Is CBD Oil Worth the Hype?
You'll find cannabidiol (CBD) at pharmacies, spas, gyms, grocery stores, vet's offices — even gas stations. It can be added to candy, lotion, sprays, oils, and supplements. It's touted to help with sleep issues, seizures, anxiety, nausea, sore muscles, and more. But one substance can't really be expected to cure all that ails us, can it?
Let's take a look at what CBD is — and the mystique around its relationship to marijuana. CBD is derived from either marijuana or hemp plants. Both are cannabis plants; the difference is that legally, hemp must have less than a 0.3 percent concentration of tetrahydrocannabinol (THC), the substance in marijuana that causes the high, says Gerald Berkowitz, professor of plant sciences at the University of Connecticut. "CBD that is legal is extracted from hemp and grown under a federal or state program that ensures the hemp is under that 0.3 percent THC," he says. CBD won't get you high. As a point of reference, most medical marijuana is about 20 percent THC.
What's in a Name?
- CBD: The acronym for cannabidiol, one of more than 100 chemical compounds found in the cannabis plant.
- THC: The acronym for tetrahydrocannabinol, the psychoactive compound in marijuana that produces the high.
- Cannabis: The plant genus that both hemp (high in CBD) and marijuana (high in THC) come from. The word may be used to refer to marijuana, CBD, or both.
- Marijuana: A drug made from the leaves and stems of the cannabis plant. It contains more than 100 compounds, including THC.
- Hemp: Legally defined as a cannabis plant with less than 0.3 percent THC. Hemp has higher concentrations of CBD than cannabis used for marijuana, and this fast-growing, fibrous plant has been used for centuries to make textiles.
Why Do People Take CBD?
According to a 2021 study in the United Kingdom, most current users take CBD for anxiety (43 percent), sleep issues (43 percent), stress (37 percent), and general well-being (37 percent). But there is not yet solid scientific evidence that CBD helps with any of these — many studies are too small or done on animals. Ask around, though, and you'll hear plenty of anecdotal evidence.
The studies we do have (see Promising Research, below) give us hope and indicate there is good reason to continue the research. An observational study of more than 1,200 people by Dr. Ryan Vandrey, professor of behavioral pharmacology research at Johns Hopkins University School of Medicine, compared cannabis users and nonusers, all of whom had existing diagnosed health issues. The study found a significant number of cannabis users reported better quality of life, improved sleep, lower pain severity, and lower anxiety. And 14 percent of participants reported decreased use of prescription medications. The study authors point out bias related to beliefs about CBD may affect study findings, but conclude that these results warrant the testing of CBD on health conditions through clinical trials.
Why All the Hype?
The only FDA-approved use of CBD is a drug that treats certain kinds of seizures. But that has little to do with the CBD products flooding the market. For those, there isn't much good science.
Dr. Vandrey attributes the hype to three factors: preclinical research that suggests CBD has therapeutic promise, anecdotal buzz, and the fact that CBD appears to be relatively safe and nontoxic. According to the World Health Organization, there is currently no evidence of public health-related problems associated with using pure CBD.
All told, it's wise to check with your doctor before trying CBD. It may interact with other medicines or health conditions. The FDA advises against using it if you are pregnant or breastfeeding.
Preliminary studies have looked at CBD for a number of health issues. Here are a few conditions that you can expect researchers to follow up on.
Anxiety & Depression
Emerging research suggests CBD may be effective as an antipsychotic and antidepressant, and that CBD might be able to replace or reduce the use of other drugs with unwanted side effects.
A small study on humans published in 2020 confirms the findings of animal studies, which found that CBD lowered anxiety. Interestingly, it also showed that too little or too much CBD is not effective, which means finding the right dose of CBD is key. A doctor may be able to help you find the right dosage.
In a 2020 study of 131 people with chronic pain who took opioids for treatment, 53 percent reported reduced opioid use or entirely eliminated their opioid use after 8 weeks of adding CBD-rich hemp extract into their care regimens. And 94 percent reported quality of life improvements.
In a small 2019 study of 72 people, sleep improved in 67 percent of patients within the first month of use, but the benefit fluctuated over time. A number of animal studies also showed that CBD helped improve sleep.
According to an American Arthritis Foundation survey, 29 percent of the 2,600 respondents said they used CBD to manage their arthritis symptoms. Of the respondents who used it, 67 percent reported improved physical function, and more than 30 percent said they experienced less fatigue.
In several small studies, CBD was shown to reduce swelling, inflammation, and pain in arthritic rats. And a small study showed CBD increased mobility and reduced pain levels in arthritic dogs. (PS: Check with your vet before trying CBD on a pet.)
Consumers should do their own research to find out if a product comes from a reliable source. Contaminants, including heavy metals, pesticides, microbes, and other toxins could be lurking in CBD products. "It's the wild West," says Dr. Berkowitz. "There is no federal authority checking on it. I am not trying to imply CBD is unsafe or untrustworthy, but there's just not a lot of regulation." On the other hand, he adds, there are reputable companies selling products that are highly documented. That is, they can provide information from an approved source showing the CBD has been analyzed.
CBD research, though promising, is in its infancy. Even with two highly esteemed researchers deep in the weeds of cannabis research, opinions about CBD use differ. When asked if they would recommend it for inflammation and pain to a family member, Dr. Berkowitz said he had done just that for his daughter's knee pain. But Dr. Vandrey, while not opposed to CBD use, recommends that consumers first talk to their physician.
The Bottom Line
It's relatively low risk to try CBD, as long as it comes from a trustworthy source. While some studies have shown associations with stomach and liver issues and sleepiness, Dr. Vandrey points out that the study participants were children with serious health conditions who were takingother medications.
Overall, Dr. Vandrey says, CBD is "well-tolerated with a low risk of side effects, but it is likely to interact with other medications." To be safe, always discuss with your physician first.
How to Buy CBD
Before you try CBD, check with your doctor and your state's laws. The 2018 Farm Bill made CBD products derived from hemp that has less than a 0.3 percent concentration of THC federally legal, but the bill did not change state laws. Possession of CBD may be illegal depending on the state.
- Buy from a regulated state dispensary, which will carry products that adhere to more rigorous quality control and testing standards.
- Do your research and choose reputable brands.
- Read online forums hosted by unbiased patient advocates and physicians, not brands or sellers.
- Match the product with your goal. Inhalation products are best for short-term, immediate fixes. If you have long-term pain, go for the slower-acting formats, such as consumables (food and drink). For muscle soreness, transdermal patches and topical lotions may be best.
- Avoid products with health claims on the label. It is illegal to make health claims about CBD, and doing so is an indication the company isn't reputable.
This article originally appeared in the August/September 2021 issue of Allrecipes Magazine.