Donald Abrams was a member of the committee that reviewed the evidence that went into producing the report, and he said that the studies they reviewed overwhelmingly used pharmaceutically available preparations that contain THC, including dronabinol, nabilone and the whole-plant extract spray nabiximols, which contains equal parts CBD and THC. It’s impossible to know whether the benefits of cannabis can also be obtained from CBD alone, Abrams said, because CBD is just one of 400 chemicals present in the plant. So far, CBD in isolation has been studied in only a handful of randomized, placebo-controlled trials (considered the gold standard of evidence in medical research), and the evidence remains sparse.
In the meantime, some physicians are forging ahead — and cashing in. Joe Cohen is a doctor at Holos Health, a medical marijuana clinic in Boulder. I asked him what CBD is good for, and he read me a long list of conditions: pain, inflammation, nausea, vomiting, intestinal cramping, anxiety, psychosis, muscle spasms, hyperactive immune systems, nervous system degeneration, elevated blood sugar and more. He also claimed that CBD has anti-cancer properties and can regenerate brain cells and reduce the brain’s levels of amyloid beta — a kind of protein that’s been linked to Alzheimer’s disease. I asked for references, noting that most of these weren’t listed in the Academies report or a similar review published in the Journal of the American Medical Association. “I think you just have to Google search it,” he said. It’s true that a preliminary study found hints that cannabinoids might reduce beta amyloid proteins in human brain cells, but the study was done in cells grown in a lab, not in people. As for cancer, the FDA sent warning letters last year to four companies that were selling products that claimed to “prevent, diagnose, treat or cure” cancer.
Last year, the National Academies of Sciences, Engineering and Medicine released a nearly 500-page report on the health effects of cannabis and cannabinoids. A committee of 16 experts from a variety of scientific and medical fields analyzed the available evidence — more than 10,000 scientific abstracts in all. Because so few studies examine the effects of CBD on its own, the panel did not issue any findings about CBD specifically, but it did reach some conclusions about cannabis and cannabinoids more generally. The researchers determined that there is “conclusive or substantial evidence” supporting the use of cannabis or cannabinoids for chronic pain in adults, multiple sclerosis-related spasticity (a kind of stiffness and muscle spasms), and chemotherapy-induced nausea and vomiting. The committee also found “moderate” evidence that cannabis or cannabinoids can reduce sleep disturbances in people with obstructive sleep apnea, fibromyalgia, chronic pain and multiple sclerosis, as well as “limited” evidence that these substances can improve symptoms of Tourette’s syndrome, increase appetite and stem weight loss in people with HIV/AIDs, and improve symptoms of PTSD and anxiety.
Most of these products promised to relieve pain or otherwise enhance well-being, and none of it was cheap. (Prices started at about $30.) But I wanted to know: Does any of this stuff really work? After a deep dive into the scientific research, I learned that the answer was a big fat maybe.
As marijuana is legalized in more and more states, the wellness world has whipped itself into a frenzy over a non-intoxicating cannabis derivative called cannabidiol. CBD products can be found on the internet and in health-food stores, wellness catalogs and even bookstores. (A bookstore in downtown Boulder, Colorado, displays a case of CBD products between the cash register and the stacks of new releases.) Celebrities like Gwyneth Paltrow, disgraced cyclist 1 Floyd Landis and former Denver Broncos quarterback Jake Plummer are all touting CBD products, and according to Bon Appétit, CBD-infused lattes have become “the wellness world’s new favorite drink.”
But, uh, what is it that CBD is supposed to do? I visited a cannabis dispensary in Boulder to find out what the hype was all about. After passing an ID check, I was introduced to a “budtender” who pointed me to an impressive array of CBD products — tinctures, skin patches, drink powders, candies, salves, massage oil, lotions, “sexy time personal intimacy oil” and even vaginal suppositories to treat menstrual cramps.
Those warning letters aside, there’s not a lot of federal oversight right now over the claims being made or the products that are being sold. Cohen warned against buying CBD products online, because “there’s a lot of scams out there.” Yet his clinic sells CBD, and he admits, “I say ‘Don’t buy online,’ but ours is worth doing, because we know what we’re doing. We ship all over.”
It’s possible that some users feel the presence of any amount of THC when it’s mixed with CBD. That’s the well-known “entourage effect” theory, which basically says cannabinoids combine to create more than the sum of their parts. It’s worth experimenting with different kinds of CBD products to see what feels best to you.
Interestingly, marijuana strains that have significant quantities of both CBD and THC rarely produce the undesirable effects—like paranoia and anxiety—sometimes experienced with weed that’s high in THC but has low CBD content. CBD apparently “competes” with THC on the CB1 receptors, and thereby moderates the psychological effects of its racier relative.
Both hemp and marijuana are the same species of plant—Cannabis sativa—but hemp has been selectively bred for thick, heavy stalks, whose fibers have been used for centuries to make clothing, sails, paper and rope. Since most of the THC in cannabis is found in the flowering portions of the plant, marijuana breeders have sought plants with lush, heavy flowers (buds), and for decades have selectively bred out the CBD, which moderates the racy high of THC.
How does CBD make you feel?
CBD is a compound found in cannabis plants (a cannabinoid) that provides proven therapeutic benefits. Because it doesn’t have the same intoxicating effects as its cannabinoid cousin tetrahydrocannabinol (THC), cannabidiol (CBD) is more lightly regulated, and can be sold without a prescription in most U.S. locations. Even high CBD strains of cannabis can be purchased online without a medical marijuana card.
Cannabinoids created outside the body—called exogenous cannabinoids—like CBD and THC from the cannabis plant, can also bind with the CB1 or CB2 (and other) receptors to produce various effects and moderate some physical functions. THC can relieve nausea and increase appetite, and both CBD and THC are effective for pain relief. CBD is an antioxidant and an anti-inflammatory, and has proven medically effective in treating certain seizure disorders.
CBD derived from hemp plants almost always contains less than 0.3% THC, which is the legal maximum it can include unless it’s sold by a licensed dispensary in a state with a legal marijuana market. You can verify how much THC a product contains by checking the third-party test on the manufacturer’s website. If the seller can’t produce a test, or you feel hesitant, move on to a different company.
Both CBD and THC are mood-altering compounds that have significant therapeutic benefits, like relieving pain and nausea, reducing inflammation, and treating some seizure disorders. But even though both cannabinoids are psychoactive, only THC is intoxicating. While CBD promotes relaxation and calmness, THC produces actual euphoria, and alters perceptions of space and time.