With the debate around cannabis legalisation growing in New Zealand, the conversation can often start and end with THC, the psychoactive cannabinoid in cannabis. However, cannabis’ other primary active cannabinoid CBD also offers a range of therapeutic benefits that add to the medicinal potential of cannabis.
CBD, or cannabidiol, is one of the primary cannabinoids found in cannabis, although CBD is also found in hemp plants and can be extracted from both hemp and cannabis. Hemp is a strain of the cannabis plant that contains < 0.35% THC, with traditional cannabis plants being those which contain higher concentrations of THC. Hemp can be legally grown, processed, and traded in New Zealand with an industrial hemp license.
Humans have been consuming cannabis and the CBD inside it for thousands of years, but it wasn’t until 1940 that CBD was isolated by Dr Roger Adams and his team from the University of Illinois, with further details about CBD’s structure being discovered in 1963.
CBD can be found in the form of oils, supplements, extracts, gummies and gels. CBD is more widely available globally and in New Zealand than THC, primarily because CBD is not psychoactive and has a range of medicinal properties (not to say that THC doesn’t).
CBD has the same molecular structure as THC, with 21 carbon atoms, 2 oxygen atoms and 30 hydrogen atoms. What makes CBD non-psychoactive despite its similar molecular structure to THC are subtle differences in the arrangement of its atoms.
In this article, we’re going to cover how CBD works and what current research says about CBD’s medicinal effects and safety.
How Does CBD Work?
THC binds to cannabinoid 1 (CB1) receptors in the body, causing a range of physiological effects that result in a user experiencing a ‘high’. CBD doesn’t produce a high, and in fact, research shows that CBD may actually reduce the psychoactive effects of THC. In scientific terms this means that CBD functions as a ‘negative allosteric modulator’.
Rather than directly targeting receptors like CB1 as THC does, CBD modifies the ability of receptors to bind to cannabinoids. CBD also plays a more significant role in the endocannabinoid system, modulating other types of receptors and increasing levels of endocannabinoids through its effects on enzyme activity.
The Medical Benefits Of CBD
CBD is often marketed as being able to help relieve anxiety, depression, insomnia, pain, and a range of other symptoms and conditions. With so many therapeutic claims and its non-psychoactive effects, it is no surprise that CBD is becoming increasingly popular. But is CBD really as effective as it is claimed to be, or are the medicinal benefits of CBD being overexaggerated by marketers?
CBD For Mood Disorders
One of the claimed benefits of CBD is its ability to reduce the symptoms of mood disorders such as anxiety, post-traumatic stress disorder (PTSD), and depression.
One small study published in the journal Neuropsychopharmacology set out to see whether CBD was able to decrease nervousness in patients who have social anxiety. A public speaking task was simulated and CBD was administered to some participants to see whether it made a noticeable difference in their levels of nervousness. The results showed that participants given CBD exhibited less signs of nervousness and social anxiety.
An animal study from 2010 published in the British Journal of Pharmacology found that CBD induced antidepressant-like effects in mice that were comparable to the effects of the antidepressant imipramine. According to the researchers, the possible mood-improving actions of CBD may be caused by CBD’s activation of the 5-HT1A serotonin receptor. The 5-HT1A receptor initiates the production of serotonin when activated, with serotonin being a neurotransmitter associated with improving mood and treating depression.
While the results of these studies are impressive, they come from restrictive-sized models and animal studies, which don’t give us the grounds to make concrete claims about CBD’s ability to cure conditions like depression.
There is contradicting evidence showing us that CBD has no effect on mood. One double-blind placebo-controlled study found that healthy people given CBD didn’t experience any changes in mood compared to a placebo group when exposed to unpleasant images or words.
CBD For Seizures
Several clinical trials have been conducted to explore the effects of CBD on children and teenagers who have drug-resistance epilepsy.
The FDA approved a concentrated CBD medicine called Epidiolex in 2018 in the US as a form of seizure therapy for patients over the age of 2. Epidiolex is also legally available in New Zealand, given one has a prescription.
The research into Epidiolex is promising, with multiple randomized double-blind and placebo-controlled clinical trials (including over 500 people), concluding that Epidiolex is effective in reducing seizure frequency.
The use of CBD as a seizure therapy is particularly appealing as CBD is non-psychoactive, meaning that CBD can be used on children without the worry that the psychoactive effects of THC will harm a child’s developing brain.
CBD For Sleep
Many anecdotal reports claim that CBD has sleep-inducing effects, although current research is not as certain on just how effective CBD may be for sleep.
A large case series looking at the effects of CBD on anxiety and sleep found that it was able to reduce anxiety in 80% of patients and improve sleep scores in 66% of patients. Another chart review of 72 psychiatric patients who were given CBD concluded that while CBD did decrease anxiety levels, sleep wasn’t significantly affected
Research does tell us that CBD may be able to reduce the symptoms of excessive daytime sleepiness and REM sleep behaviour disorders. However, it is possible that the sleep-inducing qualities that CBD is becoming known for may actually be caused by CBD’s ability to reduce anxiety, which is a known cause of sleep-related conditions such as insomnia.
CBD For Pain
Pain relief is by far the most popular use for CBD. One survey of 5,000 people in the US concluded that 60% of CBD users consume CBD for pain relief, according to the Brightfield Group, which is a cannabis market research firm.
While surveys are not enough to claim CBD is a cure for pain, there is a substantial amount of research showing that CBD can help reduce pain through a variety of mechanisms.
CBD can bind to and activate the 5-HT1A serotonin receptor, which can lead to a cellular cascade and inhibitory response that results in reduced pain perception. CBD also enhances the expression of Glycine receptors (GlyRs), which are receptors that are involved in the suppression of pain and inflammation. Studies show that CBD may also help to reduce chronic pain by modifying cannabinoid receptor type 2 (CB2) activity which may cause a reduction in inflammation associated with pain.
CBD For Addiction
It may seem counterintuitive to use compounds found within an illegal drug to treat addiction. With that being said, strong evidence does exist showing that CBD may be effective for treating opioid use disorders.
One double-blind randomized placebo-controlled trial explored the effects of CBD on 42 drug-abstinent individuals addicted to heroin. CBD was administered to some participants, while a placebo was administered to others. The results showed that CBD was able to “reduce cue-induced craving and anxiety” which prompted the researchers to conclude that these results show it’s worthwhile to explore the potential of CBD as a treatment for opioid use disorders.
CBD For Multiple Sclerosis
CBD can also be prescribed for patients with Multiple Sclerosis in the form of the medicine Sativex. Sativex is a mouth spray containing both CBD and THC, which is available in New Zealand.
In one study, researchers examined 47 people with multiple sclerosis taking Sativex for one month. The results showed that participants displayed improved symptoms, with an improved ability to walk and decreased muscle spasticity. These are promising results, but it’s important to keep in mind that this study had no control group.
Is CBD Safe?
The World Health Organisation (WHO) has publicly stated that CBD is “generally well-tolerated with a good safety profile”. But this doesn’t mean CBD is for everyone, as some side effects are possible.
One 2017 review of multiple studies on CBD concluded that diarrhoea, fatigue, appetite and weight changes are the most commonly reported side effects, although these are side effects are uncommon, and, ofcourse, dose-dependent.
CBD is one of two primary cannabinoids found in cannabis and is non-psychoactive, meaning it does not induce a high in users like THC does. CBD is popular for stress, anxiety, insomnia, and pain relief.
Although there is a considerable amount of evidence supporting the medicinal benefits of CBD, more rigorous double-blind controlled trials are needed to make more concrete claims about CBD’s efficacy for treating conditions such as sleep and mood disorders.