Table of Contents
- Cannabidiol: Separating Fact from Fiction
- The CBD Glossary: What Is the Difference between Cannabis and Cannabidiol?
- The Explosive Popularity of CBD
- Forms of Delivery & Bioavailability
- The Cold Hard Science: What Can CBD Really Do?
- The Pharmacological Profile of CBD
- Incredible Anti-Seizure Effects
- Anxiolytic Effects
- Depression & Psychotic Disorders
- Inflammation and Neuroinflammation
- Insomnia and Sleep Disorders
- Chronic and Acute Pain
- Social Anxiety Disorder
- The Body’s Endocannabinoid System and the True Power of CBD
- What is the Endogenous Cannabinoid System?
- The Possibilities of the ECS and CBD
- The Best Herbal Remedy in the World
Cannabidiol: Separating Fact from Fiction
At this point nearly everyone knows about CBD (cannabidiol) in some capacity as its unrelenting prominence in media and pop culture persists long after the waves of initial hype recede. Yet there remains an undeniable gulf between what we think about CBD and what we know about CBD.
On the one side of the gulf, peer reviewed research establishes enough as fact to solidly rank CBD as one of the most promising herbal extracts on the market. On the other side, avid CBD users proclaim with earnest enthusiasm an array of anecdotal benefits seemingly too good to be true, such as those who claim CBD resolved or cured a chronic disease or serious condition.
Are these stories of CBD’s amazing effects too good to be true? Or will the science support such claims? The answer lies in one of the least discussed aspects of CBD–at least in laymen discussions–the relationship between CBD and the human body’s endocannabinoid system.
But before we dive-in to the relationship between CBD and the endocannabinoid system, first we should clear the air and separate fact from fiction and myth from reality. Because while CBD can do much more than you think, a veil of misinformation obfuscates any inquiry aimed at such an appraisal.
Ironically, the real possibilities of CBD seem less believable than many of the most erroneous claims. So let’s lift the veil of confusion and clarify the true science of the world’s most intriguing herbal extract to discuss what is possible and what is not.
The CBD Glossary: What Is the Difference between Cannabis and Cannabidiol?
For any depth of discussion in research and science to take place, the primary actors must be identified and the plot of the story must be clear. So let’s take a look at the various plant species and chemical compounds at the center of this discussion.
What is Cannabis / Marijuana?
Marijuana or Cannabis is the name of the plant which depending on its sex will contain varying amounts of THC and dozens of other cannabinoids–around 113 have been identified at present. Professional growers focus on growing many different strains of Cannabis that contain key ratios of cannabinoids such as THC, CBD, CBG, CBN, etc. Female cannabis plants present budding flowers which are the primary focus for growers targeting high-concentrations of THC.
While state legislation may establish conflicting legalities, the cannabis plant remains federally illegal for recreational use.
What is Hemp?
Hemp is a variety of Cannabis sativa L which presents in either a male or female sex and is commonly referred to as ‘industrial hemp’. This designation is important because it designates hemp as a safe crop for procuring cannabinoids in a legal fashion. While industrial hemp does contain THC, it is in a low enough concentration that achieving an intoxicating effect is at least, unlikely and at most, terribly inefficient (at around 0.3% THC).
What is a Cannabinoid?
The term ‘Cannabinoid’ refers to the active constituents or compounds unique to cannabis plants, of which there have been about 113 identified to date, out of more than 400 chemical components in the plant. While there are many cannabinoids, the primary cannabinoids of note are CBD (cannabidiol) and THC (tetrahydrocannabinol).
The FDA has not approved the cannabis plant for medical use, however they have approved several drugs that contain specific cannabinoids. Many researchers are currently working to establish the benefits associated with different cannabinoids
What is THC?
THC or tetrahydrocannabinol, one of the most infamous actors in the conversation about cannabis and its cannabinoids, is primarily responsible for the intoxicating effects of cannabis–the “high” experienced by cannabis users–which is due to its psychoactive component. THC also claims responsibility for the illegality of the cannabis plant, since these intoxicating effects rendered it an appropriate target for the war on drugs in America.
What is Cannabidiol?
Cannabidiol is another well-known and well-researched non-psychoactive cannabinoid found both in cannabis and industrial hemp. Industrial hemp is the primary crop used for harvesting CBD, since industrial hemp is federally legal while cannabis is not. This is due to Cannabidiol lacking any intoxicating effect, even at higher doses since it lacks the psychoactive component of THC.
Clinical studies have demonstrated a range of medical benefits due to its anxiolytic effects and uses as an anti-inflammatory. Ongoing research looks to demonstrate the full range of its uses, but as of now we have only a partial picture of its capabilities.
The Explosive Popularity of CBD
Due to controversy and legal ambiguity the science and research communities historically displayed reluctance in exploring the effects of CBD, however that all changed when CBD hit the mainstream. According to a 2020 survey, the explosive popularity of CBD presents as a viral phenomenon.
33% of adult Americans have used CBD at least once.
As of 2019, 64% of Americans were familiar with CBD products (Gallup, 2019)
According to a 2019 Consumer Report, approximately 64 million Americans have tried CBD in the last 24 months.
Outlined in the same report was the amazing statistic that of those who use CBD, 22% said it helped them supplement or replace prescription or over-the-counter drugs.
The most commonly reported uses of CBD are for pain relief (64%), anxiety (49%), and insomnia (42%). (SingleCare, 2020)
Hemp-derived CBD products are legal in all 50 states, as long as they contain no more than 0.3% THC. (Food and Drug Administration, 2020)
Web searches for CBD increased by 125.9% from 2016 to 2017 and 160.4% from 2017 to 2018. (JAMA Network, 2019)
The declaration that CBD presents no risk for abuse or potential for dependence acted as a boon for researchers–who can now organize human trials without the risk of endangering participants. 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.”
The significance of this data shouldn’t be underestimated. It is profound and has had far-reaching implications for the CBD industry. While Americans use CBD in a range of applications, around 40-60% use it for a serious medical condition and around 22% use it to replace prescription or over-the-counter drugs, which are notoriously associated with detrimental side-effects and health concerns.
The idea that one can take CBD and feel serious results without experiencing a downside is the foundation of its popularity. Even the most popular herbal supplements come with a laundry list of health concerns.
Take ginseng for example. It is one of the most popular herbal supplement products on the planet and is widely regarded as safe. Yet there is a laundry list of reported side-effects and potential negative interactions to consider (Medical News Today):
- Changes to blood pressure and blood sugar
- Digestive problems
- Rapid heartbeat
- Sleep problems
- Severe skin reaction
There is also strong evidence against long-term use of herbal supplements, due to overtaxing the body’s kidneys and liver. With CBD however, the body seems eerily receptive–as if it were designed to receive and process cannabinoids.
NOTE: It should be noted that while extremely rare, individuals have encountered some very mild side-effects with CBD such as dry mouth and nausea. It is believed however that this typically occurs when someone has an allergy to cannabinoids, or an underlying health problem. And while daily, long term use has been shown to be safe so far, we still lack data to measure this conclusively.
Forms of Delivery & Bioavailability
You can find CBD in many forms. Here are some of the most common options:
- Beverages, such as coffees and teas
- Edibles, such as gummies, chocolates, and cookies
- Oral sprays
- Oils and tinctures
- Pills and capsules
- Topical solutions, including lotions, creams, patches, gels, and ointments
- Vapes and vape juices to use in a vaping pen
As CBD products become common household items, innovation in delivery methods become central components of brand recognition in the marketplace. Countless products claim to improve CBD’s effects by offering a new spin on the delivery method–typically by one of two methods. By either directly increasing the bioavailability of the CBD, or by including other active ingredients to improve the effects of CBD.
Bioavailability is an important concept in the science of CBD. Bioavailability refers to the concept of physiological absorption, that is, how much of the CBD effectively enters the bloodstream in order to deliver its effects. With this in mind, the delivery method of CBD is the primary mechanism for determining the bioavailability of a particular product.
For instance, when one swallows a CBD capsule it enters the stomach and is broken down by stomach acids before being sent to the liver to be processed. It is only after being processed by the liver that the CBD then enters the bloodstream–at which point roughly 40% of it is lost to the filtering mechanism of the liver, which is referred to as the ‘First Pass Effect.’ (Pharmacokinetics)
For this reason, sublingual drops are a preferred method of delivery for CBD. Sublingual drops are typically administered under the tongue where a dense collection of blood vessels and thin skin layer allows for more efficient and effective absorption that entirely skips the first pass effect.
It is estimated that CBD sublingual drops provide anywhere from 40% to 60% more bioavailability than swallowed capsules. But bioavailability isn’t everything, since many people want to enjoy their daily doses of CBD through other delivery methods such as drinks, foods, and even e-cigarette devices.
In 2021, you can find CBD in practically anything. There is CBD beer, CBD kombucha, CBD soaps, CBD chocolate, CBD vape pens, CBD gummies. If you can think of it, you can probably find it.
But with this level of market saturation, this question gains significance–what can all that CBD really do for you?
The Cold Hard Science: What Can CBD Really Do?
Is CBD just an overhyped snake oil, or is it one of the most miraculous herbal compounds in the world? Before we consider the alluring possibilities of CBD’s unproven applications–such as those suggested in anecdotal evidence–it is necessary to first lay out the baseline, that is, what CBD has been clinically proven to do. Then one can effectively evaluate whether individuals’ anecdotal experiences might be backed by science or not.
The Pharmacological Profile of CBD
One can begin to grasp the pharmacological significance of CBD by noting the different attributes that researchers currently assign to CBD’s pharmacological profile. Clinical researchers point out out its attributes in the following categories (Cannabidiol: A Potential New Alternative for the Treatment of Anxiety, Depression, and Psychotic Disorders, 2020):
- Antimicrobial – Combats or totally eradicates the growth of pathogenic microorganisms.
- Immunosuppressive – Suppresses the body’s immune system and its ability to fight infections and other diseases, but often employed in clinical settings to combat against negative immune responses–such as the rejection of a donor organ.
- Antiemetic – Prevents vomiting, specifically the physiological contractions responsible for vomiting.
- Anti-resorptive – Bone matter is slowly reabsorbed in the body over time. This resorptive function can outpace bone production to cause osteoporosis. Anti-resorptive properties help to restore balance to the skeletal system.
- Spasmolytic – Able to relieve spasm of smooth muscle.
- Antitumor – Limits or inhibits the growth of tumors.
- Antifibrotic – Prevents or even entirely blocks tissue scarring.
- Anti-inflammatory – Limits or prevents inflammation of tissue.
- Anticonvulsant – Limits or prevents the convulsion response.
Incredible Anti-Seizure Effects
What really made the pharmaceutical industry take CBD seriously was its incredible ability to stop seizures in their tracks. Popular videos circulate that show a child struggling violently in the grips of a seizure, which is then near-instantly resolved after ingesting a dose of CBD.
As such, the Mayo Clinic cites CBD’s primary benefit as an effective anti-seizure medication. The effectiveness of CBD in this context has led to it being offered as one of the only FDA approved CBD products in the pharmaceutical industry–Epidiolex, which is a popular and effective prescription medicine used to treat two of the cruelest forms of child epilepsy, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS).
One of the most promising and wide-spread uses of CBD is to prevent anxiety or to reduce its symptoms. Published in the Journal of Neurotherapeutics, the study entitled Cannabidiol as a Potential Treatment for Anxiety Disorders, comes to an incredible conclusion–that CBD effectively treats a range of neuropsychiatric conditions such as the following:
- Generalized anxiety disorder
- Panic disorder
- Social anxiety disorder
- Obsessive–compulsive disorder
- Post-traumatic stress disorder
The current state of the research however, bumps against the constraints of a limited timeframe. Because CBD has only recently been taken seriously in clinical inquiries, the effects of CBD are necessarily measured in acute fashion, that is to say that we have very little to say about the chronic use of CBD.
The researchers responsible for the above article state it like this: “Evidence from human studies supports an anxiolytic role of CBD, but is currently limited to acute dosing, also with few studies in clinical populations.” But the fact remains, CBD is proven to be effective in the treatment of anxiety-conditions with plenty to suggest promising effects in other similar psychological conditions as well.
Depression & Psychotic Disorders
In the study entitled Cannabidiol: A Potential New Alternative for the Treatment of Anxiety, Depression, and Psychotic Disorders, we see that CBD demonstrates a positive effect in the treatment of clinical depression, psychotic disorders, and depression-like symptoms. Those taking CBD to treat such symptoms report feeling more mental wellbeing, as well as having more control over one’s mental state. The aforementioned study makes careful note of CBD’s positive risk-benefit profile–meaning there are many things to be gained from the US of CBD with little or no downside.
Inflammation and Neuroinflammation
Two primary studies demonstrate the highly promising and dynamic anti-inflammatory effects of CBD: Cannabinoid Modulation of Neuroinflammatory Disorders, and Cannabinoids as novel anti-inflammatory drugs. What is so interesting about how the body uses CBD to combat inflammation is how dynamic the effect can be.
The body’s endocannabinoid system processes CBD and then generates different enzymes according to what the body needs. Theoretically, for example, one could expect a different effect from CBD if taken before a workout or after a workout–with CBD producing preventative anti-inflammatories in the former case, while producing intervening anti-inflammatory enzymes in the latter case.
The same dynamic interaction occurs when CBD is used to treat neuroinflammation. The endocannabinoid system converts the CBD into neurotransmitters in a ratio that is suggested to be more conducive to homeostasis. In other words, the endocannabinoid system is able to restore balance to the body’s inflammatory responses–both in the brain and in muscle or joint tissue.
Insomnia and Sleep Disorders
Around 70% of Americans report not sleeping enough and roughly one-third of Americans sleep less than six hours in a night, while the recommended amount is between 7-9 hours depending on personal factors. In short, many people are struggling to develop healthy sleeping routines–even those who don’t have a traditional sleep disorder often experience negative symptoms of poor sleep.
CBD has been shown to work as effective intervention and prevention in the case of sleep problems. While it still remains unclear exactly how CBD interacts with insomnia, it has been shown to help alleviate some of the symptoms of insomnia which cause sleeplessness–such as a reduction of anxiety. Overall however, sleep remains one of the least investigated areas of CBD treatment outcomes.
Chronic and Acute Pain
The use of CBD in the treatment of pain–both acute and chronic–is one of the most hotly contested areas of its pharmacological profile. Many clinicians are quick to dismiss CBD having any serious clinical use, but the science is clear: CBD has very real, measurable, and significant uses in the treatment of pain.
The deciding factor in whether it is effective or isn’t seems to be connected to the type of pain being treated. For instance in the study entitled, A Balanced Approach for Cannabidiol Use in Chronic Pain, there is a comprehensive list of clinical studies which demonstrate the effectiveness of CBD in the treatment of pain resulting from the following conditions:
- Multiple sclerosis
- Spinal cord injury
- Brachial plexus injury
- Limb amputation
Anything that has been proven to help mitigate the pain of losing a limb is enough to be called ‘effective’ in my book. CBD has also proven significantly effective in managing the chronic pain associated with a kidney transplant. That’s big business.
Social Anxiety Disorder
The treatment of Social Anxiety Disorder (SAD) with CBD is studied in the following article, Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders published in the Journal, Frontiers in Psychology. Teenagers were given 300mg doses of CBD doses daily for four weeks, in which time participants noted significant reductions in the symptoms and experiences of SAD.
In this context, CBD is shown to be even more effective than potent pharmaceuticals in some cases. When you factor in the fact that CBD delivers these effects without the risk of abuse, dependence, or other severe side-effects, it becomes clear why CBD is becoming such a central component of health enthusiasts’ regimens.
The Body’s Endocannabinoid System and the True Power of CBD
Through reviewing the clinical studies listed above, hopefully it has been made clear that the hype and fever-pitch popularity surrounding CBD are well-deserved. In fact, it seems that CBD might be the real deal: there is a significant body of research suggesting that it is capable of producing the wide-range of anecdotal benefits that you hear about from CBD advocates.
But we’re not quite done, because we have not yet even addressed the most impressive and borderline magical component of CBD, or any cannabinoid for that matter, that is, the ‘Endocannabinoid System.”
The body has a physiological system specifically designed for the processing of cannabinoids. That’s right. We were built to capitalize on the offerings of the cannabis plant. And no–this isn’t science fiction, or pseudoscience for that matter.
What is the Endogenous Cannabinoid System?
The Endogenous Cannabinoid System (ECS) is a neuromodulatory system that interacts with the human body in a number of highly important functions:
- Central nervous system (CNS) development
- Synaptic plasticity – How the brain’s synapses adapt to change, stress, or disease
- The response to endogenous and environmental insults – Or how the body responses to damage, stress, or sickness
According to the study entitled, An introduction to the endogenous cannabinoid system, the ECS is a system that is made up of cannabinoid receptors, endogenous cannabinoids, as well as the synthesizing enzymes responsible for breaking down the endocannabinoids.
In plain English, this means that the ECS is built entirely to receive and process cannabinoids–and what the ECS synthesizes these cannabinoids into is largely dependent on what the body needs at that time. In other words, through cannabinoids we have found a backdoor to homeostasis in the human body–and the significance of this cannot be understated.
Scientists are scrambling to understand just how far reaching this implications truly are, and how to take advantage of this miraculous system.
The Possibilities of the ECS and CBD
While this modular system of the ECS does provide a backdoor to homeostasis, the scope of what is possible is still limited. For instance, the ECS is limited by what parts of the body can receive and process cannabinoids, and is limited again by what the body can synthesize from these cannabinoids.
While we are just beginning to scratch the surface in terms of what is possible through the ECS, the foundation of research is solid enough for us to begin mapping out the science:
Cannabinoid receptors, 5-HT1A receptor, and neurogenesis factors
So far scientists have mapped the above receptors in relation to neurogenesis factors, which is the process by which the body creates neurons in the brain throughout a human’s lifespan. And neurons of course are the building blocks of human consciousness with their health and functionality or lack thereof being a central aspect of degenerative brain diseases.
In other words, there is a strong argument to be made that the ECS might be capable of preventing or intervening in cases of dementia, Alzheimer’s, or other brain diseases. One might think that if this were a possibility, it would have been proven by now, but the problem is that those kinds of studies take years or even decades to play out and we also are woefully lacking in technology that can accurately track a causal relationship between neuronal activity.
For now, we can only acknowledge the tremendously promising possibility and wait for our technology to catch up.
CB1 and CB2 receptors
In the article entitled, Cannabinoid Modulation of Neuroinflammatory Disorders, researchers establish another amazing link between the ECS and achieving homeostasis, but this time in the context of the immune system:
“The fact that both CB1 and CB2 receptors have been found on immune cells suggests that cannabinoids play an important role in the regulation of the immune system.
The endocannabinoid system is also involved in immunoregulation. For example, administration of endocannabinoids or use of inhibitors of enzymes that break down the endocannabinoids, led to immunosuppression and recovery from immune-mediated injury to organs such as the liver.”
In this capacity, it seems the body is even capable of employing the ECS to achieve harmony when the body demonstrates a chaotic immune system response. The study suggests that we have only begun to understand the body’s ability to modulate the immune system through cannabinoids and the ECS–a hopeful notion for the millions of people who struggle with immune system challenges.
The Best Herbal Remedy in the World
Archeological evidence suggests humans have been using hemp since 8,000BC, meaning our bodies have built a relationship with this crop, consisting of a jaw-dropping 10,000 year history (The People’s History).
People back then used hemp for an array of applications, but it is clear that throughout this time they consumed it, too. Did they know something that we are just now coming to realize?
Regardless of the answer, the truth is clear. The relationship between humanity and that funny little crop called cannabis is a far more deep and complex one than we could have ever imagined. Scientists are often consumed with looking ahead into the future for answers, but at least in the case of hemp and CBD, the answers might have been behind us, in the past all along.
The 2020 CBD survey, SingleCare 2019
The People’s History, MIT.edu
A Balanced Approach for Cannabidiol Use in Chronic Pain, US National Library of Medicine
An introduction to the endogenous cannabinoid system, US National Library of Medicine
CBD goes mainstream, Consumer Reports
CBD as a Sleep Aid, Sleep Foundation
Cannabidiol as a Potential Treatment for Anxiety Disorders, US National Library of Medicine
Cannabinoids as novel anti-inflammatory drugs, US National Library of Medicine
Cannabinoids in the management of difficult to treat pain, US National Library of Medicine
Cannabidiol: A Potential New Alternative for the Treatment of Anxiety, Depression, and Psychotic Disorders, US National Library of Medicine
Cannabinoid Modulation of Neuroinflammatory Disorders, US National Library of Medicine
Cannabidiol (CBD)-what we know and what we don’t, Harvard.edu
FDA regulation of cannabis and cannabis-derived products, including cannabidiol (CBD), U.S. Food and Drug Administration
Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders, US National Library of Medicine
Medical cannabis evidence on efficacy, D.C. Department of Health
Pharmacokinetics, Mark Kester, PhD; Kelly D. Karpa, PhD; Kent E. Vrana, PhD
Transdermal cannabidiol reduces inflammation and pain-related behaviors in a rat model of arthritis, European Journal of Pain
Trends in internet searches for cannabidiol (CBD) in the United States, The Journal of the American Medical Association
U.S. CBD market anticipated to reach $20 billion in sales by 2024, BSDA
What are the benefits of CBD — and is it safe to use?, Mayo Clinic
What are the health benefits of ginseng?, Medical News Today