Medical

What is CBD?

Cannabidiol (CBD) is a naturally occurring chemical compound found in cannabis. In studying the plant, researchers identified more than 100 such phytochemical compounds that are collectively called cannabinoids, and CBD and tetrahydrocannabinol (THC) are the most prominent in terms of typical volume. CBD does not have psychoactive properties that produce euphoric highs, and it potentially reduces or delays THC-related euphoria. More importantly, clinical studies show that CBD has extensive medical applications, probably more so than any other cannabinoid. Users experience the benefits of CBD with traditional delivery devices, but various extraction methods (e.g., ethanol, olive oil, solvent, grain alcohol, C02) help produce non-psychoactive CBD oils with high potency and measured dosage. The oil concentrate can be smoked, ingested or applied to the skin as a topical cream depending on the medicinal need.

How CBD Works

Each person has a cannabinoid receptor system in the brain that includes receptor type 1 (CB1) primarily in the central and peripheral nervous system and receptor type 2 (CB2) primarily in the immune system. Whereas THC binds directly to the receptors, CBD affects them indirectly through endocannabinoids produced naturally in the body. In addition to stimulating natural production, CBD suppresses the enzyme that metabolizes endocannabinoids. Though it lacks an affinity for the primary receptors, CBD might increase receptor density and coupling efficiency, and it does bind to other receptors associated with adenosine (A2A), serotonin, pain perception, mood and inflammation, among others. It also appears to deactivate the GPR55 receptor associated with cancer cell proliferation. The cannabinoid receptor system plays an important role in maintaining a stable biological environment, and fittingly, CBD seems to counter potential THC side effects like anxiety, paranoia and short-term memory disruptions.

Medical Use of CBD

In the medical marijuana (MMJ) field, CBD shows immense promise for a wide range of diseases and disorders, and its non-psychoactive profile allows for practical and inclusive applications. As noted by the Brazilian Journal of Psychiatry in 2008, researchers determined the chemical structure of CBD in 1963, and it sparked an initial wave of medical research into its antiepileptic and sedative properties. These studies, while informative, only captured a glimpse of CBD’s medical potential, and renewed research in the new millennium identified antiinflammatory, antioxidant, neuroprotective, analgesic, anxiolytic, antiemetic and neuroleptic properties. Furthermore, Current Drug Safety in 2011 stated that humans tolerate CBD well, even with chronic use and high dosage, and it is nontoxic with no adverse effects related to heart rate, blood pressure, body temperature, food intake, gastrointestinal transit or psychological function.

To date, clinical studies involving CBD suggest medical applications for anxiety disorders, schizophrenia, inflammation, diabetes, rheumatoid arthritis, multiple sclerosis, epilepsy, post-traumatic stress disorder (PTSD), opiate addiction, neurodegenerative disorders, heart disease, Parkinson’s, Alzheimer’s, Crohn’s disease and a debilitating form of epilepsy called Dravet’s Syndrome. Furthermore, the British Journal of Clinical Pharmacology noted in 2013 that CBD has anticancer properties that interfere with “tumor neovascularization, cancer cell migration, adhesion, invasion and metastasization.”

CBD and THC

CBD is appealing for medicinal users since the non-psychoactive oil can be taken in measured, concentrated doses that do not adversely affect cognition or motor skills. Several studies do suggest, however, that CBD reaches optimal efficacy when paired with THC. In addition to boosting the antioxidant potency of CBD, studies show that THC has its own therapeutic profile that includes potential anticancer agents. The two cannabinoids seem to have a symbiotic relationship that fosters mutual enhancement, and some medicinal experts advocate for whole-plant use when appropriate. Still, many individuals prefer the singular use of CBD, especially when the treatment involves children, and the extracted oil is undeniably a potent medicine with or without THC. The immense game-changing potential for CBD-based medical treatments is a primary force driving the cannabis legalization movement.

CBD Without THC

Cannabidiol (CBD) and tetrahydrocannabinol (THC) are chemical compounds called cannabinoids that act on the endocannabinoid system (ECS) in the brain, organs, glands, connective tissues and immune cells. Described as the bridge between the mind and body, the ECS helps maintain/restore a healthy biological balance (or homeostasis) that adjusts for external changes in environment. As needed, the human body naturally produces endocannabinoids like anandamide (AEA), 2-arachidonoylglycerol (2-AG) and 2-arachidonyl glyceryl ether from arachidonic acid derivatives in the cell membrane. The cannabis plant, from which the system gets its name, contains at least 100 cannabinoids including THC, CBD, cannabinol (CBN), cannabigerol (CBG) and others that act on the same ECS receptors.

Whether released by the body or the plant, cannabinoids promote healthy ECS function and adaptation to harmful stressors. To date, researchers have identified numerous medicinal benefits from cannabis-based cannabinoids, but the compound that seems to have the most promise is CBD. When extracted into liquid form, CBD oil allows for concentrated, measured dosage, and since the cannabinoid is non-psychoactive, CBD use is safe for children, recovering addicts and patients operating vehicles/machinery. Nevertheless, CBD poses an interesting question for the research community, i.e., whether the cannabinoid loses some of its medicinal efficacy when isolated away from THC and other cannabis compounds.

Whole-Plant Cannabis Medicine

Various extraction methods (e.g., ethanol, solvent, grain alcohol, super-/sub-critical C02) help isolate CBD in an oil form, but some studies suggest that whole-plant cannabis might have greater medicinal benefits. For example, a study published in Molecular Cancer Therapeutics in 2014 investigated the effects of THC and CBD and found that whole-plant cannabis can prime glioma cancer cells to respond better to ionizing radiation. Dr. Sean McAllister, a government-backed researcher at the Pacific Medical Center, contributed to a 2010 study in the same journal that said “THC and cannabidiol (CBD) acted synergistically to inhibit cell proliferation,” while his other research found that CBD impairs metastatic cancers of the brain and breast by inhibiting ID-1 gene expression. Higher amounts of CBD appear to reduce the psychoactive effects of THC, but interestingly, it also inhibits the breakdown of THC in the liver extending its therapeutic benefits. Additional studies show that THC helps CBD maximize its antioxidant potency.

The two cannabinoids seem to have a symbiotic relationship that fosters mutual enhancement, but that does not necessarily mean that whole-plant therapy is ideal for every disorder. In some cases, a single-cannabinoid therapy might be more efficacious, and the specific cannabinoid might be THC, CBD, CBN or an entirely different cannabis compound altogether. Likewise, the benefits of whole-plant therapies might be negligible or substantial depending on the particular disorder and the patient. These questions highlight the need for comprehensive clinical studies that provide more precise information about the medicinal use of cannabis compounds. The findings from such studies will better inform health professionals on the use of cannabinoid-based medicine.


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