How the CBD Craze Could Change Pharmacology

Cannabidiol (CBD) is hot. It’s popping up everywhere: in coffee, pastries, toast, cocktails, lotions, beauty masks, haircare products, and more.

Proponents and peddlers promise that CBD alleviates pain and anxiety, making users more relaxed without the psychoactive qualities of marijuana’s other famous compound, tetrahydrocannabinol (THC).

Cannabis is still illegal, which makes studying it difficult, but science has made some inroads. Not surprisingly, CBD’s purported vast benefits are probably overstated at best. But CBD does show huge potential in helping treat patients with devastating and intractable diseases.

What it is

Like THC, CBD reacts with some of the body’s cannabinoid receptors, which are part of the nervous system.

Cannabis has been used in medicine for thousands of years, especially for epilepsy, and science is confirming this use. Even though marijuana is still classified a schedule 1 drug (with no currently accepted medical use and a high potential for abuse), in 2018 the FDA approved a CBD medication for two severe types of epilepsy.

Youtube is full of videos of children’s seizures ending instantly after a spritz of cannabis nasal spray, or people with uncontrollable Parkinson’s disease stilling minutes after rubbing CBD oil under the tongue.

“The endogenous cannabinoid system is very important in regulating motor activity, the same motor activity that is impaired in Parkinson’s disease,” says Dr. Daniele Piomelli, the directory of pharmacology at UC Irvine, in one of those videos. “From animal experiments we also know boosting certain branches of the endocannabinoid system is helpful in relieving the symptoms of Parkinson’s.”

The National Academies of Sciences, Engineering and Medicine released a report in 2017 analyzing over 10,000 abstracts about the potential medicinal benefits of cannabis writ large (not CBD specifically). As FiveThirtyEight reports, the findings are promising:

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.

There are over 400 chemicals in cannabis, so it’s unclear how much of these benefits derive from CBD itself.

What it isn’t

CBD might show incredible promise in treating all kinds of conditions, especially intractable ones like epilepsy, but what about CBD in cosmetics and food ― what does that do?

It’s unclear, but so far, looks like not much. The problem is dosage.

Studies examining CBD’s effectiveness in alleviating anxiety, for example, show the required dose is around 300mg. The dose in a latte? Around 10mg, as Vox reports.

Esther Blessing is a professor and researcher at NYU who performs and reviews clinical trials on CBD’s effectiveness in treating post-traumatic stress, anxiety, substance addiction, and other conditions. Speaking about widely available and unregulated CBD oils, she says, “This is the main scam, snake oil thing going on out there now.”

Research is still limited, but that also means regulation is also limited, so there’s no telling where CBD oil is coming from or its potency.

What it could be

CBD and cannabis in general could offer more gentle alternatives, and more effective treatments, for everything from epilepsy to pain relief. As more states legalize its medicinal use, its removal from the Class 1 schedule appears increasingly inevitable. With more study, CBD might go the way of low-carb diets and Crossfit as a health trend, but it could become a mainstay of pharmacology. And the world will be better for it.