What if we told you that the cannabis and hemp extract can be found in everything from lattes to kids’ vitamins, but doctors are still trying to learn if it’s healthy.
In 2013, Charlotte Figi made national news by becoming the youngest patient in Colorado to receive cannabidiol (CBD) therapy to soothe her seizures. The five-year-old had struggled with severe epilepsy since infancy, sometimes experiencing 50 or more episodes a day, with little relief from standard drugs and dietary tweaks. By the time her parents started consulting doctors about CBD extracts, she had difficulty walking, talking, and eating without help.
Figi’s neurologist put her on a low dose of a specially bred strain of medical cannabis, later dubbed “Charlotte’s Web.” The effects were almost immediate. The seizures slowed from daily to weekly events, and soon, the kid was living life almost normally. After close to two years of the oral treatment, the doctors decided to wean Figi off other epilectic medications.
Figi’s story represents one of the clearest, most well-documented cases of the healing potential of CBD. (The young pioneer died last year, due to complications of COVID-19.) Though people have used the plant-based chemical to treat migraines and other bodily aches for centuries, the science around its efficacy is still inconclusive because it’s tricky to study its direct effect on the nervous system. Regardless, the industry has boomed in the past decade. Today, CBD can be found in a range of products— from lattes to bath bombs to dog treats— and is marketed as a cure-all for pain, anxiety, insomnia, and even AIDS.
So, what should a person who’s buying CBD expect? There’s plenty of information out there, but the bottom line is confusing. Here’s an overview of what medical experts say about the ingredient and whether it lives up to its hype.
What is CBD?
CBD is essentially cannabis, minus the strong psychoactive bits. The carbon-oxygen-hydrogen compound can be found in high concentrations in Cannabis sativa and less-potent hemp plants. Sometimes manufacturers mix it with traces of tetrahydrocannabinol (THC), the cannabis-based chemical that gets people high, but it generally doesn’t carry the same dopamine-heightening and possibly addictive properties.
Like THC, though, CBD works its “magic” by cozying up to the nervous system. From what molecular scientists know so far, it somehow changes proteins found all over the body that are responsible for managing pain, inflammation, mood, appetite, and even memory. It’s still unknown how extensively it affects that internal chemistry, especially when combined with other ingredients, says Johns Hopkins University food scientist Kantha Shelke.
Is it legal?
The Food and Drug Administration (FDA) updated its CBD regulations this past October, and is gearing up to review them again for 2021. The industry is lobbying to have it legalized nationwide, but for now, the extract is considered a controlled substance if it comes from cannabis plants. It’s less restricted when it’s harvested from hemp.
That seems relatively straightforward, but throw local laws into the mix and the standards become a lot more unwieldy. CBD is legal to sell and buy in one form or another around the US, though it can’t be hawked across state lines because of the federal regulations. In places where it’s lawful, the ingredient can be added to any product as long as it contains less than 0.3 percent THC and is marketed as a cosmetic or supplement. If it’s labeled as a drug or dietary substance it has to undergo clinical tests and win FDA approval before the public can lay hands on it. The FDA has only approved one CBD medication so far: Epidolex, which is used to treat the same genetic syndrome that Charlotte Figi had.
Overall, the FDA seems unconcerned with low doses of the extract in food and wellness items. It does, however, caution against giving CBD products to children, pregnant and lactating people, and pets. In its most recent guidelines, the agency states that it supports further research on the benefits of CBD and is open to emergency use of drugs that are still in development.
What are the proven benefits?
Some of the best research on CBD’s therapeutic effects comes from treating childhood epilepsy (thanks to the Figi family), schizofrenia, sleep deprivation, and anxiety disorders. The chemical has shown strong results in relieving all four of these conditions, with “a clear calming effect,” according to one 2019 analysis. That said, most of the studies exploring this connection don’t include a control group, or a baseline for comparison.
When it comes to looking at CBD for pain relief, the research is even more flimsy. Tests have shown that it can be effective against arthritis in rats, and that it might work as well as opioids for multiple sclerosis and cancer patients. But many of these treatments also included some amount of THC, so it’s hard to say if CBD was the primary cause of relief.
There’s also the question of which forms of CBD are safe enough for consumers but strong enough to make a difference. For neurological conditions like anxiety or apnea, the chemical needs to be absorbed into the bloodstream to have maximum impact. That means it needs to be ingested, inhaled, or rubbed in at high concentrations. But as health reporter Sarah Jacoby wrote in Self while vetting her own CBD buys, many of the proteins that trigger pain and inflammation are located between the skin and veins. So, any cream or gel that wants to counter aching joints and tight muscles needs to be able to get through the dermis but not as deep as the blood vessels. That’s a tall order for any drugstore formula.
Overall, doctors are reluctant to call CBD a pain panacea. But companies keep putting it in gels, goos, tinctures, massage oils, and roll-on creams, and people continue to snap them up. (One market report put CBD sales at nearly $5 billion sales in 2020.) It’s clear that the ingredient is somewhat beneficial to humans, health—science just needs to understand how much…..
By Purbita Saha