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CBD is an anticonvulsant, and some other compounds in the plant, including THC and cannabidivarin, may be too. There is good evidence from clinical trials in the US and Europe that pharmaceutical preparations of CBD can treat two severe forms of childhood epilepsy known as Dravet syndrome and Lennox-Gastaut syndrome. Both forms of epilepsy often fail to improve with existing epilepsy drugs. CBD is generally considered safe, but some trials have reported side effects including dry mouth, lightheadedness and altered liver enzyme activity.

Cannabis oils are extracts from cannabis plants. Unprocessed, they contain the same 100 or so active ingredients as the plants, but the balance of compounds depends on the specific plants the oil comes from. The two main active substances in cannabis plants are cannabidiol, or CBD, and delta-9 tetrahydrocannabinol, or THC. Oil extracted from hemp plants can contain a lot of CBD, while oil from skunk plants will contain far more THC. THC produces the high that recreational cannabis users seek, while oils for medical use contain mostly CBD.

Does it work as a medicine?

Other forms of cannabis are solid and are usually sold either as resin or dried plant material. In commercially-produced medical cannabis oils, the concentrations of CBD and THC tend to be well-controlled, which makes it easy to calculate doses.

Four drugs based on cannabis compounds are already on the market in Europe. Among them are Nabilone, a synthetic compound that mimics THC, is prescribed for nausea and vomiting caused by chemotherapy, and Sativex, an oil that contains equal parts THC and CBD, is used to treat muscle spasms in multiple sclerosis. Both contain too much THC to administer to children. “The only medicines that are approved in the UK would get children stoned,” said David Nutt, professor of neuropsychopharmacology at Imperial College, London.

Cannabis oil can only be sold legally in Britain if it contains less than 0.05% THC. But the nation’s medicines regulator, the MHRA, announced recently that even pure CBD could not be sold as a medicine without first going through the usual clinical testing and safety checks required for all new medicines. This month, the US Food and Drug Administration will consider the approval of Epidiolex, a CBD-based medicine from GW Pharmaceuticals, which has completed such clinical trials. The European Medicines Agency (EMA) will rule on the drug early next year. If the EMA approves Epidiolex, it could be available to prescribe to named patients in Britain next year, Brexit notwithstanding.

Currently, it is only likely to be prescribed for the following conditions:

The risks of using cannabis products containing THC (the chemical that gets you high) are not currently clear. That’s why clinical trials are needed before they can be used.

Epidyolex for children and adults with epilepsy

Possessing cannabis is illegal, whatever you’re using it for. That includes medical use unless it has been prescribed for you.

And some cannabis-based products are available on prescription as medicinal cannabis. These are only likely to benefit a very small number of patients.

Many cannabis-based products are available to buy online, but their quality and content is not known. They may be illegal and potentially dangerous.

CBD oil comes as full-spectrum oils or in forms that contain CBD isolates. Unlike isolates, which contain CBD only, full-spectrum oils contain a variety of compounds found naturally in the cannabis plant, including proteins, flavonoids, terpenes, and chlorophyll. Alternative practitioners believe these compounds offer more substantial health benefits, although there is no clear evidence of this.

According to a 2012 study in the Journal of Experimental Medicine, rats injected with inflammatory chemicals in their hind feet experienced less inflammation and neuropathic pain when treated with an oral dose and spinal injection of CBD.  

According to the investigators, men provided 300 mg of CBD exhibited less anxiety than those given a placebo. Interestingly, those provided 100 mg or 600 mg of CBD oil did not.

What to Look For

Human studies evaluating the use of CBD in treating chronic pain are lacking. Those that do exist almost invariably include THC, making it difficult to isolate CBD’s distinct effects.

Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health.

The findings suggest that CBD oil may be a suitable complementary therapy for people whose hypertension is complicated by stress and anxiety. However, there is no evidence that CBD oil can treat hypertension on its own or prevent hypertension in people at risk. While stress is known to complicate high blood pressure, it cannot cause hypertension.

To use CBD oil, place one or more drops under the tongue and hold the dose there for 30 to 60 seconds without swallowing. Capsules and gummies are easier to dose, although they tend to be more costly. CBD sublingual sprays are available as well.