiol (CBD) is a naturally occurring compound found in the resinous flower of cannabis, a plant with a rich history as a medicine going back thousands of years. Today the therapeutic properties of CBD are being tested and confirmed by scientists and doctors around the world. A safe, non-addictive substance, CBD is one of more than a hundred “phytocannabinoids,” which are unique to cannabis and endow the plant with its robust therapeutic profile.
CBD is closely related to another important medicinally active phytocannabinoid: tetrahydrocannabinol (THC), the compound that causes the high that cannabis is famous for. These are the two components of cannabis that have been most studied by scientists. Both CBD and THC have significant therapeutic attributes. But unlike THC, CBD does not make a person feel “stoned” or intoxicated. That’s because CBD and THC act in different ways on different receptors in the brain and body. CBD can actually lessen or neutralize the psychoactive effects of THC, depending on how much of each compound is consumed. Many people want the health benefits of cannabis without the high – or with less of a high. The fact that CBD is therapeutically potent as well as non-intoxicating, and easy to take as a CBD oil, makes it an appealing treatment option for those who are cautious about trying cannabis for the first time.
CBD Benefits
- Reduced Risk of Diabetes and Obesity
Several studies have shown that regular cannabis users have a lower body mass index, smaller waist circumferences, and reduced risk of diabetes and obesity. One 2011 report published in the American Journal of Epidemiology, based on a survey of more than fifty-two thousand participants, concluded that rates of obesity are about one-third lower among cannabis users. This is despite the findings that participants tend to consume more calories per day, an activity that is potentially related to THC’s stimulation of ghrelin, a hormone that increases appetite but also increases the metabolism of carbohydrates. CBD on its own was shown in 2006 to lower the incidence of diabetes in lab rats, and in 2015 an Israeli-American biopharmaceutical collective began stage 2 trials related to using CBD to treat diabetes. Research has demonstrated that CBD benefits weight loss by helping the body convert white fat into weight-reducing brown fat, promoting no atherogenesis normal insulin production and sugar metabolism.
Better Cholesterol Profiles and Lowered Risk of Cardiovascular Disease
A 2013 study that measured data from 4,652 participants on the effect of cannabis on metabolic systems compared non-users to current and former users. It found that current users had higher blood levels of high-density lipoprotein (HDL-C) or “good cholesterol.” The same year, an analysis of over seven hundred members of Canada’s Inuit community found that, on average, regular cannabis users had increased levels of HDL-C and slightly lower levels of LDL-C (“bad cholesterol”).
Reduced Risk of Cancer
Could cannabidiol help prevent tumors and other cancers before they grow? A 2012 study showed that animals treated with CBD were significantly less likely to develop colon cancer after being induced with carcinogens in a laboratory. Several studies had already shown that THC prevents tumors and reduces them, including one in 1996 on animal models that found that it decreased the incidence of both benign and hepatic adenoma tumors. In 2015, scientists analyzed the medical records of over eighty-four thousand male patients in California and found that those who used cannabis, but not tobacco, had a rate of bladder cancer that was 45 percent below the norm. Topical products can be used to treat and prevent skin cancers. Continuing research is focused on the best ratio of CBD to THC and the most effective dose level in cancer prevention and treatment.
Helps Maintain Brain Health and Create Resilience to Trauma and Degeneration
Cannabinoids are neuroprotective, meaning that they help maintain and regulate brain health. The effects appear to be related to several actions they have on the brain, including the removal of damaged cells and the improved efficiency of mitochondria. CBD and other antioxidant compounds in cannabis also work to reduce glutamate toxicity. Extra glutamate, which stimulates nerves in the brain to fire, causes cells to become over-stimulated, ultimately leading to cell damage or death. Thus, cannabinoids help protect brain cells from damage, keeping the organ healthy and functioning properly. CBD has also been shown to have an anti-inflammatory effect on the brain.
As the brain ages, the creation of new neurons slows down significantly. In order to maintain brain health and prevent degenerative diseases, new cells need to be continuously created. A 2008 study showed that low doses of CBD- and THC-like cannabinoids encouraged the creation of new nerve cells in animal models, even in aging brains. CBD also benefits the brain by helping to prevent other nerve-related diseases like neuropathy and Alzheimer’s disease.
- Protects against Bone Disease and Broken Bones
Cannabinoids are facilitative of the process of bone metabolism—the cycle in which old bone material is replaced by new at a rate of about 10 percent per year, crucial to maintaining strong, healthy bones over time. CBD in particular has been shown to block an enzyme that destroys bone-building compounds in the body, reducing the risk of age-related bone diseases like osteoporosis and osteoarthritis. In both of those diseases, the body is no longer creating new bone and cartilage cells. CBD helps spur the process of new bone-cell formation, which is why it has been found to speed the healing of broken bones and, due to a stronger fracture callus, decrease the likelihood of re-fracturing the bone (bones are 35–50 percent stronger than those of non-treated subjects).
- Protects and Heals the Skin
The skin has the highest amount and concentration of CB2 receptors in the body. When applied topically as an infused lotion, serum, oil, or salve, the antioxidant (a more powerful antioxidant than vitamins E and C) in CBD oil has many benefits and can repair damage from free radicals like UV rays and environmental pollutants. Cannabinoid receptors can be found in the skin and seem to be connected to the regulation of oil production in the sebaceous glands. Cannabis-based topical products are being developed to treat related issues from acne to psoriasis and can promote faster healing of damaged skin. In fact, historical documents show that cannabis preparations have been used for wound healing in both animals and people in a range of cultures spanning the globe and going back thousands of years. The use of concentrated cannabis and CBD oils to benefit and treat skin cancer is gaining popularity with a number of well-documented cases of people curing both melanoma and carcinoma-type skin cancers with the topical application of CBD and THC products. Best known is the case of Rick Simpson, who cured his basal cell carcinoma with cannabis oil and now has a widely distributed line of products. Cannabis applied topically is not psychoactive.
- Anti-inflammatory Benefits of CBD
Cannabinoids have been proven to have an anti-inflammatory effect in numerous studies. CBD engages with the endocannabinoid system in many organs throughout the body, helping to reduce inflammation systemically. The therapeutic potential is impressively wide-ranging, as inflammation is involved in a broad spectrum of diseases.
- Anxiety and Stress
The oral use of cannabis and CBD for anxiety appears in a Vedic text dated around 2000 BCE, and it is one of the most common uses of the plant across various cultures. While THC can increase anxiety in some patients, it lowers it in others. However, CBD effects have been shown to consistently reduce anxiety when present in higher concentrations in the cannabis plant. On its own, CBD has been shown in a number of animal and human studies to lessen anxiety. The stress-reducing effect appears to be related to activity in both the limbic and paralimbic brain areas.
A 2012 research review assessed a number of international studies and concluded that CBD has been shown to reduce anxiety, and in particular social anxiety, in multiple studies and called for more clinical trials. Two years later, researchers in an animal study related to stress and the endocannabinoid system wrote that augmentation of the endocannabinoid system might be an effective strategy to mitigate behavioral and physical consequences of stress. In addition to elucidating the relationship between CBD and anxiety, these findings appear to support that the anxiolytic effect of chronic CBD administration in stressed mice depends on its pro neurogenic action in the adult hippocampus by facilitating endocannabinoid-mediated signaling.
- Depression and Mood Disorders
Clinical depression is a serious mood disorder characterized by persistent sadness and loss of interest, sometimes leading to decreased appetite and energy and suicidal thoughts. Commonly used pharmaceuticals for depression often target serotonin, a chemical messenger that is believed to act as a mood stabilizer. The neural network of the endocannabinoid system works similarly to the way that serotonin, dopamine, and other systems do, and, according to some research, cannabinoids have an effect on serotonin levels. Whereas a low dose of THC increases serotonin, high doses cause a decrease that could worsen the condition. In 2009 researchers concluded that there was substantial evidence pointing to endocannabinoid signaling as a target for the pharmacotherapy of depression. Authors of a 2016 study wrote that “CBD could represent a novel fast antidepressant drug, via enhancing both serotonergic and glutamate cortical signaling through a 5-HT1A receptor-dependent mechanism.”
CBD might especially be effective for depression related to chronic stress, which has been shown to cause a decrease in endocannabinoid levels.
- Pain
Of all the reasons that people use CBD today, pain is the most common. The same can be said of cannabis in general. In the United States, over seventy million people suffer from chronic pain, which is defined as experiencing over one hundred days per year of pain. Physicians differentiate between neuropathic (usually chronic) and nociceptive pains (usually time-limited), and cannabis works on most neuropathic and many nociceptive types of pain. A number of studies have demonstrated that the endocannabinoid system is both centrally and peripherally involved in the processing of pain signals. Most discussions of using CBD for pain treatment suggest that finding the right dosage is critical. Cannabinoids can be used along with opioid medications, and a number of studies have demonstrated that they can reduce the amount of opioids needed, lessen the buildup of tolerance, and reduce the severity of withdrawal. At least ten randomized, controlled trials on over one thousand patients have demonstrated efficacy of cannabinoids for neuropathic pain of various origins.
- Sleep Disorders (Insomnia, Sleep Apnea)
Cannabis and sleep have a complex relationship that is only beginning to be understood by science. In general, for most people, indica strains are more relaxing and effective for sleep disorders, whereas sativa strains are more stimulating and tend to keep people awake.
Several studies conducted between 2004 and 2008 demonstrated the variable effect of different cannabinoids on sleep. In one, 15 mg of THC appeared to have sedative properties, while 15 mg of CBD appeared to have alerting properties. Another tested the effects of CBD on animal models in both lights-on and lights-off environments and found that this non-psychoactive cannabis compound increased alertness with the lights on and had no discernable effects on lights-off sleep. The study’s authors concluded that CBD might actually hold therapeutic promise for those with somnolence, or excessive daytime sleepiness from a not-so-good night’s rest. Another study found CBD to be wake-inducing for most subjects, though some reported better sleep a few hours after taking it. “Many of my patients report either better energy or sleepiness on the same high-CBD/low-THC plants,” Dr. Michael Moskowitz reported. “Most, however, feel more energy on high-CBD cannabis.” In general, indica varieties of THC appear to work best as a sleep aid for most people. However, a significant number of people find THC, even indica strains, will make the mind more active. For these people, CBD oil can benefit them and tends to work well, providing the relaxation and calm for the mental as well as the physical body. For these people, CBD taken at nighttime as part of a bedtime regime produces a restful sleep, not the alertness produced in the daytime. This bidirectional effect of CBD is the result of balancing the endocannabinoid system. In relation to sleep apnea, a 2002 animal study observed the ability of THC to restore respiratory stability by modulating serotonin signaling and reducing spontaneous sleep-disordered breathing. In 2013 a trial using the pharmaceutical drug dronabinol, a synthetic THC mimic, noted improvements in fifteen out of seventeen study participants following twenty-one days of treatment.
How to Take CBD: Dosage and Delivery
It is suggested that patients work with a health care practitioner experienced in recommending CBD or medicinal cannabis so that dosage and delivery methods can be developed and fine-tuned on an individual basis. At the same time, educated and aware patients can be their own highly informed health consultants.
As mentioned previously, while CBD-dominant products help some people sleep, in others it promotes wakefulness. Orally administered THC, especially products from heavier “Kush” strains and Purple cannabis varieties, are very effective for sleep disorders. These tend to be high in myrcene and linalool, a terpene shared with lavender and known to be effective for relaxation. Cannabis combinations with ratios of 1:1, 4:1, or 24:1 CBD:THC can be used when patients want to reduce psychoactivity. Oral consumption is recommended as it usually lasts the whole night. Always start with the micro dose to test sensitivity and go up as needed within the dosing range before going to the next, until symptoms subside. The micro to standard dose is usually recommended to treat insomnia and sleep apnea. When relaxing indica strains are used with higher THC levels, a dose of 5–10 mg is usually sufficient. Other people find they need larger doses, such as 15–40 mg. CBD taken as a tincture or edible will aid in a restful six to seven hours of sleep. This type of disorder varies widely from one patient to the next. Often, one needs to perform some experimental research and try strains of different CBD:THC ratios to figure out how CBD oil benefits their sleep and the best protocol. For immediate medicinal effects, vaporizing or smoking work well. This can be helpful for either initial sleep onset or for wakefulness in the middle of a rest period but only lasts one to three hours. The medication effect is immediate, whereas most ingested products take thirty to sixty minutes before taking effect (faster on an empty stomach) and last six to eight hours. Vaporizers that use a cartridge filled with the CO2 concentrate are convenient and highly effective, and these are available in various ratios of CBD to THC. Herbal vaporizers that use the whole plant are also an effective delivery method. Sublingual sprays or tinctures taken as liquid drops also take effect quickly and last longer than inhaled products.