CBD - What We Know So Far |
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Many of our patients have begun asking us about CBD. And it’s no wonder – in almost no time, CBD has gone from a niche product in specialty stores to a substance that’s being integrated into everything from mascara, sprays and lotions, to bath soap and more. It’s easy to find in pharmacies, big-box stores, supermarkets, and online. There are at least four cafes within a 15-minute walk of the White House that sell CBD coffee.
So what is the bottom line on CBD? That question is still being answered. But it has shown promise for treating some conditions, including those that many of our patients have. So if you’re curious, here’s an introduction that will help you decide whether to have further conversations with Dr. Pierce or Afrookteh about whether CBD might be right for you. We have summarized below some of the most common questions we get from patients:
What Exactly is CBD?
CBD stands for Cannabidiol, one of hundreds of active ingredients in hemp plants, which are cousins to marijuana plants. Hemp plants do not contain the intoxicating chemical substance (THC) found in cannabis plants, so CBD does NOT make people “high.” It is commonly sold in oil form.
What is CBD used for?
According to recent studies, the majority of people using CBD are utilizing it to reduce pain from inflammation, such as joint or muscle pain. Another large group of people use CBD to reduce anxiety and help them sleep. Anecdotally, people have reported that CBD has helped with a variety of other conditions including depression and sleep disorders.
The only FDA-approved use for CBD so far is to treat certain childhood types of epilepsy. A commercially-available medication called Epidiolex was approved by the FDA in mid-2018 after the completion of three clinical trials that showed the drug to be effective in reducing the frequency of seizures.
Is CBD legal?
The 2018 federal Farm Bill legalized the production of hemp and hemp-based products. As a result, commercially derived CBD from the hemp plant is fully legal under federal law. CBD derived from the cannabis plant is regulated by individual states.
However, the labelling on CBD products can sometimes get producers in trouble. While the production of CBD is legal, the Food and Drug Administration takes the position that when CBD is sold with an express claim of therapeutic benefit, it becomes a “drug” that has not been formally approved. Similarly, when it is infused in food or drinks, it becomes illegal because then it is technically a “food additive.”
Is CBD dangerous?
A 2017 report by the World Health Organization found that CBD “is generally well tolerated, with a good safety profile.” That report also found that CBD has “low toxicity [the degree to which a substance can harm humans or animals]” and is “not associated with abuse potential.”
As with any ingested substance, CBD may have side effects. Observed side effects have included reduced appetite, drowsiness and fatigue among some people. It can also raise levels of certain other medications in your blood (like blood thinners) in the same way that grapefruit juice sometimes does.
Why isn't more known about CBD?
Knowledge about medicinal substances comes from systematic, scientific, controlled studies. The common use of CBD is fairly recent, and there have not yet been very many controlled clinical trials. In addition, CBD is one of 400 chemicals present in cannabis plants. While some studies have been done on cannabis compounds generally, 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 is still being developed.
The scientific community is also studying CBD in isolation. A 2017 study published in the journal Pain found that CBD reduced inflammation resulting from osteoarthritis in animals, and has the potential to reduce pain. Similarly, the Arthritis Foundation has found that “some people with arthritis who have tried CBD, but not all, report noticeable pain relief, sleep improvement and/or anxiety reduction.” A recent controlled study in Europe on animals showed that CBD applied on the skin could indeed help reduce pain and inflammation. And the Veterans Administration is just starting a study to look at the effects of CBD on Post Traumatic Stress Disorder.
What should I look for in a CBD product?
The one most important thing to look for in a CBD product is a reputable manufacturer and seller. A 2017 study found that more than one-quarter of 84 randomly-chosen CBD products actually contained less CDB than what was claimed on the label. This obviously could result in patients observing no benefit from using it.
It’s also important to find CBD that is both grown and manufactured in the United States. Some US companies manufacture CBD from hemp grown overseas, which can affect the quality of the product.
Two recommended local sources for CBD are The Common Market in Frederick, and Whitesell’s Pharmacy on Market Street, both of which thoroughly investigate their suppliers.
It’s also probably wise to steer clear of CBD-infused products, like shampoo and makeup. As stated by Yasmin Hurd, director of the Addiction Institute of Mount Sinai in New York City, “[CBD] has a potential medical value, but when we are putting it into mascara and putting it into tampons, for God’s sake, to me, that’s a scam.”
Is CBD for me?
CBD may offer a low-risk way to try to alleviate pain. If you are interested in learning more or investigating whether CBD may help address any medical issues you are dealing with now, make an appointment with Dr. Pierce or Afrookteh to discuss whether CBD is right for you.
How do I use CBD?
Generally speaking, Dr Pierce recommends first trying CBD as a topical application, rather than ingesting it. There are many CBD lotions available on the market, however the purity and potency may vary considerably. Reputable distributors will often offer trial samples if contacted.
When using CBD orally, it is advised to start with the lowest recommend dose on the product information and see if it helps before trying a larger dose.
Above all, since CBD research is ongoing, drug interactions are not fully understood and should be discussed with your doctor. For those using CBD, even occasionally, always tell your doctor and include it on your medication list along with any other supplements, vitamins, etc.
Resources
If you’d like to learn more on your own, check out the articles below:
Cannabidiol (CBD) — What we Know and What we Don’t - Harvard Medical School.
What are the Benefits of CBD? - New York Times
What are the Benefits of CBD – and is it Safe to Use? – Mayo Clinic
Can CBD Really do all That? – New York Times
Arthritis Foundation CBD Guidance for Adults with Arthritis – Arthritis Foundation
So what is the bottom line on CBD? That question is still being answered. But it has shown promise for treating some conditions, including those that many of our patients have. So if you’re curious, here’s an introduction that will help you decide whether to have further conversations with Dr. Pierce or Afrookteh about whether CBD might be right for you. We have summarized below some of the most common questions we get from patients:
What Exactly is CBD?
CBD stands for Cannabidiol, one of hundreds of active ingredients in hemp plants, which are cousins to marijuana plants. Hemp plants do not contain the intoxicating chemical substance (THC) found in cannabis plants, so CBD does NOT make people “high.” It is commonly sold in oil form.
What is CBD used for?
According to recent studies, the majority of people using CBD are utilizing it to reduce pain from inflammation, such as joint or muscle pain. Another large group of people use CBD to reduce anxiety and help them sleep. Anecdotally, people have reported that CBD has helped with a variety of other conditions including depression and sleep disorders.
The only FDA-approved use for CBD so far is to treat certain childhood types of epilepsy. A commercially-available medication called Epidiolex was approved by the FDA in mid-2018 after the completion of three clinical trials that showed the drug to be effective in reducing the frequency of seizures.
Is CBD legal?
The 2018 federal Farm Bill legalized the production of hemp and hemp-based products. As a result, commercially derived CBD from the hemp plant is fully legal under federal law. CBD derived from the cannabis plant is regulated by individual states.
However, the labelling on CBD products can sometimes get producers in trouble. While the production of CBD is legal, the Food and Drug Administration takes the position that when CBD is sold with an express claim of therapeutic benefit, it becomes a “drug” that has not been formally approved. Similarly, when it is infused in food or drinks, it becomes illegal because then it is technically a “food additive.”
Is CBD dangerous?
A 2017 report by the World Health Organization found that CBD “is generally well tolerated, with a good safety profile.” That report also found that CBD has “low toxicity [the degree to which a substance can harm humans or animals]” and is “not associated with abuse potential.”
As with any ingested substance, CBD may have side effects. Observed side effects have included reduced appetite, drowsiness and fatigue among some people. It can also raise levels of certain other medications in your blood (like blood thinners) in the same way that grapefruit juice sometimes does.
Why isn't more known about CBD?
Knowledge about medicinal substances comes from systematic, scientific, controlled studies. The common use of CBD is fairly recent, and there have not yet been very many controlled clinical trials. In addition, CBD is one of 400 chemicals present in cannabis plants. While some studies have been done on cannabis compounds generally, 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 is still being developed.
The scientific community is also studying CBD in isolation. A 2017 study published in the journal Pain found that CBD reduced inflammation resulting from osteoarthritis in animals, and has the potential to reduce pain. Similarly, the Arthritis Foundation has found that “some people with arthritis who have tried CBD, but not all, report noticeable pain relief, sleep improvement and/or anxiety reduction.” A recent controlled study in Europe on animals showed that CBD applied on the skin could indeed help reduce pain and inflammation. And the Veterans Administration is just starting a study to look at the effects of CBD on Post Traumatic Stress Disorder.
What should I look for in a CBD product?
The one most important thing to look for in a CBD product is a reputable manufacturer and seller. A 2017 study found that more than one-quarter of 84 randomly-chosen CBD products actually contained less CDB than what was claimed on the label. This obviously could result in patients observing no benefit from using it.
It’s also important to find CBD that is both grown and manufactured in the United States. Some US companies manufacture CBD from hemp grown overseas, which can affect the quality of the product.
Two recommended local sources for CBD are The Common Market in Frederick, and Whitesell’s Pharmacy on Market Street, both of which thoroughly investigate their suppliers.
It’s also probably wise to steer clear of CBD-infused products, like shampoo and makeup. As stated by Yasmin Hurd, director of the Addiction Institute of Mount Sinai in New York City, “[CBD] has a potential medical value, but when we are putting it into mascara and putting it into tampons, for God’s sake, to me, that’s a scam.”
Is CBD for me?
CBD may offer a low-risk way to try to alleviate pain. If you are interested in learning more or investigating whether CBD may help address any medical issues you are dealing with now, make an appointment with Dr. Pierce or Afrookteh to discuss whether CBD is right for you.
How do I use CBD?
Generally speaking, Dr Pierce recommends first trying CBD as a topical application, rather than ingesting it. There are many CBD lotions available on the market, however the purity and potency may vary considerably. Reputable distributors will often offer trial samples if contacted.
When using CBD orally, it is advised to start with the lowest recommend dose on the product information and see if it helps before trying a larger dose.
Above all, since CBD research is ongoing, drug interactions are not fully understood and should be discussed with your doctor. For those using CBD, even occasionally, always tell your doctor and include it on your medication list along with any other supplements, vitamins, etc.
Resources
If you’d like to learn more on your own, check out the articles below:
Cannabidiol (CBD) — What we Know and What we Don’t - Harvard Medical School.
What are the Benefits of CBD? - New York Times
What are the Benefits of CBD – and is it Safe to Use? – Mayo Clinic
Can CBD Really do all That? – New York Times
Arthritis Foundation CBD Guidance for Adults with Arthritis – Arthritis Foundation