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Cannabidiol (CBD) is an active ingredient in cannabis that is derived from the hemp plant, but it does not cause a high and is not addictive. CBD has been shown to be effective in treating conditions like pain, insomnia, and anxiety. The cannabis-derived chemical is non-psychoactive, and – while federally illegal – has been hailed as a cure for disease<br> Cannabidiol (CBD) is a naturally occurring, non-psychotropic cannabinoid of the hemp plant <i>Cannabis sativa</i> L. and has been known to induce several physiological and pharmacological effects. While CBD is approved as a medicinal product subject to prescription, it is also widely sold over the c …

Cannabidiol (CBD): What we know and what we don’t

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?

How is cannabidiol different from marijuana, cannabis and hemp?

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.”

Is cannabidiol legal?

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.

The evidence for cannabidiol health benefits

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:

    Studies and clinical trials are exploring the common report that CBD can reduce anxiety.
  • Insomnia. Studies suggest that CBD may help with both falling asleep and staying asleep.
  • Chronic pain. Further human studies are needed to substantiate claims that CBD helps control pain. One animal study from the European Journal of Pain suggests CBD could help lower pain and inflammation due to arthritis when applied to skin. Other research identifies how CBD may inhibit inflammatory and neuropathic pain, which are difficult treat.
  • Addiction. CBD can help lower cravings for tobacco and heroin under certain conditions, according to some research in humans. Animal models of addiction suggest it may also help lessen cravings for alcohol, cannabis, opiates, and stimulants.
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Is CBD safe?

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.

How can CBD be taken?

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.

The bottom line on cannabidiol

Some CBD manufacturers have come under government scrutiny for wild, indefensible claims, such that CBD is a cure-all for cancer or COVID-19, which it is not. We need more research but CBD may prove to be a helpful, relatively non-toxic option for managing anxiety, insomnia, and chronic pain. Without sufficient high-quality evidence in human studies, we can’t pinpoint effective doses, and because CBD currently is typically available as an unregulated supplement, it’s hard to know exactly what you are getting.

If you decide to try CBD, make sure you are getting it from a reputable source. And talk with your doctor to make sure that it won’t affect any other medicines you take.

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What is CBD? The ‘miracle’ cannabis compound that doesn’t get you high

In early May, a federal court declined to protect cannabidiol (CBD), a chemical produced by the cannabis plant, from federal law enforcement, despite widespread belief in its medical value.

The ruling was contrary to existing evidence, which suggests the chemical is safe and could have multiple important uses as medicine. Many cannabis advocates consider it a miracle medicine, capable of relieving conditions as disparate as depression, arthritis and diabetes.

The perception of its widespread medical benefits have made the chemical a rallying cry for legalization advocates.

The first thing to know about CBD is that it is not psychoactive; it doesn’t get people high. The primary psychoactive ingredient in marijuana is tetrahydrocannabinol (THC). But THC is only one of the scores of chemicals – known as cannabinoids – produced by the cannabis plant.

So far, CBD is the most promising compound from both a marketing and a medical perspective. Many users believe it helps them relax, despite it not being psychoactive, and some believe regular doses help stave off Alzheimer’s and heart disease.

While studies have shown CBD to have anti-inflammatory, anti-pain and anti-psychotic properties, it has seen only minimal testing in human clinical trials, where scientists determine what a drug does, how much patients should take, its side effects and so on.

Despite the government ruling, CBD is widely available over the counter in dispensaries in states where marijuana is legal.

CBD first came to public attention in a 2013 CNN documentary called Weed. The piece, reported by Dr Sanjay Gupta, featured a little girl in Colorado named Charlotte, who had a rare life-threatening form of epilepsy called Dravet syndrome.

At age five, Charlotte suffered 300 grand mal seizures a week, and was constantly on the brink of a medical emergency. Through online research, Charlotte’s desperate parents heard of treating Dravet with CBD. It was controversial to pursue medical marijuana for such a young patient, but when they gave Charlotte oil extracted from high-CBD cannabis, her seizures stopped almost completely. In honor of her progress, high-CBD cannabis is sometimes known as Charlotte’s Web.

CBD has been sought for its healing properties. Illustration: George Wylesol

After Charlotte’s story got out, hundreds of families relocated to Colorado where they could procure CBD for their children, though not all experienced such life-changing results. Instead of moving, other families obtained CBD oil through the illegal distribution networks.

In late June, the US Food and Drug Administration could approve the Epidiolex, a pharmaceuticalized form of CBD for several severe pediatric seizure disorders. According to data recently published in the New England Journal of Medicine, the drug can reduce seizures by more than 40%. If Epidiolex wins approval it would be the first time the agency approves a drug derived from the marijuana plant. (The FDA has approved synthetic THC to treat chemotherapy-related nausea.)

Epidiolex was developed by the London-based GW Pharmaceuticals, which grows cannabis on tightly controlled farms in the UK. It embarked on the Epidiolex project in 2013, as anecdotes of CBD’s value as an epilepsy drug began emerging from the US.

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While parents treating their children with CBD had to proceed based on trial and error, like a folk medicine, they also had to wonder whether dispensary purchased CBD was professionally manufactured and contained what the package said it did. GW brought a scientific understanding and pharmaceutical grade manufacturing to this promising compound.

Fortunately, like THC, CBD appears to be well tolerated; as far as I can tell, there are no recorded incidents of fatal CBD overdoses.

Conversion of Cannabidiol (CBD) into Psychotropic Cannabinoids Including Tetrahydrocannabinol (THC): A Controversy in the Scientific Literature

Cannabidiol (CBD) is a naturally occurring, non-psychotropic cannabinoid of the hemp plant Cannabis sativa L. and has been known to induce several physiological and pharmacological effects. While CBD is approved as a medicinal product subject to prescription, it is also widely sold over the counter (OTC) in the form of food supplements, cosmetics and electronic cigarette liquids. However, regulatory difficulties arise from its origin being a narcotic plant or its status as an unapproved novel food ingredient. Regarding the consumer safety of these OTC products, the question whether or not CBD might be degraded into psychotropic cannabinoids, most prominently tetrahydrocannabinol (THC), under in vivo conditions initiated an ongoing scientific debate. This feature review aims to summarize the current knowledge of CBD degradation processes, specifically the results of in vitro and in vivo studies. Additionally, the literature on psychotropic effects of cannabinoids was carefully studied with a focus on the degradants and metabolites of CBD, but data were found to be sparse. While the literature is contradictory, most studies suggest that CBD is not converted to psychotropic THC under in vivo conditions. Nevertheless, it is certain that CBD degrades to psychotropic products in acidic environments. Hence, the storage stability of commercial formulations requires more attention in the future.

Keywords: Cannabis sativa; cannabidiol; degradation; psychotropic effects; tetrahydrocannabinol.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Chemical structures of ( a…

Chemical structures of ( a ) cannabinol (CBN) including the numbering system, (…

Chemical structures of (a) cannabinol (CBN) including the numbering system, (b) Δ 9 -tetrahydrocannabinol (Δ 9 -THC) and (c) cannabidiol (CBD).

Google trends analysis for cannabidiol…

Google trends analysis for cannabidiol (CBD) (Data source: Google Trends [23]).

Chemical structures of ( a…

Chemical structures of ( a ) hexahydrocannabinol (HHC), ( b ) cannabigerol (CBG)…

Chemical structures of (a) hexahydrocannabinol (HHC), (b) cannabigerol (CBG) and (c) cannabichromene (CBC).

Overview of various chemical conversions…

Overview of various chemical conversions of cannabidiol (CBD) to different conversion products and…

Overview of various chemical conversions of cannabidiol (CBD) to different conversion products and the respective conditions, which are reported in the literature.

Chemical structures of ( a…

Chemical structures of ( a ) cannabidiolic acid (CBDA) and ( b )…

Chemical structures of (a) cannabidiolic acid (CBDA) and (b) Δ 9 -tetrahydrocannabinolic acid (Δ 9 -THCA).

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