Science behind cbd oil what is it effective for

Does CBD Oil Work? The Science Behind Cannabidiol

What is CBD oil? What does science have to say about the extract’s proposed health benefits?

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Weed, pot, ganja, reefer, Mary Jane, cannabis. Whatever you call it, marijuana has been used for its supposed medicinal properties since ancient cultures experimented with the plant in China, the Netherlands, Egypt, India, and Greece. Its medicinal use is suspected to date back to more than 5,000 years ago in what is now present-day Romania.

Cannabidiol, or CBD, one of marijuana’s active ingredients which has seen a recent surge in popularity, was discovered almost 80 years ago. Depending on whom you ask, CBD oil can relieve pain, aid sleep, inspire appetite, ease stress and anxiety, act as an anti-inflammatory or an analgesic, boost the immune system, assist memory, and ease asthma-related symptoms. But despite these widespread applications, the medical effects of CBD are still debated.

If we’ve known about the potential health benefits of CBD specifically and marijuana more generally for so long, then why hasn’t science come down more conclusively either to support or refute these claims? The reason is in large part because, at least in the US, the federal government classified marijuana as a “Schedule I” drug, alongside heroin, LSD, and ecstasy, back in the 1970s. Schedule I drugs have “no currently acceptable medical use and a high potential for abuse” and thus are very difficult to study in the laboratory due to the administrative hurdles.

Difficult. but not impossible. So let’s take a look at what we do know from scientific studies about the health benefits of CBD oil.

What is CBD oil?

Tetrahydrocannabinol (THC) is the main psychoactive or mind-altering ingredient in marijuana. Cannabidiol, or CBD, is another prevalent component of marijuana (and hemp) plants that is considered by many to have medicinal benefits but without the same “high” associated with THC. CBD is typically extracted from the plant and sold as a concentrated liquid. Just as with other herbal extracts, that extraction process can vary and thus so can the additional chemicals found in the resulting cannabis oil.

Although the US Drug Enforcement Administration is wary enough of marijuana to classify it as a Schedule I drug, CBD on its own does not cause a “high” and two years ago the US Food and Drug Administration eased regulations on CBD that make it easier to research. The World Health Organization also notes that CBD “exhibits no effects indicative of any abuse or dependence potential.”

What are the proposed health benefits of CBD oil?

CBD oil and epilepsy

Among the “strongest scientific evidence” for the effectiveness of CBD, according to Harvard Health, is that CBD can reduce the number of seizures experienced by children with different epilepsy syndromes. In fact, the only FDA-approved use of CBD is in the drug Epidiolex, which treats two rare but very severe forms of childhood epilepsy.

The phrases that comes up most commonly in the scientific literature surrounding CBD use for non-epilepsy related health issues are “considerable potential” and “need for further study.” For example, studies suggest that the anti-inflammatory and anti-oxidant nature of CBD make the extract a strong candidate for helping patients with diabetes and heart disease. CBD can reduce pressure in the eye (called intraocular pressure) and thus may work as a treatment for glaucoma. However, these studies are still “pre-clinical,” meaning that these benefits are so far only a hypothesis, and there are many stages of trials that still have to be conducted to draw a clear connection.

CBD oil and anxiety

Other, mostly pre-clinical or mice-based studies, suggest that CBD might help people suffering from anxiety, panic attacks, obsessive-compulsive disorder, and post-traumatic stress.

In 2012 in a German study actually involving humans, CBD was found to reduce psychotic symptoms like hallucinations and scattered thinking in patients with schizophrenia.

CBD oil and cancer

One study also found that CBD reduced the proliferation, invasion, and metastasis of human breast cancer cells grown in dishes, highlighting a possible non-toxic route toward thwarting cancer progression. However, the American Cancer Society warns that, although cannabinoids have so far been found to be safe in treating cancer, they should not be used as the only method of treatment as studies have not conclusively shown that they help control or cure it.

Research into other purported CBD benefits have been less conclusive. For example, CBD was found “safe but not effective” in treating Crohn’s Disease in a study of 20 patients.

CBD oil side effects

There are reasons to be wary of extensive CBD use as well. CBD does come with side effects, including nausea, fatigue, and changes in appetite. (Although these side effects are less problematic than those associated with other anti-seizure medications.) It may also lead to increased levels of certain types of blood thinner in your blood. Perhaps most importantly, CBD is considered a supplement, at least in the US, which means its safety and purity are not regulated by the FDA. So there is no way to know if the contents of your CBD oil are as promised on the label.

Our limited understanding of CBD’s health benefits also means that we don’t yet know what the proper dosage is for addressing different ailments. The fraction of a cannabis oil dose that a person absorbs and how long it stays in their system also vary widely depending on the person, making dosages even harder.

Is CBD oil legal?

In 2016, Forbes reported predictions that CBD could become a $2-3 billion industry by 2020. This will no doubt be due in part to the increase in legal access to the extract and to marijuana itself. In September of 2018, the FDA placed certain drugs containing CBD, like Epidiolex, into Schedule V, or the least restricted category of drugs. Biologists are also working to grow strains of marijuana that have lowered THC content and increased production of CBD. More broadly, cannabis is legal for medical use in 23 states in the United States as well as in Israel, Canada, and the Netherlands. Uruguay has also voted to legalize it.

So while we may start to see more CBD oil being offered in smoothies or as add-ons at coffee shops, we also may see more concrete research on whether or not we can credit CBD with as many health benefits as its supporters would like.

Please note that archive episodes of this podcast may include references to Ask Science. Rights of Albert Einstein are used with permission of The Hebrew University of Jerusalem. Represented exclusively by Greenlight.

About the Author

Dr Sabrina Stierwalt earned a Ph.D. in Astronomy & Astrophysics from Cornell University and is now a Professor of Physics at Occidental College.

CBD Oil: 9 Science-Backed Benefits

Dr. Bindiya Gandhi is an integrative medicine physician with expertise in functional and holistic medicine based in Atlanta, Georgia.

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Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.

Cannabidiol, or CBD, is a chemical compound found in the cannabis sativa plant. When applied topically or consumed through smoke inhalation or edible consumption, CBD interacts with neuroreceptors in your endocannabinoid system, which sends signals between your cells to help regulate your movement, mood, homeostasis and immune system.

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CBD is often extracted from the cannabis sativa plant in oil form and mixed with an inert carrier oil like hemp seed oil for consumption. In fact, of the 60% of U.S. adults who report having used CBD before, 55% of them use CBD oils and tinctures specifically, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll.

CBD research is growing, too. Here are nine ways studies suggest CBD oil could benefit your health.

1. Offset Anxiety and Depression

CBD’s ability to calm is perhaps its most popular effect and the reason its use is so widespread. A 2017 study in the Brazilian Journal of Psychiatry tested the anxiety levels of 57 men in a simulated public speaking test. Some received a placebo while others received either 150 milligrams, 300 milligrams or 600 milligrams of CBD before their speeches. Those who received 300 milligrams of CBD experienced significantly reduced anxiety during the test compared to those who received the placebo. Interestingly, participants who received either 150 or 600 milligrams of CBD experienced more anxiety during the test than the 300 milligrams group.

Meanwhile, at least one study in mice revealed CBD had effects similar to the antidepressant imipramine. Human trials are needed, though, to confirm whether CBD can induce this same antidepressant reaction in our bodies.

2. Treat Select Epilepsy Syndromes

In some instances, CBD can be used to treat epileptic seizures.

In 2018, the Food and Drug Administration (FDA) approved the use of CBD under the brand name Epidiolex to treat seizures resulting from Lennox-Gastaut syndrome and Dravet syndrome—two rare forms of epilepsy—in patients at least 2 years old.

Three well-vetted studies provide the basis of support for the FDA’s decision. In these trials, 516 patients with Lennox-Gastaut syndrome or Dravet syndrome received either Epidiolex or a placebo. Epidiolex, when taken along with other prescribed medications, decreased the frequency of participants’ seizures compared to the placebo.

3. Reduce PTSD Symptoms

In a small 2018 study in the Journal of Alternative and Complementary Medicine, 11 people with post-traumatic stress disorder (PTSD) received CBD along with routine psychiatric care for eight weeks in an outpatient psychiatric clinic. Ten of the 11 experienced a decrease in their PTSD symptoms. CBD was generally well tolerated, the researchers write.

Margaret Rajnic, a doctor of nursing practice experienced in medical cannabis and CBD, emphasizes the importance of using therapy in tandem with any type of cannabis or CBD for PTSD. “There is an amount of therapy that is needed for PTSD,” she says. “But CBD will give you that little bit of decreased anxiety.”

Four other human trials from 2012 to 2016 suggest CBD reduces PTSD symptoms, although some include THC, or tetrahydrocannabinol, the main mind-altering element in cannabis. When THC and CBD work together, they create what’s called an “entourage effect,” complementing each other’s benefits and potency. For example, taking the same dose of THC and CBD together tempers the “high” from THC, while just a little THC paired with more CBD enhances the effects of the CBD.

4. Treat Opioid Addiction

Some studies—both preclinical animal and human clinical trials—suggest CBD could be used to help treat people who are dependent on opioids.

In one such study, researchers administered CBD to people with heroin use disorder. Over the course of a week, CBD significantly reduced heroin users’ cue-induced cravings, withdrawal anxiety, resting heart rate and salivary cortisol levels. No serious adverse effects were found.

Other studies find CBD helpful in reducing various psychiatric and medical symptoms like anxiety, insomnia and pain in patients with substance use disorders, indicating that CBD may be an effective treatment for opioid addiction. However, further studies are necessary.

5. Alleviate ALS Symptoms

Amyotrophic lateral sclerosis (ALS) is a disease that causes nerve cells in the brain and spinal cord to deteriorate, resulting in loss of muscle control that worsens over time. It’s not yet understood exactly why ALS occurs, although it can be hereditary in some cases. There’s no known cure, and there are only two FDA-approved medications to help treat ALS symptoms.

Research suggests people with ALS can benefit from the entourage effect created by the combination of THC and CBD, similar to people with PTSD. In a 2019 study, patients received a combination of THC and CBD in varying doses depending on their needs and preferences. Those with mild, moderate or severe spasticity (muscle tightness and stiffness) due to ALS reported high levels of satisfaction with the treatment, and those with moderate to severe spasticity reported higher satisfaction rates than those with mild spasticity.

6. Relieve Unmanageable Pain

In 2005, Canada approved the use of Sativex, an oromucosal (absorbed in the lining of the mouth) spray with equal proportions of THC and CBD, for the treatment of multiple sclerosis-related central neuropathic pain. In 2007, Canada approved the medicine’s use again for cancer pain that proved unresponsive to other medications.

Meanwhile, continued studies in the U.S. indicate CBD is effective in treating chronic, non-cancer pain. In one 2020 study, researchers administered CBD topically to a group of patients with symptomatic peripheral neuropathy (a result of brain nerve and spinal cord nerve damage) while another group with the same condition received a placebo. Results showed a significant reduction in intense, sharp pains and cold, itchy sensations in those who used the topical CBD compared to those who used the placebo. No participants reported adverse side effects.

When introduced topically, CBD oil doesn’t affect the systemic issue as it might if it were introduced directly into the bloodstream. Instead, topical CBD is more localized and treats pain in a certain area. Since it’s more direct, it may have a more pronounced effect.

7. Ease Diabetic Complications

For starters, tests on human cells found that CBD helps reduce the effects of high glucose levels on other cells in the body, which typically precedes the development of diabetes and various complications. Researchers concluded that with further studies, CBD could have significant benefits when used in patients with diabetes, diabetic complications and plaque buildup in artery walls.

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In another small study, 13 patients with type 2 diabetes who weren’t on insulin treatment were given both CBD and a placebo (in lieu of insulin). Researchers found CBD decreased their levels of resistin (which causes resistance to insulin, the protein that regulates sugar levels) and increased their levels of glucose-dependent insulinotropic peptide (a hormone that ensures a sufficient release of insulin from digested food) compared to their baselines before they started the test. These results suggest CBD could be a natural treatment for diabetes by helping the body regulate insulin-related hormone levels.

8. Protect Against Neurological Disease

Preclinical and clinical studies show that CBD has antioxidant and anti-inflammatory properties. Researchers deduce these characteristics can provide significant neuroprotection, or protection against numerous pathological disorders.

Several preclinical studies suggest CBD can produce beneficial effects against Parkinson’s disease, Alzheimer’s disease and multiple sclerosis. Huntington’s disease and cerebral ischemia were also tested, although significant positive results were not recorded. Further clinical studies are needed to confirm CBD’s benefits when used as a treatment for these disorders.

9. Inhibit Arthritis Symptoms

Arthritis involves the deterioration of the tissues in and around your joints. There are several types of arthritis, and symptoms include pain, stiffness and loss of motion. Arthritis treatment usually targets pain relief and improved joint function.

A 2006 study found that Sativex—a CBD-based botanical drug approved in the United Kingdom in 2010—promoted statistically significant improvements in quality of sleep, pain during movement and pain at rest in patients with rheumatoid arthritis when compared to a placebo. It was the first controlled trial of Sativex as a treatment for rheumatoid arthritis, involving 58 patients. CBD was found to have a pain-relieving effect, as well as an ability to suppress disease activity.

In 2018, in a study of more localized treatment, researchers administered a synthetic CBD gel in either 250-milligram or 500-milligram doses daily or a placebo to patients with knee pain due to osteoarthritis. Patients also stopped taking any other anti-inflammatory medications or painkillers, with the exception of acetaminophen, before and during the study period.

The results were interesting, although not entirely conclusive. On one hand, those treated with CBD did not experience much change in pain when compared with placebo patients. On the other hand, there were statistically significant differences between the group receiving the 250-milligram dose and the placebo group when measuring the average weekly improvement of their worst pain levels and their WOMAC (Western Ontario and McMaster Universities Arthritis Index) physical function rating. Additionally, men seemed to benefit from CBD more significantly than women in this test.

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More than 60 percent of CBD users were taking it for anxiety, according to a survey of 5,000 people. Does it help?

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By Dawn MacKeen

The CBD industry is flourishing, conservatively projected to hit $16 billion in the United States by 2025. Already, the plant extract is being added to cheeseburgers, toothpicks and breath sprays. More than 60 percent of CBD users have taken it for anxiety, according to a survey of 5,000 people, conducted by the Brightfield Group, a cannabis market research firm. Chronic pain, insomnia and depression follow behind. Kim Kardashian West, for example, turned to the product when “freaking out” over the birth of her fourth baby. The professional golfer Bubba Watson drifts off to sleep with it. And Martha Stewart’s French bulldog partakes, too.

What is CBD?

Cannabidiol, or CBD, is the lesser-known child of the cannabis sativa plant; its more famous sibling, tetrahydrocannabinol, or THC, is the active ingredient in pot that catapults users’ “high.” With roots in Central Asia, the plant is believed to have been first used medicinally — or for rituals — around 750 B.C., though there are other estimates too.

Cannabidiol and THC are just two of the plant’s more than 100 cannabinoids. THC is psychoactive, and CBD may or may not be, which is a matter of debate. THC can increase anxiety; it is not clear what effect CBD is having, if any, in reducing it. THC can lead to addiction and cravings; CBD is being studied to help those in recovery.

Cannabis containing 0.3 percent or less of THC is hemp. Although last year’s Farm Bill legalized hemp under federal law, it also preserved the Food and Drug Administration’s oversight of products derived from cannabis.

What are the claims?

CBD is advertised as providing relief for anxiety, depression and post-traumatic stress disorder. It is also marketed to promote sleep. Part of CBD’s popularity is that it purports to be “nonpsychoactive,” and that consumers can reap health benefits from the plant without the high (or the midnight pizza munchies).

Just as hemp seedlings are sprouting up across the United States, so is the marketing. From oils and nasal sprays to lollipops and suppositories, it seems no place is too sacred for CBD. “It’s the monster that has taken over the room,” Dr. Brad Ingram, an associate professor of pediatrics at the University of Mississippi Medical Center, said about all the wild uses for CBD now. He is leading a clinical trial into administering CBD to children and teenagers with drug-resistant epilepsy.

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  • Psychedelic Drugs: As studies explore the therapeutic value of substances like MDMA, veterans are becoming unlikely advocates for their decriminalization.
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  • Virtual Reality: A treatment using new technology to immerse patients in a simulation of a memory could helpthemovercome trauma.

Does CBD work?

“It’s promising in a lot of different therapeutic avenues because it’s relatively safe,” said James MacKillop, co-director of McMaster University’s Michael G. DeGroote Center for Medicinal Cannabis Research in Hamilton, Ontario.

Last year, the F.D.A. approved Epidiolex, a purified CBD extract, to treat rare seizure disorders in patients 2 years or older after three randomized, double-blind and placebo-controlled clinical trials with 516 patients that showed the drug, taken along with other medications, helped to reduce seizures. These types of studies are the gold standard in medicine, in which participants are divided by chance, and neither the subject nor the investigator knows which group is taking the placebo or the medication.

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While there is hope for treating other conditions with the plant extract, Epidiolex remains the only CBD-derived drug approved by the F.D.A. Most of the research on cannabidiol has been in animals, and its current popularity has outpaced science. “We don’t have the 101 course on CBD quite figured out yet,” said Ryan Vandrey, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.

Does CBD help anxiety and PTSD?

For students with generalized social anxiety, a four-minute talk, with minimal time to prepare, can be debilitating. Yet a small experiment in the journal Neuropsychopharmacology found that CBD seemed to reduce nervousness and cognitive impairment in patients with social anxiety in a simulated public speaking task.

However, a double-blind study found healthy volunteers administered CBD had little to no change in their emotional reaction to unpleasant images or words, compared to the placebo group. “If it’s a calming drug, it should change their responses to the stimuli,” said Harriet de Wit, co-author of the study and a professor in the University of Chicago’s department of psychiatry and behavioral neuroscience. “But it didn’t.”

Many soldiers return home haunted by war and PTSD and often avoid certain activities, places or people associated with their traumatic events. The Department of Veterans Affairs is funding its first study on CBD, pairing it with psychotherapy.

“Our top therapies attempt to break the association between reminders of the trauma and the fear response,” said Mallory Loflin, an assistant adjunct professor at the University of California, San Diego and the study’s principal investigator. “We think that CBD, at least in animal models, can help that process happen a lot faster.” While large clinical trials are underway, psychologists say there isn’t compelling evidence yet as to whether this is a viable treatment.

Does CBD help sleep and depression?

Up in the wee hours of the night, stuck watching videos of puppies? CBD may be promising as a sleep aid; one of the side effects of the Epidiolex trials for epilepsy was drowsiness, according to Mr. MacKillop, a co-author of a review on cannabinoids and sleep. “If you are looking for new treatments for sleep, that may be a clue,” he said.

But he cautions that the side effects could have been because of an interaction with other medications the children were taking to control the seizures. So far, there hasn’t been a randomized, placebo-controlled, double-blind trial (the gold standard) on sleep disorders and CBD.

A recent chart review of 72 psychiatric patients treated with CBD found that anxiety improved, but not sleep. “Over all, we did not find that it panned out as a useful treatment for sleep,” said Dr. Scott Shannon, assistant clinical professor of psychiatry at the University of Colorado, Denver and the lead author of the review in The Permanente Journal.

Sleep can be disrupted for many reasons, including depression. Rodents seemed to adapt better to stressful conditions and exhibited less depressive-like behavior after taking CBD, according to a review in Journal of Chemical Neuroanatomy. “Surprisingly, CBD seems to act faster than conventional antidepressants,” wrote one of the authors of a new review, Sâmia Joca, a fellow at the Aarhus Institute of Advanced Studies in Denmark and an associate professor at the University of São Paulo in Brazil, in an email interview. Of course, it’s difficult to detect depression in animals, but the studies that Ms. Joca and her colleagues reviewed suggested that in models of chronic stress exposure, the mice and rats treated with CBD were more resilient.

But without clinical trials in humans, psychologists say CBD’s effect on depression is still a hypothesis, and not an evidence-based treatment.

Is CBD harmful?

“If you take pure CBD, it’s pretty safe,” said Marcel Bonn-Miller, an adjunct assistant professor at the University of Pennsylvania’s Perelman School of Medicine. Side effects in the Epidiolex trial included diarrhea, sleepiness, fatigue, weakness, rash, decreased appetite and elevated liver enzymes. Also, the safe amount to consume in a day, or at all during pregnancy, is still not known.

Recently, the F.D.A. sent a warning letter to Curaleaf Inc. about its “unsubstantiated claims” that the plant extract treats a variety of conditions from pet anxiety and depression to cancer and opioid withdrawal. (In a statement, the company said that some of the products in question had been discontinued and that it was working with the F.D.A.)

Dr. Smita Das, chair of the American Psychiatric Association’s Council on Addiction Psychiatry’s cannabis work group, does not recommend CBD for anxiety, PTSD, sleep or depression. With patients turning to these to unproven products, she is worried that they may delay seeking appropriate mental health care: “I’m dually concerned with how exposure to CBD products can lead somebody into continuing to cannabis products.”

Some CBD products may contain unwanted surprises. Forensic toxicologists at Virginia Commonwealth University examined nine e-liquids advertised as being 100 percent natural CBD extracts. They found one with dextromethorphan, or DXM, used in over-the counter cough medications and considered addictive when abused; and four with a synthetic cannabinoid, sometimes called Spice, that can cause anxiety, psychosis, tachycardia and death, according to a study last year in Forensic Science International.

Earlier research found fewer than a third of 84 products studied contained the amount of CBD on their labels. Some users of CBD have also failed drug tests when the product contained more THC than indicated.

This year, 1,090 people have contacted poison control centers about CBD, according to the American Association of Poison Control Centers. Over a third are estimated to have received medical attention, and 46 were admitted into a critical care unit, possibly because of exposure to other products, or drug interactions. In addition, concern over 318 animals poured into the American Society for the Prevention of Cruelty to Animals’ Animal Poison Control Center.

Is CBD a scam or not?

A few drops of CBD oil in a mocha or smoothie are not likely to do anything, researchers contend. Doctors say another force may also be at play in people feeling good: the placebo effect. That’s when someone believes a drug is working and symptoms seem to improve.

“CBD is not a scam,” said Yasmin Hurd, director of the Addiction Institute of Mount Sinai in New York City who led a double-blind study of 42 recovering heroin addicts and found that CBD reduced both cravings and cue-based anxiety, both of which can cycle people back into using. “It has a potential medicinal value, but when we are putting it into mascara and putting it into tampons, for God’s sake, to me, that’s a scam.”