What is cbd used for?
Cannabis has been used to treat pain since as far back as 2900 B.C. (2).
More recently, scientists have discovered that certain components of cannabis, including CBD, are responsible for its pain-relieving effects.
The human body contains a specialized system called the endocannabinoid system, which is involved in regulating a variety of functions, including sleep, appetite, pain sensation, and immune system response (3).
The body produces endocannabinoids, which are neurotransmitters that bind to cannabinoid receptors in your nervous system.
Studies have shown that CBD may help reduce chronic pain by affecting endocannabinoid receptor activity, reducing inflammation, and interacting with neurotransmitters (4).
Some research suggests that CBD may be effective for certain types of pain, including nerve pain and back pain, when used on its own. However, it seems to be most effective when combined with THC (5, 6).
Several human studies have found that a combination of CBD and THC is effective in treating pain related to multiple sclerosis (MS) and arthritis.
An oral spray called Sativex (nabiximols), which is a 1:1 combination of THC and CBD, is approved in several countries to treat pain related to MS.
A study that included 47 people with MS examined the effects of taking Sativex for a month. The participants experienced improvements in pain, walking ability, and muscle spasms (7).
Still, the study didn’t include a control group, so placebo effects cannot be ruled out (7).
In one review, researchers noted that Sativex may benefit those with MS-associated neuropathic pain and chronic severe neuropathic pain. The review also found that Sativex may help relieve anxiety and stress, which are major drivers of chronic pain (8).
Additionally, some research suggests that CBD may relieve symptoms of rheumatic diseases such as fibromyalgia.
A study that included survey data from 2,701 people with fibromyalgia found that those who used CBD for pain relief generally reported slight to significant improvement in symptoms (9).
And according to preclinical evidence from rodent studies, CBD may have beneficial effects on pain and inflammation related to arthritis, but human studies are lacking (10).
Although researchers are cautiously optimistic that CBD may be helpful in the treatment of some types of pain, especially when combined with THC, more high quality studies are needed to determine its effectiveness in pain management.
It is most commonly used to treat chronic pain, anxiety, inflammation, and insomnia. One study showed that CBD may relieve pain by affecting receptors of the endocannabinoid system, which helps regulate pain, mood, and memory, in addition to many other physiological and cognitive functions.
Cannabidiol (CBD) is often covered in the media, and you may see it touted as an add-in booster to your post-workout smoothie or morning coffee. You can even buy a CBD-infused sports bra. But what exactly is CBD? And why is it so popular?
CBD, or cannabidiol, is the second most prevalent active ingredient in cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, a cousin of marijuana, or manufactured in a laboratory. One of hundreds of components in marijuana, CBD does not cause a "high" by itself. According to a report from the World Health Organization, "In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD."
CBD is readily obtainable in most parts of the United States, though its exact legal status has been in flux. All 50 states have laws legalizing CBD with varying degrees of restriction. In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials. In 2018, the Farm Bill made hemp legal in the United States, making it virtually impossible to keep CBD illegal – that would be like making oranges legal, but keeping orange juice illegal.
The Farm Bill removed all hemp-derived products, including CBD, from the Controlled Substances Act, which criminalizes the possession of drugs. In essence, this means that CBD is legal if it comes from hemp, but not if it comes from cannabis (marijuana) – even though it is the exact same molecule. Currently, many people obtain CBD online without a medical marijuana license, which is legal in most states.
CBD has been touted for a wide variety of health issues, but the strongest scientific evidence is for its effectiveness in treating some of the cruelest childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), which typically don't respond to antiseizure medications. In numerous studies, CBD was able to reduce the number of seizures, and, in some cases, stop them altogether. Epidiolex, which contains CBD, is the first cannabis-derived medicine approved by the FDA for these conditions.
Animal studies, and self-reports or research in humans, suggest CBD may also help with:
Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level of blood thinning and other medicines in your blood by competing for the liver enzymes that break down these drugs. Grapefruit has a similar effect with certain medicines.
People taking high doses of CBD may show abnormalities in liver related blood tests. Many non-prescription drugs, such as acetaminophen (Tylenol), have this same effect. So, you should let your doctor know if you are regularly using CBD.
A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So, you cannot be sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other unknown elements. We also don't know the most effective therapeutic dose of CBD for any particular medical condition.
CBD comes in many forms, including oils, extracts, capsules, patches, vapes, and topical preparations for use on skin. If you're hoping to reduce inflammation and relieve muscle and joint pain, a topical CBD-infused oil, lotion or cream – or even a bath bomb -- may be the best option. Alternatively, a CBC patch or a tincture or spray designed to be placed under the tongue allows CBD to directly enter the bloodstream.
Outside of the US, the prescription drug Sativex, which uses CBD as an active ingredient, is approved for muscle spasticity associated with multiple sclerosis and for cancer pain. Within the US, Epidiolex is approved for certain types of epilepsy and tuberous sclerosis.
Project CBD
Started by two journalists covering medical marijuana, Project CBD offers a wealth of information on the therapeutic uses of CBD, including a Beginner’s Guide on CBD, how to use it for different conditions ranging from cancer to anxiety to inflammation, the science behind it, where to locate products, and more.
National Conference of State Legislatures (NCSL)
It’s hard to keep up with the ever-changing laws in all 50 states surrounding recreational marijuana, medical marijuana, CBD, and everything related. Fortunately, the NCSL has a handy, up-to-date, color-coded map to keep it all straight, along with explanations of all key terms and links to further research.
Consumer Reports
With all the seemingly countless CBD-infused products and places to purchase them, how do you know what’s safe and effective — and what’s not? Consumer Reports has a helpful guide on How to Shop for CBD as well as articles on its mainstream popularity, how to use it, and even a video on trying CBD for your pet.
WayOfLeaf
This site produces an annual guide to the best CBD oil brands, as well as reviews of various oils. They also have tips on how to find medical marijuana doctors and dispensaries near you, and state-by-state guides on how to get a medical marijuana card.
CBD Oil Review
The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Nih.gov. Accessed 5/13/2021.
Corroon J, Felice JF. The Endocannabinoid System and its Modulation by Cannabidiol (CBD). Altern Ther Health Med. 2019;25(S2):6-14.
Cannabidiol (CBD) — what we know and what we don’t – Harvard Health Blog. Harvard Health Blog. Accessed 5/13/2021.
Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria. 2019;41(1):9-14.
Zanelati TV, Biojone C, Moreira FA, Guimarães FS, Joca SR. Antidepressant-like effects of cannabidiol in mice: possible involvement of 5-HT1A receptors. Br J Pharmacol. 2010;159(1):122-128.
Office of the Commissioner. FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. U.S. Food and Drug Administration. Accessed 5/13/2021.
Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. The Journal of Alternative and Complementary Medicine. 2019;25(4):392-397.
Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Frontiers in Neuroscience. 2018;12.
Hurd YL, Spriggs S, Alishayev J, et al. Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial. American Journal of Psychiatry. 2019;176(11):911-922.
Hurd YL, Yoon M, Manini AF, et al. Early Phase in the Development of Cannabidiol as a Treatment for Addiction: Opioid Relapse Takes Initial Center Stage. Neurotherapeutics. 2015;12(4):807-815.
Bilsland LG, Dick JR, Pryce G, et al. Increasing cannabinoid levels by pharmacological and genetic manipulation delay disease progression in SOD1 mice. FASEB J. 2006;20(7):1003-1005.
Meyer T, Funke A, Münch C, et al. Real world experience of patients with amyotrophic lateral sclerosis (ALS) in the treatment of spasticity using tetrahydrocannabinol:cannabidiol (THC:CBD). BMC Neurol. 2019;19(1):222.
Russo EB. Cannabinoids in the management of difficult to treat pain. Ther Clin Risk Manag. 2008;4(1):245-259.
Xu DH, Cullen BD, Tang M, Fang Y. The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities. Curr Pharm Biotechnol. 2020;21(5):390-402.
Weiss L, Zeira M, Reich S, et al. Cannabidiol lowers incidence of diabetes in non-obese diabetic mice. Autoimmunity. 2006;39(2):143-151.
Rajesh M, Mukhopadhyay P, Bátkai S, et al. Cannabidiol attenuates high glucose-induced endothelial cell inflammatory response and barrier disruption. American Journal of Physiology-Heart and Circulatory Physiology. 2007;293(1):H610-H619.
A Randomised, Double Blind, Placebo Controlled, Parallel Group, Pilot Study of 1:1 and 20:1 Ratio of Formulated GWP42003 : GWP42004 Plus GWP42003 and GWP42004 Alone in the Treatment of Dyslipidaemia in Subjects With Type 2 Diabetes. clinicaltrials.gov. Accessed 5/13/2021.
Mannucci C, Navarra M, Calapai F, et al. Neurological Aspects of Medical Use of Cannabidiol. CNS Neurol Disord Drug Targets. 2017;16(5):541-553.
Malfait AM, Gallily R, Sumariwalla PF, et al. The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis. Proc Natl Acad Sci U S A. 2000;97(17):9561-9566.
Nagarkatti P, Pandey R, Rieder SA, Hegde VL, Nagarkatti M. Cannabinoids as novel anti-inflammatory drugs. Future Med Chem. 2009;1(7):1333-1349.
