In short: not much.
On top of that, researchers hypothesize that the endocannabinoid system—the network of neurotransmitters in our brains and nervous systems that’s stimulated by cannabinoids, including CBD—acts as a powerful “dimmer switch” that helps modulate brain activity and mood. Some even suggest it’s the endocannabinoid system, rather than endorphins, that exercise activates, resulting in the euphoric elation of a “runner’s high.”
What are all these people using CBD for?
More than half of the CBD-users surveyed—some 55%—said they use it to relax. Half reported using it to reduce stress and anxiety, and the proportions of people who use CBD to improve their sleep and relieve pain (including muscle, chronic, and joint pain) were not far behind. Also on the list were relief from migraines, menstrual symptoms, nausea, and sexual enhancement.
All of this shows a major shift in the way mainstream medical professionals—and consumers—have thought about cannabis and CBD.
Are you a rat or a mouse? If so, chances are good that CBD administered in moderate doses—10 mg/kg is too low; 100 mg/kg is too high—could have an anti-anxiety effect, particularly if you’re feeling anxious because you’ve been placed in a maze or are panicking because a snake has been introduced to your environment.
But, uh, what is it that CBD is supposed to do? I visited a cannabis dispensary in Boulder to find out what the hype was all about. After passing an ID check, I was introduced to a “budtender” who pointed me to an impressive array of CBD products — tinctures, skin patches, drink powders, candies, salves, massage oil, lotions, “sexy time personal intimacy oil” and even vaginal suppositories to treat menstrual cramps.
Donald Abrams was a member of the committee that reviewed the evidence that went into producing the report, and he said that the studies they reviewed overwhelmingly used pharmaceutically available preparations that contain THC, including dronabinol, nabilone and the whole-plant extract spray nabiximols, which contains equal parts CBD and THC. It’s impossible to know whether the benefits of cannabis can also be obtained from CBD alone, Abrams said, because CBD is just one of 400 chemicals present in the plant. So far, CBD in isolation has been studied in only a handful of randomized, placebo-controlled trials (considered the gold standard of evidence in medical research), and the evidence remains sparse.
As marijuana is legalized in more and more states, the wellness world has whipped itself into a frenzy over a non-intoxicating cannabis derivative called cannabidiol. CBD products can be found on the internet and in health-food stores, wellness catalogs and even bookstores. (A bookstore in downtown Boulder, Colorado, displays a case of CBD products between the cash register and the stacks of new releases.) Celebrities like Gwyneth Paltrow, disgraced cyclist 1 Floyd Landis and former Denver Broncos quarterback Jake Plummer are all touting CBD products, and according to Bon Appétit, CBD-infused lattes have become “the wellness world’s new favorite drink.”
Right now, there’s a good chance that you don’t really know what you’re getting from any source. Testing and labeling rules vary by state, but many states that allow legal cannabis also require some kind of testing to verify that the THC and CBD levels listed on the label are accurate. However, this testing is controversial, and results can vary widely between labs, Jikomes said. A study published in March found measurable variations in test results, with some labs consistently reporting higher or lower levels of cannabinoids than others. There are no guarantees that the label accurately reflects what’s in the product. For a 2015 study published in JAMA, researchers tested 75 products purchased in San Francisco, Los Angeles and Seattle and found that only 17 percent were accurately labeled. More than half of the products contained significantly lower levels of cannabinoids than the label promised, and some of them contained only negligible amounts of the compounds. “We need to come up with ways to confidently verify the composition of cannabis products and make this information available to consumers,” Jikomes said.
Although there’s enticing evidence that good ol’ cannabis can ease chronic pain and possibly treat some medical conditions, whether CBD alone can deliver the same benefits remains an open question. What is clear, at this point, is that the marketing has gotten way ahead of the science.
Sleep can be disrupted for many reasons, including depression. Rodents seemed to adapt better to stressful conditions and exhibited less depressive-like behavior after taking CBD, according to a review in Journal of Chemical Neuroanatomy. “Surprisingly, CBD seems to act faster than conventional antidepressants,” wrote one of the authors of a new review, Sâmia Joca, a fellow at the Aarhus Institute of Advanced Studies in Denmark and an associate professor at the University of São Paulo in Brazil, in an email interview. Of course, it’s difficult to detect depression in animals, but the studies that Ms. Joca and her colleagues reviewed suggested that in models of chronic stress exposure, the mice and rats treated with CBD were more resilient.
Some CBD products may contain unwanted surprises. Forensic toxicologists at Virginia Commonwealth University examined nine e-liquids advertised as being 100 percent natural CBD extracts. They found one with dextromethorphan, or DXM, used in over-the counter cough medications and considered addictive when abused; and four with a synthetic cannabinoid, sometimes called Spice, that can cause anxiety, psychosis, tachycardia and death, according to a study last year in Forensic Science International.
Dr. Smita Das, chair of the American Psychiatric Association’s Council on Addiction Psychiatry’s cannabis work group, does not recommend CBD for anxiety, PTSD, sleep or depression. With patients turning to these to unproven products, she is worried that they may delay seeking appropriate mental health care: “I’m dually concerned with how exposure to CBD products can lead somebody into continuing to cannabis products.”
Tips for Better Sleep
However, a double-blind study found healthy volunteers administered CBD had little to no change in their emotional reaction to unpleasant images or words, compared to the placebo group. “If it’s a calming drug, it should change their responses to the stimuli,” said Harriet de Wit, co-author of the study and a professor in the University of Chicago’s department of psychiatry and behavioral neuroscience. “But it didn’t.”
A few drops of CBD oil in a mocha or smoothie are not likely to do anything, researchers contend. Doctors say another force may also be at play in people feeling good: the placebo effect. That’s when someone believes a drug is working and symptoms seem to improve.
take your money?
While there is hope for treating other conditions with the plant extract, Epidiolex remains the only CBD-derived drug approved by the F.D.A. Most of the research on cannabidiol has been in animals, and its current popularity has outpaced science. “We don’t have the 101 course on CBD quite figured out yet,” said Ryan Vandrey, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.