CBD Oil, Myth or Magic

CBD, short for cannabidiol the non-psychoactive compound found in the marijuana and hemp plant, is one of the hundreds of cannabidiols which are present in these plants but do not cause euphoria or intoxication.  Its cousin, THC or tetrahydrocannadadiol, is responsible for these effects and is present in marijuana.

CBD works in the body’s endocannabinoid system which can influence appetite, energy, immune function and the nervous system.  However, researchers have only begun to investigate these potential effects and much that is discussed about the utility of CBD is unproven.  Part of the reason for the lack of study of this substance has been the fact that hemp and marijuana are in the same plant species and have been linked together and considered illicit substances until recently.  However, hemp does not contain enough THC to cause intoxication.

A farm bill passed in 2018 made hemp legal according to the federal government.  Thus, CBD manufactured properly from hemp is legal, although this has not been accepted by all states.  People traveling to different states should check regulations before they take CBD across state lines or through airports. There are no clear federal or state standards established yet for the manufacture of CBD so that not all sources of the product reliably contain real CBD oil.  Some authorities advise that the safest sources for the oil are manufactured in states where marijuana is legal.

In terms of proven benefit, there are a few indications including the treatment of seizures in two epileptic syndromes and the treatment of chemotherapy induced nausea.  There is also some evidence that it is helpful for sleep in patients who have multiple sclerosis, Parkinson’s disease, fibromyalgia, and chronic pain.  Side effects of CBD can include diarrhea, changes in appetite and fatigue.

Researchers suspect that most the benefits in other areas claimed by people using CBD are secondary to placebo effect.  This is not necessarily thought to be a problem however, if the effects can help patients to reduce their dependence on opioids and benzodiazepine tranquilizers.

In addition to oral CBD, topical creams are available.  Although these have not been shown to benefit arthritis more than placebo, there are anecdotal reports of usefulness with muscle strain and myalgia which sometimes accompany joint pain, especially back strain.  That being said, CBD creams are often made with additives such as menthol and camphor which can be helpful topically by themselves.

In summary, there are a few scientifically proven benefits to the use of CBD oil as it is currently available.  Much more research as needed to identify ideal dosages and combinations of different cannabidiols to see what works best.  Also, better regulation of the manufacturer of CBD should result in more pure and reliable products.  Even if CBD’s reported good effects on pain and anxiety are based on placebo effect, any decrease in the use of narcotic pain medicine or tranquilizers would be helpful to many patients.  As far as most physicians are concerned, the CBD saga is “to be continued”.

 

Dr. Lorraine Nardi is a board certified Internist and Nephrology Specialist at Premier Medical Group.

To make an appointment with our Internal Medicine Division, please call  # (845) 790-6100