The CBD industry is flourishing, conservatively projected to hit $16 billion in the United States by 2025. Already, the plant extract is being added to cheeseburgers, toothpicks and breath sprays. More than 60 percent of CBD users have taken it for anxiety, according to a survey of 5,000 people, conducted by the Brightfield Group, a cannabis market research firm. Chronic pain, insomnia and depression follow behind. Kim Kardashian West, for example, turned to the product when “freaking out” over the birth of her fourth baby. The professional golfer Bubba Watson drifts off to sleep with it. And Martha Stewart’s French bulldog partakes, too.
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.
What is CBD?
“If you take pure CBD, it’s pretty safe,” said Marcel Bonn-Miller, an adjunct assistant professor at the University of Pennsylvania’s Perelman School of Medicine. Side effects in the Epidiolex trial included diarrhea, sleepiness, fatigue, weakness, rash, decreased appetite and elevated liver enzymes. Also, the safe amount to consume in a day, or at all during pregnancy, is still not known.
More than 60 percent of CBD users were taking it for anxiety, according to a survey of 5,000 people. Does it help?
For students with generalized social anxiety, a four-minute talk, with minimal time to prepare, can be debilitating. Yet a small experiment in the journal Neuropsychopharmacology found that CBD seemed to reduce nervousness and cognitive impairment in patients with social anxiety in a simulated public speaking task.
“CBD is kind of a tricky drug because it’s not very well absorbed orally,” Welty explained. “Less than 20 percent of the drug is absorbed orally. If it isn’t made in the right way, you may not be getting much drug into your systemic circulation.”
Last month, a U.S. Food and Drug Administration advisory panel unanimously recommended approval of the CBD medication Epidiolex to treat two rare forms of childhood epilepsy.
Because of the legally murky nature of marijuana, the FDA has not stepped in to regulate products like CBD oil, Bonn-Miller said. States are struggling to put regulations in place, but they don’t have the deep pockets of the federal government.
There also are concerns about both the quality of CBD oil being produced and its potential side effects, the experts added.
Strong Evidence for Treating Epilepsy
“If I were a consumer, purchasing it for myself or my kid, I would want to test it so that I knew what it actually had in it, because I couldn’t trust what was on the label,” Bonn-Miller concluded.
Welty recommends that people interested in CBD seek out a doctor who has read up on the extract and its potential uses.
The study was published online recently in Experimental and Clinical Psychopharmacology.
“CBD-induced pain relief is not just driven by psychological placebo effects, but also pharmacological action,” explained study author Martin De Vita, a researcher in the psychology department at Syracuse University, in New York. “It’s a little bit of both.”
Now, the researchers hope to look at how CBD affects pain perception in people with different pain conditions, he noted.
The body’s central nervous system has its own processes to dampen pain based on information about when (temporal processing) and where (spatial processing) the pain is happening, he explained. “Expectancies alone enhanced temporal pain inhibition, and CBD and expectancies both enhanced the spatial pain inhibition independently, but not when combined,” De Vita said.
The bottom line? CBD — and your expectations about whether it will help (the “placebo effect”) — can make pain feel less bothersome, but it doesn’t appear to reduce pain intensity.
Kevin Boehnke, a research investigator in the anesthesiology department and the Chronic Pain and Fatigue Research Center at the University of Michigan, in Ann Arbor, agreed.
Unfortunately, the flood gates are already open when it comes to CBD, and science has a lot of catching up to do, said Boehnke, who was not involved in the new study.