Cannabidiol, or CBD, is a compound derived from the hemp plant, a member of the cannabis family. Unlike tetrahydrocannabinol (THC), the well-known psychoactive compound in marijuana that produces an intoxicating psychoactive effect, CBD provides therapeutic benefits without a high. These properties are the reason that CBD has become so popular.
Highlighted below is an overview of the history of cannabis, as well as an overview of the science behind its properties, and how it can be incorporated into your wellness routine.
History of Cannabis
The discovery of the health benefits of CBD stemmed from the cultivation of hemp. Hemp is valued for its highly nutritious and abundant seeds, as well as its fibers that can be used to make paper and clothes. Evidence suggests that hemp may have been cultivated on the island of Taiwan as far back as 8,000 BCE.1
Apart from its functional uses, three distinct species and seven subspecies of cannabis have been used as medicine throughout the ancient world from Europe and the Middle East to China.
It didn’t take early herbalists long to recognize the benefits of this fascinating family of plants. The Chinese word for cannabis is “DaMa” which loosely translates to “great spice that causes numbness.” The modern Chinese term for anesthesia, “MaZui,” is a derivative of “DaMa” and translates to “intoxication by cannabis”—a testament to the central role this herb has played for thousands of years in traditional Chinese medicine (TCM).2
Today, cannabis is at the center of an exciting wave of scientific discovery. Research on the natural compounds found in cannabis has led to a greater understanding of the inner workings of the human body.
Until recently, little was known about the endocannabinoid system, which has essential functions in the central nervous system, gastrointestinal tract, endocrine system, immune system, and all major organs with the primary function of maintaining homeostasis.3
The discovery of cannabinoid (CBN) in the 1930s, CBD in 1940, and THC in 1964 and the information researchers learned from studying them allowed Dr. Ralph Mechoulam and his colleagues to isolate two major endocannabinoids that are naturally produced by the body: anandamide and 2-arachidonoylglycerol in the early and mid-1990s.4
The discovery of the endocannabinoid system (ECS) allowed for a greater understanding of the mechanisms of cannabinoids, as well as insight into the role that the endocannabinoid system plays in overall health.
To better understand the therapeutic benefits of CBD, it is first important to understand the purpose and functions of the endocannabinoid system, as well as the mechanisms by which CBD interacts with this system to produce wide-ranging effects.
What Is the Endocannabinoid System?
As mentioned previously, the ECS has essential functions in regulating many organ systems which ultimately contributes to maintaining homeostasis, or stability in the internal environment of the body. The ECS is composed of three primary components: endocannabinoids, receptors, and enzymes.5
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Endocannabinoids are molecules made by the body as needed that bind to receptors in the ECS to help it execute its primary functions. The two key endocannabinoids that have been identified thus far are anandamide (AEA) and 2-arachidonoylglyerol (2-AG).
There are two primary types of receptors in the ECS to which these endocannabinoids can bind: CB1 and CB2.
CB2 receptors are found throughout the peripheral nervous system, especially in immune cells and the gastrointestinal tract. When the body experiences inflammation, CB2 receptors work to restore homeostasis. CB2 receptors are also found in the skin, so an individual experiencing ECS dysfunction may show symptoms like psoriasis or eczema.
Once the endocannabinoids have carried out their functions through interactions with CB1 and CB2 receptors, enzymes break them down. The two main enzymes that carry out this process are fatty acid amide hydrolase, which breaks down AEA, and monoacylglycerol acid lipase, which breaks down 2-AG.7
Cannabinoids and the Endocannabinoid System
Cannabinoids are the active compounds in cannabis. From this large family, the two best-known cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). Though structurally similar, these compounds interact with the ECS in very different ways, leading to different effects.
THC is the cannabinoid well-known for its intoxicating psychoactive effects, which produce feelings of deep relaxation and euphoria.
THC causes this distinct reaction through the way it activates CB1/CB2 receptors. THC is a CB1/CB2 receptor partial agonist, meaning it binds to these receptors and mimics the effects of endogenous cannabinoids to a slightly lesser extent.
THC also has a high binding affinity for these receptors, meaning it can spend more time at the binding site, resulting in prolonged effects. THC binding to CB1/CB2 receptors activates neurons in the brain that affect mood, appetite, and pain. 8
CBD reacts differently with ECS receptors and therefore produces a different physiological response than THC. Since CBD is not an intoxicating psychoactive active compound, like THC, it provides therapeutic benefits without a “high.”
The mechanisms for how CBD achieves therapeutic effects are still being explored; however, there is a range of potential mechanisms that have been supported by several studies.
First, it is important to note that, unlike THC, CBD is not an agonist for CB1/CB2 receptors and has a low binding affinity for these receptors. In fact, CBD antagonizes the actions of CB1/CB2 receptor agonists meaning that in counteracts the actions that CB1/CB2 receptor agonists would have.9
Another well-studied way mechanism for CBD’s actions in the body is that it has been shown to inhibit FAAH, which, as mentioned previously, typically breaks down the endocannabinoid anandamide. This allows for increased anandamide levels and, therefore, more prolonged activation of CB1/CB2 receptors.
In other words, CBD works to modulate other activities that affect the function of CB1 and CB2 receptors. This activation of CB1 and CB2 receptors allows for wide-ranging benefits like better mood, reduced pain, and improved immune system function.10
Scientifically-Demonstrated Benefits of CBD
The modulating effects of CBD on CB1 and CB2 receptors have been linked to a range of health benefits. Highlighted below are some of the most noteworthy benefits of CBD backed by clinical studies.
Relieves Stress and Anxiety
While stress is completely normal, many individuals suffer from prolonged episodes of stress that keep the body in a perpetual state of panic. Constant stress can negatively affect the body physiologically and psychologically. For instance, constant stress weakens the immune system and can evolve into mental health conditions.
One of the most notable ways that CBD works to reduce stress is by maintaining higher anandamide levels, which among many other functions is known as the “joy” molecule. This compound is only produced in the body when it is needed and is typically quickly broken down by the enzyme FAAH. CBD provides mood-boosting action by inhibiting FAAH and therefore allowing for more prolonged anandamide action.11
Another study focused on the effects of CBD on remedying anxiety symptoms using the Vogel Conflict Test. This test determines the anxiolytic—anxiety-reducing—effects of a substance. In this test, a subject is provided either water or food and every time they receive it, they are mildly punished. The more the subject eats or drinks during the tests, the better their capacity to deal with stress, and the more anxiolytic the substance. The results of the test demonstrated that CBD can reduce anxiety symptoms.12
CBD offers a potentially effective alternative or complement to synthetic pain medications and has demonstrated no side effects after prolonged use. CBD has even been found effective against difficult-to-treat pain.13
The body experiences pain as a result of chemical processes in the brain that occur in response to nerve signals from the body. In the brain, the anterior cingulate cortex plays an important role in processing this information and managing the experience of pain because of the relationship between pain and emotional processing. CBD has been found to modulate the activity of the anterior cingulate cortex, and therefore potentially modulating pain relief.14
One study looked at CBD’s ability to manage clinical pain in rat models. The subjects studied had mechanical allodynia, where pain occurs from even the slightest touch, which was intended to mirror surgical incisions. The researchers injected different doses of CBD intraperitoneally to determine the effects of CBD on pain.
The study demonstrated that CBD influences several dimensions of the rats’ response to surgical incisions and established that CBD exerts pain-relieving effects through interaction with the anterior cingulate cortex. Additionally, the study showed that CBD may differentially affect sensorial versus affective perceptions of pain. 15
Relieves Arthritis Symptoms
In rheumatoid arthritis, the immune system targets healthy tissues while pathogens aggravate the joints and tissues with severe inflammation. Someone suffering from this condition may have swollen joints that lack mobility. This can become painful as the lining of the joints deteriorates and cartilage and bone tissues soon follow.16
Both environmental and genetic factors can contribute to this condition. In addition to mild or severe discomfort of the joints, rheumatoid arthritis can also result in persistent fatigue, insomnia caused by pain, and muscle weakness.
CBD is an effective remedy for some of these symptoms for a few reasons. First, the anti-nociceptive (pain-blocking) properties of CBD are especially well-suited to the type of pain characteristic of arthritis. Furthermore, CBD oil contains anti-inflammatories that can help soothe swollen joints.
Several studies have been conducted to ascertain the efficacy of CBD in remedying arthritis symptoms under controlled conditions.
One such study looked at the effects of topical CBD application in rats with osteoarthritis. The results demonstrated that topical CBD application minimized arthritis pain. Additionally, the study demonstrated that prophylactic CBD application could prevent later pain or nerve damage. 17
Regulates Epilepsy and Seizures
Epilepsy is a term used to describe a variety of conditions characterized by seizures. An epileptic seizure can be mild or severe enough to be life-threatening.
CBD and cannabinoids have shown promise in controlling seizures and preventing neurodegeneration.
Reports from a parent survey showed that CBD-enriched cannabis may be a promising treatment for pediatric treatment-resistant epilepsy. Of the 19 cases examined, 13 children were diagnosed with Dravet Syndrome, four with Doose Syndrome, and one with Lennox-Gestaut syndrome.
By the end of the survey, 16 of the 19 exhibited a significant reduction in seizure occurrence while on cannabinoid treatments. Eight out of 19 reported the seizures had been reduced by 80% and 6 reported 25 to 60% seizure reduction. Two of the cases reported that their children were seizure-free after the treatments.
Other positive effects reported in the study included improved mood, better sleep, and heightened alertness.18
In a press release dated June 25, 2018, the U.S. Food and Drug Administration approved the first drug derived from the Cannabis sativa plant: epidiolex.19
Epidiolex is an oral solution of cannabidiol (CBD) that is approved for the treatment of certain types of epilepsy. It’s the first FDA-approved drug for the treatment of seizures in Dravet and Lennox-Gastaut Syndromes.
In clinical trials leading up to the approval of this drug, a total of 689 people with Dravet and Lennox-Gastaut Syndromes (LSG) were treated with epidiolex, a plant-based CBD extract. During their treatment, patients continued to take their other seizure medications.
Researchers found a significant reduction in drop-seizure frequency in both treatment groups when compared with the placebo.20
Though more clinical trials are needed to determine what effect CBD has on individuals with seizure conditions, other preliminary studies have found similarly promising results as the epidiolex clinical trials.21
Inflammation is a natural and beneficial part of good health. However, when inflammatory conditions persist, they can counterproductive to the healing process and even increase pain.
To better understand how CBD works as an anti-inflammatory, let’s take a brief look at the purpose of inflammation.
Inflammation serves two main functions: healing and protection against disease and infection. When inflammation sets in, the body becomes aware that something is not functioning as it should be. In this sense, inflammation is like the distress signal that throws the immune cells into action where needed.22
As immune cells arrive, cytokines are also released to the area. Cytokines are communication cells and can modulate the behavior of cells in the vicinity. They cause burning, redness, and swelling during an inflammatory response.23
Ideally, after the threat has been eliminated, the inflammation will subside as the healing process begins. However, if this process goes awry, inflammation may never fully subside which can hamper the healing process and produce pain and discomfort.
When it comes to relieving inflammation, CBD offers a few benefits. First, the modulation of CB1 receptors assists in relieving pain. Additionally, CBD interferes with the activity of the cytokines, thereby reducing some inflammation. This phenomenon was observed in a preclinical study on mice with spinal cord injuries.24
Another study in mouse models of acute pancreatitis further elucidated CBD’s role in reducing inflammation. This study also demonstrated that CBD improved the expression of g-protein-coupled receptor 55 (GPR55)—a novel cannabinoid receptor—in the pancreas.25
Enhances Sleep Quality
Lack of good quality sleep can compromise physical and psychological health.28 Restful sleep is most commonly disrupted by stress.
CBD may offer stress relief by increasing anandamide levels in the body, which is a neurotransmitter associated with feelings of joy. CBD also interacts with serotonin receptors, which may improve mood. By reducing stress and boosting mood, CBD reduces one of the greatest obstacles to getting good sleep.26, 27
Chronic pain and discomfort can prevent a good night’s sleep. As discussed previously, CBD has been shown to relieve pain, which may make it is easier to fall and stay asleep.
While high-dose CBD has a sedative effect, a low dose of CBD has a very different effect in that it has been associated with increased wakefulness. Increased wakefulness during the day may help improve the quality of sleep at night and establish healthy parameters for the daily sleep-wake cycle.28
CBD Oil Production Process
One of the most common CBD products is CBD oil. This oil is typically produced from hemp plants that are selected and cultivated because of their high CBD content. Additionally, these plants typically contain very little or no THC, meaning they can provide therapeutic benefits without a “high.”
All members of the cannabis family are dioecious, meaning there are male and female plants, each with their own characteristics. Female plants produce the buds or flowers of the cannabis plants that contain trichomes across their resinous surface.
The resin in these trichomes contains 95% of the plant’s cannabinoids. The stem, leaves, and seeds of the plant may contain trace amounts of cannabinoids, but not enough for them to be suitable sources of CBD. Hemp seeds are highly nutritious, however, containing essential amino acids, protein, omega-6, and other nutrients.29
Once the CBD-rich plant parts have been harvested, there are several ways to extract the CBD. Each extraction method has its advantages and disadvantages that are important to be aware of.
It is especially important to avoid products that use toxic substances like hexane or butane as solvents. These products may contain residues with harmful health benefits. Some CBD extraction methods that are considered safer are outlined below.
This extraction method uses high-pressure carbon dioxide at very low temperatures. The process allows the most beneficial elements of the oil to be isolated and preserved for future consumption. This is the most expensive and thorough process. Therefore, CBD oil made from CO2 extraction are high-priced but also the purest products available.30
Grain alcohol can also be used for CBD oil extraction, but this method also damages some of the constituents that contribute to the benefits of the oil. However, grain alcohol extraction is inexpensive and can be achieved quickly.
For this extraction method, grain alcohol is boiled in a flask. As a gas, the alcohol rises through a cooling condenser. Then, the alcohol condenses and drips through the hemp material. The cannabinoids dissolve in the alcohol and make their way to a collecting flask while hemp leaves and other insoluble material remain in the collection system.31
This may be a surprise for many, but olive oil can be used to extract CBD because it can dissolve and absorb the cannabinoids from the plant. This is the safest method of extracting CBD.
First, the leaves are crushed and ground to allow for more contact with the olive oil. The powder is then added to boiling olive oil. The mixture is allowed to simmer and cool down. Then, the extract can be filtered out.32
While this method is safe and inexpensive, olive oil is not as strong a solvent as grain alcohol. Therefore, the resulting extract contains lower cannabinoid concentrations. Additionally, CBD-infused olive oil cannot be exposed to sunlight.
Types of CBD Products
The following section presents a closer look at the range of CBD products that is currently available. Additionally, it offers important pointers for navigating the market to ensure that you find a quality product that best suits your needs.
CBD isolates, also called crystals, contain almost 99% pure CBD are therefore thought to provide the most potent health benefits. These isolates can be vaporized, crafted into a tincture, or cooked into edibles. However, placing CBD isolates under the tongue is most effective as this avoids metabolism by the liver, and therefore increases CBD bioavailability.33
CBD Topicals and Salves
CB1 and CB2 receptors are abundantly found in the skin. CBD topicals have been shown to be highly effective for reducing local inflammation and pain caused by arthritis symptoms, old injuries, or strained muscles.
In addition to creams and salves, there are also soaps, shampoos, and an entire array of natural skincare products that offer the topical benefits of CBD.24
CBD wax is designed to be “dabbed” in a dab rig and vaporized. When CBD wax is applied to a hot surface, it vaporizes. The user then breathes in the CBD vapor.25
The advantages of this method include an especially rapid delivery method and a reduced learning curve in finding the best CBD concentration for personal needs.
CBD edibles exist in just about any form you can imagine. In fact, there are even bistros and specialty bakeries that offer CBD-infused treats and meals. These can also be ordered online in the form of brownies, cookies, gummies, chocolates, butter, and potato chips.26
CBD Pills, Capsules, and Tinctures
CBD can also be found in pill or capsule form and offers a discreet option for supplementation. Because CBD is fat-soluble, these should be taken with a meal. Tinctures offer a sublingual delivery system that won’t be metabolized as quickly as pills or capsules.
Important Considerations for CBD Products
Since the laws that restricted the use of cannabis have been adjusted more states are legalizing this product. The demand for cannabinoid-infused products is increasing each day. On the one hand, an age-old treatment for many maladies is finally available on a grand scale.
However, the sudden influx of products has also produced a wide range of products designed to exploit an unassuming market with inferior products. To accrue a larger customer pool, these merchants ride the wave of hype.
Many of these products can be identified by the inflated claims they make about the benefits attributed to CBD and cannabinoids in general. You will find age-defying CBD face creams and tinctures to summon the love of your life. Most of these claims lie far beyond the scope of clinical observations.
To ensure you avoid these vendors on your way to effective treatment, follow the pointers below when selecting your products. Also, don’t miss the section on the legalities of CBD treatment featuring guidelines for staying on this side of the law.
Choose High Quality Over Low Prices
Modern technology has ushered in a golden age of consumerism. Today, just about every need is a click or two away. This has increased the competition among suppliers, and everyone is vying for the most economic routes to their profits. What does this mean for the health enthusiast looking for effective products?
It could mean that companies with inferior products may be spending the most on marketing and filling up all the top spaces in the Google search results. If you were to Google “buy CBD products,” you will also find options that claim to regenerate scar tissue, fix ingrown toenails, and a host of other outlandish benefits –– these are sometimes fairly priced as well.
The solution begins with knowing exactly what you are looking for. Discussing your needs and expectations with a qualified health professional can shed some light on this topic. After that, look for products with high-quality production, reputable raw materials, and high-concentrations of CBD. Lower concentrations indicate the presence of foreign substances which could diminish efficacy at best and at worst carry toxins.
To create a quality product that extracts CBD without trace elements of other organic compounds requires cutting-edge technology and very costly equipment. Because CBD is not regulated by any significant organization, efficacy will always be somewhat doubtful. This is why cost should not be the deciding factor when selecting your CBD products.
Study Product Labels
A search into CBD oils will result in a wide range of products, some of which may seem similar but are very different, even legally so. There are CBD oils, hemp seed oils, hemp CBD oils, cannabis CBD oils, and many more.
Knowing exactly what you are looking for will help you avoid the myriad of options and go directly to the products you need. Once again, don’t make decisions based on the benefits listed but the contents of the products themselves.
Make Sure Your Oil Is Non-Psychoactive
Remember that THC psychoactive but CBD is not. Both of these cannabinoids can be sourced from the same plant. It is essential that you select products that contain no THC if you hope to avoid psychoactive effects from your regular supplementation.
Furthermore, most of the legalities that restrict cannabis use are centered on these psychoactive properties. Products that contain only CBD are not as restricted as those with THC.
Legalities of CBD in the US
Because regulations for cannabis use are very different from state to state and even from week to week, it is easy to fall afoul of a misunderstanding as one Indiana resident discovered earlier this year.
Luckily for this man, the charges against him were dropped, but the potential for jail time and fine has led to some tension in the CBD markets. According to the DEA, CBD is not legal and offenders can be prosecuted and have their products confiscated.38
One of the most pertinent factors deciding the legality of a product today is whether the CBD was derived from hemp or from marijuana. Both come from the cannabis family and share many chemical constituents. Nevertheless, hemp grown for CBD products contains only 0.3 percent of the psychoactive THC cannabinoid. This ensures it has no psychoactive properties and is theoretically legal.39
Some states have restrictions requiring that CBD products are only derived from the stalk and stem of the hemp plant to further reduce any THC inclusions. One problem with this is that hemp plants are phytoremediators, meaning they clean toxins from the air and store them within their plant fibers, especially the stalk. There is a reason to believe these toxins could end up in the final product.
While the legal and medical community is certain that all restrictions on CBD use will likely be lifted, as yet, CBD users must practice caution and research the laws pertaining to their each state.
States Where CBD Is Legal for Recreational Use
As of January 2019, there are eight states in which cannabis and CBD are completely legal for recreational use, no matter its origin. Both marijuana and hemp-derived CBD products can be used for medicinal and recreational use in Alaska, California, Colorado, Maine, Massachusetts, Michigan, Nevada, Oregon, and Washington.40
If you live in any one of these states you are in the clear legally for all types of CBD products.
States Where CBD Is Legal for Medicinal Use
There are forty-six states that have adjusted laws to allow for medical use of CBD and cannabis products as of January 2019. Twenty-nine of these states so far have fully legalized medical CBD products derived from either hemp or marijuana plants:
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Dakota
- Rhode Island
- West Virginia
In addition to the states mentioned above, 17 other states have modified their restrictions to allow CBD medical treatments to be used. Even still, the specifics of the laws in these states are very different in regards to THC and CBD ratios. Taking the time to research how they apply to an individual condition and product can prevent legal troubles.
- North Carolina
- South Carolina
The laws in these states permit the use of medical CBD products, which means anyone looking to use them will need a condition that warrants this treatment as well as a prescription from a qualified medical professional.
Furthermore, states will have different stipulations regarding what warrants a legal amount of THC in any CBD product. This is typically below 0.3 percent, but some states will make allowances for products with up to 8 percent THC –– which is still not enough to induce a high.
States Where All CBD Use Is Illegal
Finally, there are four states where CBD use in any way, shape, or form is illegal. States, where CBD use is forbidden, include Idaho, Kansas, Nebraska, and South Dakota.
Even though restrictions are being lifted, the DEA still lists cannabis as a controlled substance and all use should be done with caution. Those looking to use CBD for health reasons should consider discussing their plans with a medical professional. This could also shed light on the legal options available.41
Side Effects and Risks of CBD Products
CBD has been declared “safe to use” for adults by the medical community. Adults seem capable of tolerating wide ranges of dosages with only isolated reports of negative side-effects. These CBD dosages are considered safe for adults:42
- 300 mg daily for up to six months.
- 1200 to 1500 mg daily for as long as four weeks.
- Sublingual administration of 2.5 mg for up to two weeks.
One important thing to consider is how different doses can be experienced differently by people of different sizes, weights, and metabolisms. Taking a slow, intuitive approach under the direction of an experienced medical professional is an advisable route for the best results. No significant negative side-effects affecting the central nervous system, the mood, or vital signs have been reported including from long-time heavy users.
The most common side effects that have been reported include tiredness. For others, appetite changes have led to bowel discomfort or weight gain. However, these issues are more closely related to diet rather than the effects of CBD.
There still have been no considerable risks associated with regular use of CBD. Nevertheless, pregnant and nursing mothers should always practice caution when adjusting their diets.
Some research suggests those suffering from Parkinson’s disease may see complications in their conditions after taking high-doses of CBD.
On a related note, research has been performed on the use of marijuana. Studies have suggested that marijuana use during pregnancy is linked to affected development of neurons in unborn children. Furthermore, long-term ingestion of cannabis has been associated with behavioral changes and memory problems.42
Medical science continues to learn more about the human body and how it functions through the interaction of cannabinoids with the endocannabinoids system. These insights have led to great advances, not only in the way individuals view health conditions but in the approach to treatments.
The capacity of CBD to address a wide range of conditions comes from its ability to improve the processes that lead to better health––a decidedly holistic approach. As perceptions about CBD continue to change, so do the realities built around them.
It is no stretch of the imagination to predict great revolutions in the field of medical science and practice. Indubitably, CBD will play a greater role in medical treatments as health experts and enthusiasts find new ways of cultivating good health as well as applying precise treatment.
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