What's The Big Deal About CBD Oil?

With more and more states approving marijuana for both medical and recreational use, unless you've been living under a rock, you've probably heard something about CBD oil. It's popping up in more and more products, and being touted as the next greatest thing for just about every disorder there is. But what are the facts, and is the hype legitimate? Read on to find out!

CBD actually stands for Cannabidiol, which is a naturally occurring constituent of industrial hemp and marijuana. Hemp and marijuana are part of a family of plants collectively called cannabis. CBD oil is one of at least 85 cannabinoid compounds found in cannabis, and they are popular for their health benefits. After tetrahydrocannabinol (THC), CBD oil is the second-most-abundant component of cannabis. Other names you may see for CBD oil include CBD-rich hemp oil, hemp-derived CBD oil, or CBD-rich cannabis oil. While CBD oil is considered to be generally safe and has been used for decades medically, it is important to note that CBD is NOT medical marijuana and does not contain THC (which has psychoactive properties and causes a "high").

So how does CBD oil work? CBD has actually been studied for several decades, and with an uptick in new research, there are actually quite a few important ways scientists have discovered it acts in our bodies:

1. There are two cannabinoid receptors are known to exist in the human body: CB1 and CB2 receptors.

2. The CB1 receptors are located mainly in the brain and affect neurotransmitter release in such a way that prevents excessive neuronal activity (thus calming and decreasing anxiety), as well as reduces pain, decreases inflammation, regulates movement and posture control, and regulates sensory perception, memory, and cognitive function.

3. CBD also helps to regulate the release of cytokines from immune cells in a way that helps to reduce inflammation and pain.

4. Another mechanism of action of CBD include stimulation of vanilloid pain receptors (TRPV-1 receptor), which are known to mediate pain perception, inflammation, and body temperature.

5. CBD may exert its anti-anxiety effect by activating adenosine receptors, which play a significant role in cardiovascular function and cause a broad anti-inflammatory effect throughout the body.

6. At high concentrations, CBD directly activates the 5-HT1A serotonin receptor, thereby providing an antidepressant effect.

So what does all that jargon mean? What it means is that the hype is real, and CBD may be a great tool, and even an alternative to certain medications, in treating a wide variety of medical conditions!

In the last decade in particular there has been an increase in the scientific publishing on CBD, owing to its identification for reducing nausea and vomiting, treating psychotic disorders, reducing inflammation, decreasing anxiety and depression, improving sleep, and increasing a sense of well-being. Additional uses recently reported included CBD being beneficial for kidney fibrosis and inflammation, metabolic syndrome, overweight and obesity, anorexia-cachexia syndrome, and modification of osteoarthritic and other musculoskeletal conditions.

CBD is also being used in cancer care because it has a number of potential benefits, especially in the management of symptoms. CBD and cannabis is useful in combatting anorexia, chemotherapy-caused nausea and vomiting, pain, insomnia, and depression. Cannabis might be less potent than other available anti-nausea and vomiting drugs, but it is the only one that also increases appetite. It could also prove useful in chemotherapy-induced neuropathy. Interestingly enough, cannabis was probably used medically in the ancient world for these very reasons. A 2500-year-old mummy known as the “Siberian Ice Maiden,” discovered in 1993, was found buried with a pouch of cannabis. Magnetic resonance imaging (MRI) revealed that the princess had a primary tumour in the right breast, with axial adenopathy and metastatic disease. Researchers hypothesized that the cannabis was used to manage her pain and perhaps other symptoms, or even possibly as a treatment for her malignant disease.

So while the ancient world was on to CBD's health benefits, for a long time cannabis was viewed unfavorably. It is encouraging to see a resurgence of new research into a potentially powerful treatment option for a variety of ailments.

Because we are so excited about its potential benefits, our clinic carries two high quality lines of CBD products - a topical ointment designed to help with aches and pains, and a sublingual oil that can help with a wide variety of conditions we commonly see in our office. It is important to note that none of our products contain THC, and other medical grade cannabis products can only be prescribed by the proper medical provider, and only for specific conditions. CBD products, such as those at our clinic, should also only be purchased directly from reputable sellers and vendors, not from third-party sites such as Amazon and eBay.

Below you will find many research articles regarding CBD and cannabis:

1. Campos AC, Moreira FA, Gomes FV, Del Bel EA, Guimarães FS. Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders. Philos Trans R Soc Lond B Biol Sci. 2012 Dec 5;367(1607):3364–78. DOI: http://dx.doi.org/10.1098/rstb.2011.0389. [PMC free article] [PubMed]

2. Mechanism of action [Internet] Cambridge, United Kingdom: GW Pharmaceuticals plc; c2014. [cited 2015 Aug]. Available from: www.gwpharm.com/mechanism-of-action.aspx.

3. McPartland JM, Guy G. The evolution of cannabis and coevolution with the cannabinoid receptor—a hypothesis. In: Guy GW, Whittle BA, Robson PJ, editors. The medicinal uses of cannabis and cannabinoids. 1st ed. London, United Kingdom: Pharmaceutical Press; 2004. pp. 71–102.

4. Leweke FM, Piomelli D, Pahlisch F, et al. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Transl Psychiatry. 2012 Mar 20;2:e94. DOI: http://dx.doi.org/10.1038/tp.2012.15. [PMC free article] [PubMed]

5. Lee MA. CBD: how it works. O’Shaughnessy’s [Internet] 2011. Autumn. [cited 2016 Apr 26]:14. Available from: www.os-extra.cannabisclinicians.org/wp-content/uploads/2012/07/CBDiary21.pdf.

6. Crippa JA, Derenusson GN, Ferrari TB, et al. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. J Psychopharmacol. 2011 Jan;25(1):121–30. DOI: http://dx.doi.org/10.1177/0269881110379283. [PubMed]

7. McHugh D, Tanner C, Mechoulam R, Pertwee RG, Ross RA. Inhibition of human neutrophil chemotaxis by endogenous cannabinoids and phytocannabinoids: evidence for a site distinct from CB1 and CB2. Mol Pharmacol. 2008 Feb;73(2):441–50. DOI: http://dx.doi.org/10.1124/mol.107.041863. [PubMed]

8. Zhornitsky S, Potvin S. Cannabidiol in humans—the quest for therapeutic targets. Pharmaceuticals (Basel) 2012 May 21;5(5):529–52. DOI: http://dx.doi.org/10.3390/ph5050529. [PMC free article][PubMed]

9. Zuardi AW. Cannabidiol: from an inactive cannabinoid to a drug with wide spectrum of action. Rev Bras Psiquiatr. 2008 Sep;30(3):271–80. DOI: http://dx.doi.org/10.1590/s1516-44462008000300015. [PubMed]

10. Burstein S. Cannabidiol (CBD) and its analogs: a review of their effects on inflammation. Bioorg Med Chem. 2015 Apr 1;23(7):1377–85. DOI: http://dx.doi.org/10.1016/j.bmc.2015.01.059. [PubMed]

11. Fernández-Ruiz J, Sagredo O, Pazos MR, et al. Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid? Br J Clin Pharmacol. 2013 Feb;75(2):323–33. DOI: http://dx.doi.org/10.1111/j.1365-2125.2012.04341.x. [PMC free article] [PubMed]

12. Zuardi AW, Crippa JA, Hallak JE, Moreira FA, Guimarães FS. Cannabidiol, a Cannabis sativa constituent, as an antipsychotic drug. Braz J Med Biol Res. 2006 Apr;39(4):421–9. DOI: http://dx.doi.org/10.1590/s0100-879x2006000400001. [PubMed]

13. Fingerle J. CB2 agonism protects from inflammation related kidney damage and fibrosis. Proceedings of the 25th Anniversary Symposium of the International Cannabinoid Research Society; 2015 Jun 28–Jul 3; Wolfville, Nova Scotia, Canada.

14. Purohit V. Role of cannabinoids in chronic pain. Proceedings of the 25th Anniversary Symposium of the International Cannabinoid Research Society; 2015 Jun 28–Jul 3; Wolfville, Nova Scotia, Canada.

15. Starowicz K. Role of endocannabinoid system in pathogenesis of osteoarthritic pain. Proceedings of the 25th Anniversary Symposium of the International Cannabinoid Research Society; 2015 Jun 28–Jul 3; Wolfville, Nova Scotia, Canada.

16. Liu A. Therapeutic efficacy of a peripherally restricted CB1R antagonist/AMPK activator in diet-induced obesity/metabolic syndrome. Proceedings of the 25th Anniversary Symposium of the International Cannabinoid Research Society; 2015 Jun 28–Jul 3; Wolfville, Nova Scotia, Canada.

17. Bergamaschi MM, Queiroz RH, Zuardi AW, Crippa JA. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf. 2011 Sep 1;6(4):237–49. DOI: http://dx.doi.org/10.2174/157488611798280924. [PubMed]

18. Ferreira VR, Carvalho LB, Ruotolo F, de Morais JF, Prado LB, Prado GF. Sleep disturbance scale for children: translation, cultural adaptation, and validation. Sleep Med. 2009 Apr;10(4):457–63. DOI: http://dx.doi.org/10.1016/j.sleep.2008.03.018. [PubMed]

19. Birmaher B, Khetarpal S, Cully M, Brent D, McKenzie S. Screen for child anxiety related disorders (SCARED) [Internet] Pittsburgh, PA: Western Psychiatric Institute and Clinic, University of Pittsburgh; 1995. Oct, [cited 2016 Apr 26]. Available from: www.pediatricbipolar.pitt.edu/content.asp?id=2333#3304.

20. Pace-Schott EF, Germain A, Milad MR. Sleep and REM sleep disturbance in the pathophysiology of PTSD: the role of extinction memory. Biol Mood Anxiety Disord. 2015 May 29;5:3. DOI: http://dx.doi.org/10.1186/s13587-015-0018-9. [PMC free article] [PubMed]

21. Hsiao YT, Yi PL, Li CL, Chang FC. Effect of cannabidiol on sleep disruption induced by the repeated combination tests consisting of open field and elevated plus-maze in rats. Neuropharmacology. 2012 Jan;62(1):373–84. DOI: http://dx.doi.org/10.1016/j.neuropharm.2011.08.013. [PubMed]

22. Scott S., Opila-Lehman J. Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. Perm J. 2016 Fall; 20(4): 108–111. Published online 2016 Oct 12. doi: 10.7812/TPP/16-005PMCID: PMC5101100

23.Abrams D.I. Integrating cannabis into clinical cancer care. Curr Oncol. 2016 Mar; 23(Suppl 2): S8–S14. Published online 2016 Mar 16. doi: 10.3747/co.23.3099PMCID: PMC4791148