If you’re thinking about taking CBD and want to know more about how it works, there are several things to keep in mind about what we know so far …
- Anecdotal Evidence Counts. Due to nearly a century of cannabis prohibition in the U.S., very little human trials have been done on CBD compared to other drugs. However, that hasn’t stopped people from using it to successfully treat pain, inflammation, anxiety, and insomnia. In fact, humans have been using cannabis medicinally for centuries.
Anecdotal evidence, not human trials, inspired desperate parents to give CBD to their children with untreatable, severe epilepsy. It was these Charlotte’s Web CBD stories that ultimately led to clinical trials and the first FDA approval of a CBD drug, Epidiolex—not the other way around. By then, CBD had already saved many children’s lives, had improved numerous families’ quality of life. And if they weren’t in the right state, some parents were even persecuted for it.
- CBD Has a Good Safety Profile. According to a 2017 World Health Organization (WHO) report, “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.”
Below, you can read about the known side effects of CBD that have been reported by researchers. They are surprisingly minimal compared to commonly prescribed drugs, like opioids and benzodiazepines.
- Researchers Are Working to Fill the Knowledge Gaps. On a molecular level, researchers have learned a lot about cannabinoids in the last century. But there is still much to learn and the majority of the research is pre-clinical—tested in cell cultures or on animal models. More and more human trials, however, are being conducted.
Also, because of cannabinoids’ impressively wide range of potential therapeutic benefits, it’s going to take time to scientifically prove the effects of certain cannabinoids on specific conditions.
- Legitimate Growing Support. The number of advocates for CBD is rising at an astonishing rate. This includes experts ranging from doctors and health industry professionals to legislators that once stood staunchly in opposition of anything cannabis-related.
In this article, we’ll explore all these topics and more to help give you an understanding of what is known about CBD and how it works so far. But first, a quick refresher about cannabinoids.
Cannabinoids 101
Cannabidiol (CBD) is a cannabinoid. Cannabinoids are chemical compounds that have a wide range of therapeutic effects. They are produced in three main places:
- In plants, like cannabis (marijuana, industrial hemp). These are known as phytocannabinoids (THC, CBD, CBG, THCV, etc.).
- In the brain of all mammals (you, your dog, your cat). These are known as endocannabinoids (anandamide, 2-AG).
- In the lab. These are known as synthetic cannabinoids (dronabinol and nabilone).
Cannabinoids activate their own receptors (CB1 and CB2) in our endocannabinoid system (ECS). The ECS is a network of receptors in your body involved in the function of the immune system, the central nervous system, and various organs. It’s responsible for regulating appetite, pain sensation, mood, memory, sleep, neuroprotection, and homeostasis (your inner balance and wellbeing). When you address something out-of-whack in the ECS, you get at the problem, not just the symptom.
Now that we’re all up to speed, on to how CBD affects your body.
How CBD Works
First, it is important to understand that unlike THC, CBD will not get you high. In fact, according to Dr. Raphael Mechoulam, “Surprisingly, although most of the plant cannabinoids have now been identified—and their structures are related chemically—the only major mood-altering constituent is THC.” He ought to know, he is one of the primary chemists to discover cannabinoids and the ECS.
THC carries out its action on the ECS through binding directly with both CB1 and CB2 receptors, with a preference CB1 receptors. CBD, however, is not as discriminating …
CBD: The “Friendly” Cannabinoid?
So, CBD is what is known as a promiscuous molecule. Yep, it’s the cannabinoid that gets around—but in a good way. It attaches itself to several receptors in a variety of systems within the body.
This may very well explain why CBD has such a range of therapeutic effects. It fits into many different receptors, getting a different reaction from each one.
Our brains have highly specialized cells called neurons. These neurons communicate by releasing neurotransmitters—chemical messengers like dopamine, serotonin, etc. These attach to the receptors on the neurons. As we’ve mentioned above, the cannabinoid system, or ECS, has cannabinoid receptors CB1 and CB2. These are designed to receive the endocannabinoids anandamide and 2-AG.
Phytocannabinoids, like THC and many others, can directly interact with cannabinoid receptors too. CBD, however, is different. In a cannabinoid receptor, it acts as an antagonist and blocks THC from directly binding to receptors and exerting its euphoric effects. This is why strains that have a high CBD:THC ratio will not get a person “very” high. The CBD works to moderate THC’s effects.
In other receptors, though, CBD can take direct action. Some of these include:
- Opioid Receptors—CBD binds directly with opioid receptors. This explains its potential to treat pain, but also the role CBD may have in the treatment of drug addiction. Opioid receptors are the docking bays for drugs like morphine, heroin, and fentanyl. CBD’s influence on opioid receptors could help deter opioid drug abuse.
- Dopamine Receptors—Because CBD interacts directly with these receptors, it could influence addiction and depression. Dopamine receptors are involved in regulating behavior and cognitions. It is believed that through these, CBD can effect motivation and reward-seeking behavior associated with drug cravings and withdrawal symptoms.
- Serotonin Receptors—CBD also has direct interaction with serotonin receptors in the brain. In this capacity, CBD has the potential to treat anxiety, depression, the drug-seeking behavior involved in addiction, and more.
Additionally, CBD works to increase anandamide levels. Anandamide (AEA), an endocannabinoid made naturally in our brain, is responsible for regulating movement control, appetite, pain, and our overall sense of wellbeing.
CBD helps keep anandamide around longer by inhibiting the enzyme that breaks down anandamide—fatty acid amide hydrolase (FAAH).
Deficiency in anandamide can lead to depression, anxiety, and mood disorders, so CBD’s anandamide-prolonging effects may help correct and maintain mental wellbeing.
Other Potential Therapeutic Effects of CBD that work through various systems in the body include:
- Anxiety
- Epilepsy
- Neurodegenerative Diseases (Alzheimer’s disease, stroke, Parkinson’s disease, multiple sclerosis (MS), and neurodegeneration due to alcoholism)
- Pain and Inflammation (chronic pain, arthritis, etc.)
- Acne
- Cancer
- Nausea
Is It Safe to Take CBD?
There is no one-size-fits-all for CBD. As with most drugs, supplements, and even food, it can have varying effects on individuals. We all process CBD differently, depending on key factors like age, weight, and diet. The form and quality of the CBD we use will effect our experience of it as well.
All these things considered, CBD has a fairly short and harmless list of side effects, compared to many traditional drugs, which includes:
- dry mouth
- dizziness
- low blood pressure
- drowsiness
- change in weight/appetite
- diarrhea
CBD may interact with some medications, so it is important to talk to your doctor about potential harmful interactions. Like grapefruit, CBD interferes with cytochromes P450 (CYPs), a group of enzymes that are involved in drug metabolism. Therefore, if you take any drugs with a “grapefruit warning”, know that CBD may also interfere with that medication.
Comparing CBD’s Side Effects to Xanax
For the sake of perspective, let’s take a look at a very commonly prescribed drug for anxiety, Xanax (a benzodiazepine). Remember, this drug, along with many others that have longer, more harmful lists of side effects, have been FDA-approved.
Common side effects of Xanax include:
- Slower than normal brain function
- Slurred speech
- Shallow breathing
- Sluggishness
- Fatigue
- Disorientation
- Lack of coordination
- Dilated pupils
Side effects of Xanax at higher doses may include:
- Impaired memory, judgment, and coordination
- Irritability
- Paranoia
- Thoughts of suicide
- Agitation and aggressiveness
Combined with other substances (alcohol, opioids, etc.), Xanax could cause:
- Slow breathing
- Slowing of both heart and respiration
- Possible death
Xanax can have serious withdrawal effects, including seizures. This may cause a physical dependence. People can also develop a tolerance for Xanax, which can lead to a risk of overdose. Because of these factors, it may become addictive for some users.
The favorable safety profile of CBD is becoming more apparent as an increasing number of people share their positive experiences with cannabinoids. More anecdotal evidence has led to more advocacy, and more advocacy has led to more support from the government and the medical industry, which leads to more research.
We’ve already mention the World Health Organization’s statement about the safety of CBD. Other organizations that have updated their views of CBD include:
- The World Anti-Doping Agency (WADA), which announced in 2017 that it was removing non-intoxicating cannabidiol (CBD) from its list of 2018 banned substances.
- There is another group of medical doctors and professionals that is pro-marijuana and wants it legalized and regulated for the sake of public health. They are the Doctors for Cannabis Regulation. This group is actually going after the N.F.L. to stop punishing their players for using marijuana and CBD for pain relief rather than opioids.
- The World Cup in 2018 became the first professional sporting organization to allow the use of a cannabis derivative. If a player used CBD, he was not penalized.
Recently, former House Speaker John Boehner changed his mind about medical cannabis after he saw what it did for a friend who needed relief from back pain. He admits that, previously, he had been “unalterably opposed” to marijuana legalization.
Results, whether anecdotal or research-driven, are continuing to illuminate the potential benefits of CBD and many other cannabinoids with medicinal applications. Now that researchers have more freedom and funding to fill in the knowledge gaps, cannabinoid science can focus on the exciting prospect of discovering how certain cannabinoids and combinations of cannabinoids can specifically target the root causes of certain diseases and disorders.
The Importance of CBD Quality
While industrial hemp-derived CBD is legal, it is not currently regulated by the FDA. This means that the quality assurance of the product is left up to the manufacturers. Transparency of a cannabinoid product is very important for several reasons. Here’s just one very important reason: Industrial hemp is a bioaccumulator, which means that it will absorb heavy metals and chemicals from the soil. In some countries, like China, farmers will plant a crop of hemp to clean out their soil, and then sell the tainted hemp to be used for CBD.