By Elements of Green
Millions of people are using CBD, or cannabidiol, daily to help them with stress, anxiety, sleep, athletic recovery, and energy. These customers know of the benefits which CBD gives them from personal experience. Because CBD became legal and widely available only recently, there have been few full-scale scientific discoveries which seek to identify the specific benefits and the mechanisms by which people receive these benefits. The studies which were done tended to be fairly small, and “observational.” That means that the studies were not generally sufficiently robust for doctors to rely upon to make recommendations for patients.
In the past few years, the number of clinical studies of CBD has grown. The European Medicines Agency is currently tracking 29 studies involving cannabidiol or other cannabinoids and the US Federal Drug Administration is tracking 66. The FDA also has 46 recent studies which have reported results.
The studies are on virtually all of the reported effects of CBD, often applied to specific diseases or the symptoms associated with those diseases or the treatment of them. It is interesting to see where researchers are looking because it gives a reflection of how people are using CBD in their ordinary lives. You should not rely on any of these studies to formulate your own approach to treating a specific condition. These studies are sometimes larger and more formal than earlier studies but some are still quite small. Additionally, they are not conclusive and none has resulted in specific therapies approved by the EMA or FDA. Many of the studies referred to in this article are ongoing and some have not yet begun.
Some of these studies are focused on an area where there has been little prior research, that of drug interaction. In other words, scientists are studying whether CBD might help or hurt the effectiveness of other drugs people take for their disorders. CBD is generally well-tolerated in people who are not taking other medications but the interaction of CBD and important treatments are mostly unknown.
Many of these studies involve different dosages from what you would get from a consumer product and often the CBD is used as an addition to another treatment. If you have one of the conditions referred to in the studies, you should consult with your doctor. This is an educational article to let you know what universities, companies, and independent research institutions are studying. It is not a guide to treatment for you or anyone else.
People who do not need to see a doctor often use CBD for pain. Whether it’s a skin rash, the aches and pains that come from age, or strain from athletic activity, pain relief is one of the main reasons people seek out CBD. So it’s only logical that it would be among the largest research areas for cannabidiol. It is also turning out to be among the most promising applications of CBD. In fact, researchers are looking not just at CBD but at the psychoactive ingredient THC and other cannabinoids to see whether they can supplement or replace opioids as pain management therapy for people who experience chronic pain. Specific applications for CBD include pain associated with osteoarthritis of the knee, inflammation from Chronic Back Pain, pain from Multiple Sclerosis, pain in the jaw and face, post-operative pain from kidney stone removal, and more. One study is examining CBD for treatment of chronic pain regardless of the cause. Researchers are also doing clinical trials on the pain relief effects of CBD more generally on otherwise healthy individuals.
Opioids and Addiction
Substance addiction is among the largest challenges facing society today. Opioids, when properly used, provide a huge benefit to patients with acute or chronic pain, but too many people become dependent on opioids and illegal sources of opioids have caused thousands of deaths and destroyed lives. A series of related promising research topics for CBD focus on whether cannabidiol can substitute for pain relief drugs, pair with other pain relief medications to improve patient outcomes, or make recovering from addiction easier.
One group of researchers are trying to learn whether CBD might reduce cravings among people addicted to opioids. Another will be using CBD along with the traditional opioid addiction treatment buprenorphine + naloxone to learn whether the CBD increases the effectiveness of the traditional treatment. Another is looking at whether CBD might ease opioid withdrawal symptoms. A different group is going to use CBD alone to see whether cannabidiol might help reduce relapses among those who have completed the traditional treatment.
Sometimes, opioids themselves can cause pain. One study is looking at using CBD to reduce opioid-related pain.
Addictions well beyond opioids are also targeted by researchers. A Canadian researcher is currently recruiting subjects, seeking to learn whether CBD can reduce craving for cocaine or even reduce relapses among people addicted to cocaine. A different study is looking at cravings among heroin users to see if CBD might help.
By far the most widespread substance addiction is to alcohol. There are several studies in progress to learn whether CBD might help with alcoholism. New York University’s Langone center is doing a small study to learn whether CBD might reduce self-reported consumption by alcoholics. In Sydney, Australia, a local health district will be conducting a small, exploratory study to learn whether CBD is a candidate for use to reduce alcohol withdrawal symptoms among inpatients.
Seizures and other motor disorders
Seizures are one of the biggest study areas for CBD. Cannabidiol first came to prominence because medical cannabis showed promise fighting childhood epilepsy and parents were seeking relief for their child’s symptoms without the psychoactive effects of THC. A family of cannabis growers in Colorado started growing cannabis with very low levels of THC and found that the anti-seizure effects were still helpful. The result of those early CBD pioneers is that the only approved pharmaceutical product made from CBD is an anti-seizure medication for some kinds of rare childhood epilepsy. Looking at the results of the use of that drug, called Epidiolex, it is natural that scientists would examine whether people suffering from seizures for other causes might benefit from CBD. The company behind Epidiolex, GW Pharmaceuticals from the UK, is sponsoring many studies, including using CBD for Rett Syndrome, and seizures related to Tuberous Sclerosis Complex. The Tuberous Sclerosis treatment has been approved in the United States; European approval is under review at the time of this article. Other companies and University-affiliated researchers are looking at CBD to see if it might help with Infantile Spasms, Pediatric Epilepsy, and treatment-resistant seizure disorders.
Another common use of cannabidiol among people who do not need medical attention is stress relief and lower anxiety. On a clinical level, CBD is also a promising candidate to help people with mental disorders, diseases, or even the common mental difficulties which confront most of us. One ongoing study is trying to assess whether CBD helps people with common phobias. Another will be testing dosages and seeking to learn whether CBD might reduce psychosis from Parkinson’s Disease. The same institution doing that study, Kings College London, is looking to learn whether CBD might help with behavioural problems from Alzheimer’s Disease. Anxiety among breast cancer patients is the subject of a coming study from the Dana Farber Cancer Institute in the United States. The researchers want to know if a single dose of CBD can reduce anxiety in advanced cancer patients before they receive a CT scan.
Post Traumatic Stress Disorder is another focus of CBD research efforts. PTSD was first discovered among combat soldiers but now psychiatrists know that many terrifying or traumatic events can cause the disorder. A study is currently recruiting patients to test the idea that CBD can help treat Post Traumatic Stress Disorder.
While most of the research efforts surrounding CBD are about properties for which people already use cannabidiol, there are some studies which could create new frontiers in CBD use. CBD works by interacting with the CB1 and CB2 receptors in our endocannabinoid system. Little is known about the endocannabinoid system relative to other signaling systems in our bodies, but we do know that is helps govern inflammation and we know that inflammation is both a cause and a symptom of many other disorders. Normally, inflammation is a good thing. As we discuss in another article, inflammation part of the body’s immune response. But when there is too much inflammation or inflammation is inappropriate because our immune systems are attacking the wrong targets, it can be harmful to us.
For example, some babies who are born prematurely tragically get a condition called Severe Hypoxic Ischemic Encephalopathy. That means that their brains do not receive enough oxygen. One of the treatments for this kind of encephalopathy is therapeutic hypothermia. The baby is cooled down to well below a human’s normal body temperature. GW Pharmaceutical is seeking to learn whether CBD might help with the success of this therapy.
Israeli researchers believe that CBD may be able to substitute for steroids in the treatment of patients with Chronic Spontaneous Urticaria, or long-term hives. That study is currently enrolling patients.
One older study even looked to find how CBD affected the levels of liver fat in patients with Fatty Liver Disease.
Researchers seem to be testing about every substance on earth to see if it can help in the ongoing fight against COVID19. A study in Brazil is recruiting patients to learn whether CBD can reduce the viral load, decrease inflammation, reduce symptoms, or otherwise help people with mild to moderate symptoms of the COVID19 disease. A different Brazilian university will be using CBD not on COVID19 patients, but on front-line health workers to learn whether the stress reducing effect that has so many people taking CBD might help with the extreme stress experienced by those crucial workers.
A pharmaceutical company is in Phase III trials of a CBD topical gel to treat the behavioral symptoms of Fragile X Syndrome, a genetic disorder sometimes associated with autism.
As you can see, CBD is being studied for a very wide variety of conditions. Everything from pain to the addiction which sometimes comes from pain treatment to liver fat. That is an indication of just how little we currently understand the endocannabinoid system. The variety also explains why people not in need of medical attention find CBD useful for such a wide variety of problems.
To be sure, some of these studies will probably have negative results. It is the nature of scientific research that often the answer is “no.” Other studies will produce positive results but require confirmatory studies before a CBD treatment protocol can be designed. And just about all of these studies use purefied CBD, so the study participants do not get the benefit of the “entourage effect” which comes from using all of the cannabinoids which are available in the hemp plant. Researchers prefer to use purified CBD because the entourage effect is so difficult to study. One of the big goals of pharmaceutical research is to isolate a compound to see what it does; the combination of several compounds is too unwieldy to reliably produce results which can be replicated.
On the other hand, some of these studies may result in therapies which can help people. As we await more clinical data, people can legally use CBD in their everyday lives to help them with pain, anxiety, athletic recovery, sleep, and more.