• Nicole Cozean, PT, DPT, WCS

CBD Oil: What's the Buzz About?

One of the most talked about "new" treatments for chronic pain is actually centuries old: cannabidiol (CBD oil). Having been used as a medicinal treatment for more than 2,500 years, CBD oil is derived from the marijuana plant, but does not contain the THC responsible for marijuana's famous 'high.'

Early studies have shown significant promise for the use of CBD. CBD has been FDA-approved to treat two rare forms of childhood epilepsy, and more than 150 clinical trials with the chemical are ongoing. Drug products containing a combination of THC and CBD are available in many countries, including the UK, Czech Republic, Spain, Germany, Denmark, and Sweden.

Some of the most important proposed uses include reducing pain, anxiety, and inflammation.

However, research is still limited and results from human trials are still several years away. Much of what we know comes from animal models, which may not directly translate to benefits in humans. Some testing has combined CBD and THC, making it difficult to determine which is responsible for the benefits seen.

CBD Oil for Pain, Anxiety and Inflammation

What is CBD Oil?

Cannabidiol (CBD) is one of more than 40 cannibidoids found in the marijuana plant. The two most famous are THC, which is responsible for marijuana's high, and CBD, which is not considered a psychoactive substance.

Derivatives of the marijuana plant have been used medicinally for centuries. There is evidence that that Chinese were using marijuana for medicinal purposes almost 5,000 years ago. Europeans began using it in the 1800s for analgesic properties, and it was available over-the-counter in the United States until the 1930s.

However, it was only in the last half-century we gained the ability to separate out the different cannabinoids within marijuana, isolating CBD and removing the THC. Most of the attention has been given to THC, and it's only in the last few decades that significant research on CBD has been started.

This history creates a challenge in researching the effects of CBD, because so much of both the research and anecdotal evidence comes from use of marijuana as a whole. It's hard to determine what is causing any beneficial effects - is it THC, CBD, all of the other components of marijuana, or the combination of them all?

New testing is seeking to answer these questions. While current research is relatively limited, more than 150 clinical trials are ongoing with CBD as we speak, seeking to determine the safety and efficacy of the isolate by itself.

The first FDA-approved indication for CBD oil has been for two rare forms of childhood epilepsy. After clinical testing, the FDA concluded that CBD was safe and effective for the treatment of certain forms of epilepsy in children. This approval has paved the way for additional research into other indications and uses for CBD. CBD has also been approved for several uses in European countries when combined with THC.

CBD and Anxiety

CBD Oil and Anxiety

One of the most promising areas of research is in the ability of CBD to reduce anxiety. In one study of individuals diagnosed with social anxiety disorder, either 600 mg of CBD oil or a placebo was given to them prior to a public speaking test. They received the dose about 1.5 hours before they were due to speak.

Those who took CBD rather than the placebo noted reduced anxiety, discomfort, and cognitive impairment.

Studies have shown mixed results in treating other conditions like schizophrenia.

CBD and Pain Reduction

Another promising avenue of research is into the ability of CBD to reduce pain. Many researchers are excited about the possibility of cannabinoids and CBD to potentially reduce our reliance on opioids for pain management. Most of the testing on the analgesic properties of these compounds have been with cannabis itself, containing both THC and CBD, there is anecdotal evidence in humans for some benefit to CBD alone and there have been several intriguing studies in animal models.

In a study of rats with arthritis, researchers found that topical CBD oil penetrated the skin to reduce both swelling and pain. Inflammation markers were also reduced in the animals that were given CBD.

When patients with the inflammatory condition of rheumatoid arthritis were given a combination of THC and CBD (approximately 13.5 mg CBD and 15 mg THC) daily in an oral spray, they saw a significant reduction in several pain scales as well as improvements in sleep quality.

Cannabis (containing both CBD and THC) has been shown to be effective in relieving pain in cancer patients, though it isn't clear how much of the benefit is due to the THC or CBD (or if the combination is more effective than either alone).

CBD and Sleep

CBD and Sleep

Another effect of CBD that has been reported anecdotally is the ability to help with sleep. Many who use CBD prefer to take it before bed, and report that it helps fall and stay asleep. Whether this is due to potential anti-anxiety effects or it actually causes drowsiness, it can be a beneficial side effect for many patients.

In patients with multiple sclerosis (MS), use of a product with both THC and CBD was proven to improve sleep quality; again, it is hard to determine whether that result was from the CBD, THC, or the combination.