The Basics of CBD

CBD, which is short for cannabidiol is a phytocannabinoid – that is, a cannabinoid made by plants as opposed to animals. Cannabinoids made by animals (humans) are called endocannabinoids. Cannabinoids have been shown to have an incredible effect on a number of systems in the body that are directly related to regulating well being. CBD is usually extracted from hemp (low THC) or Marijuana (high THC) plants. The cutoff may vary from state to state at the moment, but as a general rule any plant with over 1% THC content is considered a marijuana plant, while anything that grows below 1% THC is considered a Hemp plant. keep in mind that marijuana is a policy term, while cannabis and hemp are scientific terms.

CBD is a hot topic because it is purported to provide many of the medicinal benefits that you’d find in “marijuana” plants without the (sometimes unwanted) side effect of getting you high. You can ingest CBD by smoking/vaping/nebulizing,  or by absorbing it  through the mucosa (sublingually/ under the tongue or via suppository). You can also eat CBD and apply it topically. Keep in Mind that each method of ingestion has different absorption rates and durations and there is variability in dose and response from individual to individual. Customization is the key!

IS CBD Legal?

CBD is most notably it is known for its anti seizure properties. Many know of the story of the young girl in Colorado who was given a particular strain of CBD by her parents to help treat her intractable seizures. At the time, this was seen as reckless, but we now have large drug manufacturers like GW pharmaceuticals receiving clearance from the FDA in June of 2018 for the anti seizure drug “epidiolex”. This drugs primary active ingredient is CBD. As a result of FDA clearance for this drug, the DEA policy designating CBD as a class 1 compound (having no medical benefit) had become contradictory. Many believe this is one of biggest factors leading to the passage of the Farm Bill later that same year.

Beginning January 9, 2019 all Hemp and hemp extracts including CBD (but excluding THC) are legal in all 50 states. Language in the bill allows states to formulate their own regulations in the industry. The general rule is that if the CBD product has 0.3% THC or less it is legal. Those with the 0.3% THC content are considered “full spectrum” products. If the product has more than that, you will need a medical marijuana “prescription” in states that have legalized marijuana. The most popular routes of administration/ ingestion are sublingual drops, vaping and edibles. Most often it is used for anxiety, chronic pain, and insomnia.

What conditions can CBD help with?

I have patients that I treat with CBD for a wide variety of conditions. I’ve had success treating conditions as disparate as ADHD and insomnia, to Fibroids, depression and migraines. This remarkable compound has a number of proposed therapeutic benefits that are still in the early stages of being validated by research and science. For example, we know that CBD allows your body to maintain higher levels of your own cannabinoids (endocannabinoids). Why is this important? As mentioned earlier, these cannabinoids are involved in a number of important processes in your body such as mood stabilization; sleep wake cycle regulation, cognition and immune and inflammatory response.

You’ll hear the word “homeostasis” used a lot with regards to cbd or cannabinoids. This means it helps you stay “balanced.” By keeping a larger amount of your cannabinoids in circulation, CBD helps improve mood, and combat depression. This is the mechanism through which we infer that CBD derives its anxiolytic (anxiety relieving) and antidepressant properties. There is even research now pointing to some anti-tumor properties of CBD as well as promise in treating those with traumatic brain injury.

Can CBD help with Pain?

Full spectrum CBD is also very good at managing pain- specifically neuropathic pain (pain who’s source comes from your nerves). I’ve anecdotally observed that my patients with neuropathy; whether as a result of endocrine disorders such as diabetes, mechanical causes such as temporomandibular joint dysfunction (TMJ)  and sciatica to infectious causes such as shingles (herpes zoster) and lyme report greater analgesic effect (pain control) using CBD.  These patients have reported significantly fewer side effects, like cognitive impairment, constipation, body aches, dizziness, etc. when compared to the drugs they were taking. This is through it’s ability to inhibit neurotransmitter release at the synapse. It decreases pain signal intensity without altering cognition. CBD also works very well in modulating immune response, which is especially helpful in those with chronic painful illness such as arthritis and autoimmune diseases such as lupus and rheumatoid. CBD has also been show to provide relief from those suffering from painful crisis from genetic disorders like sickle cell.

Is CBD completely safe?

Many currently see CBD as a “cure all” or “wonder drug”. Yes CBD has many known therapeutic benefits and many more which have yet to be discovered- but I would advise caution. Although it may lessen or relieve symptoms associated with migraines, menstrual cramps, or even ADHD and autism, these are all new findings and some claims may not be based in fact. In addition, as with any medicine there are potential side effects. Allergies are something we should always be concerned about. CBD can also cause diarrhea in real high doses, it can potentiate (prolong) the effects of certain medications because of its interaction with the liver enzymes that metabolize them. This means if you are on a number of other medications, it’s probably best to consult with a licensed medical professional that can ensure you are making the best decisions for your personal health and desired outcome.

The major side effect is somnolence (sleepiness), which is a desired side effect in many users with insomnia (myself included)- but can be a negative during the day. Finding the best dose for you i imperative. Full spectrum CBD products can also cause positive THC drug tests over time in some people (be careful). CBD can also cause appetite stimulation, feelings of excitation in low doses and feelings of mild euphoria in some people. Again, It’s important that you consult with someone knowledgeable to gain as much insight and guidance as you start your CBD supplementation plan.  Because the space is unregulated, there is a lot of room for the unsavory types: “snake oil salesmen” and those looking to cash in at the expense of others health. My advice is to purchase your CBD from a source you can trust- use common sense and don’t ignore warning signs. Consult with your doctor or medical practitioner about using CBD and definitely stop using it if you experience any adverse effects.

Do you have any specific questions that you’d like answered? Feel free to post in the comments.

And, of course, if you found this information helpful- share it with your friends!

-Dr. Damas