Cannabidiol has drawn everybody’s attention when parents have discovered that the cannabis plant can significantly reduce epileptic seizures in children. Since then, CBD has become outstandingly popular; It won’t be an exaggeration if we say that cannabidiol has now more of a spotlight than THC, its intoxicating counterpart. Now widely available through online vendors and at health stores near you, CBD is taking the world by storm.
The human body also produces cannabinoids, known as endocannabinoids, in a bodily system known as the endocannabinoid system (or ECS). The ECS promotes homeostasis by regulating a wide range of functions, including motor skills, mood, appetite, and sleep. As we age, our ECS produces fewer endocannabinoids; they may also decrease due to physical injury or disease. Replenishing depleted endocannabinoids with phytocannabinoids like CBD can help restore balance to the body.
In early June, I met with Penny Pennington Howard, a mother of three, who lives in Carrollton, Texas, about 25 minutes outside of Dallas. Posted in the glass of her front door are two signs you can’t quite make out from the sidewalk: one asking visitors not to smoke, as oxygen treatments are in use; the other a yellow diamond informing guests this is the home of a special needs child. Penny welcomed me inside, out of the glare of the sun, and led me through her living room into her kitchen, where her kids were gathered for lunch. Seth, then eight months old, was plucking cereal off the tray of his highchair, while Lily, seven, was darting back and forth between the countertop and table. Harper, a blond five-year-old with hot pink toenails, was reclining in her “tomato chair,” a molded plastic seat with straps to help keep her steady.
A 2013 study conducted at the University of Haifa in Israel found that cannabinoid treatment after a traumatic experience may regulate the emotional response to the trauma and prevent stress-induced impairment. Cannabinoid treatment minimized the stress receptors in the basolateral amygdala (the nuclei that receives that majority of sensory information) and hippocampus (the part of the brain that is thought to be the center of emotion). (4)
Another major reason people reported not being able to get to sleep, or maintain substantial sleep, was due to chronic pain. Many who suffer from insomnia say that they cannot find enough relief from pain to manage to get to sleep or at least to remain asleep through the night. A rodent study submitted to the European Journal of Pain noted a significant drop in inflammation and signs of pain in rats with arthritis after they received topical treatment of CBD for sleep.
Whether any of these CBD products will do anyone any good (or bad) is moot. “Cannabidiol is the hottest new medicine in mental health because the proper clinical trials do suggest it has clinical effects,” says Philip McGuire, professor of psychiatry and cognitive neuroscience at King’s College London. “It is the No 1 new treatment we’re interested in. But although there’s tons of stuff in the news about it, there’s still not that much evidence.” Large, long-term studies are needed; a 2017 review paper into the safety profile of CBD concluded that “important toxicological parameters are yet to be studied; for example, if CBD has an effect on hormones”.
In addition to positively affecting the endocannabinoid system, CBD has been the focus of more than 23,000 published studies about cannabinoids in relation to various medical indications including anxiety, epilepsy, inflammation, cancer and chronic pain to name few. For a more comprehensive look at these and other studies, visit our medical research and education page.
In the United States, approximately 70 million people suffer from insomnia, insufficient sleep or another sleep disorder. CBD has been mistakenly described as sedating. In modest doses, CBD is mildly alerting. Cannabidiol activates the same adenosine receptors as caffeine, a stimulant. But several patients with sleep issues report that ingesting a CBD-rich tincture or extract a few hours before bedtime has a balancing effect that facilitates a good night’s sleep.
The review of evidence documented an anxiolytic-like effect of CBD in both healthy volunteers and animal models. What’s more, CBD significantly reduced feelings of anxiety among those diagnosed with social anxiety disorder (SAD). Although the specific anxiolytic mechanisms of CBD aren’t fully elucidated, researchers recommend additional trials of CBD for panic disorder, OCD, social phobia, and PTSD.
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At lower doses, CDB (15 mg/day) co-administered with tetrahydrocannabinol (THC, 15 mg/day) increased wakefulness (Nicholson et al., 2004). More recently, Chagas et al. (2014b) investigated the effects of chronically administered CBD (75–300 mg per day for 6 weeks) in patients with Parkinson’s disease and found a reduction in symptoms of REM sleep behavior disorder. After discontinuation of the drug, the frequency of symptoms returned to baseline levels, prior to treatment with CBD. Finally, CBD-enriched extract was described as a safe treatment for reducing anxiety and improving sleep in a young girl with post-traumatic stress disorder (Shannon and Opila-Lehman, 2016).
This evidence supports the idea that CBD decreases autonomic stress responses (e.g. increased blood pressure, faster heart rate, etc.) associated with stress in animal models. Additionally, the reduction in stress associated with CBD is induced predominantly via its binding to the 5-HT1A receptor sites. Based on the results, we could speculate that CBD may be equally therapeutic in attenuating exaggerated autonomic stress responses in humans.
Multiple types of anxiety: A limitation associated with CBD research is that it hasn’t been tested extensively among patients with a specific diagnostic subtype of anxiety (e.g. generalized anxiety). That said, studies note that CBD is likely efficacious in treating symptoms of many different types of anxiety including: social phobia, PTSD, panic disorder, OCD, and generalized anxiety disorder. Therefore, individuals may derive anxiolytic benefit from CBD – regardless of their specific type of anxiety.
The arrival of Epidiolex is unlikely to erase the unregulated CBD market, however. For one, Epidiolex has been studied only in connection with a small number of epileptic conditions. If and when Epidiolex makes its way to drug stores, it will be approved only for the treatment of Dravet Syndrome and Lennox-Gastaut Syndrome, two rare forms of catastrophic epilepsy. People like me, with comparatively mild Janz Syndrome, and people like Harper, with extremely rare conditions like CDKL5, may still be out of luck.
CBD may help reduces REM behavior disorder in people with Parkinson’s disease. REM behavior disorder is a condition that causes people to act out physically during dreaming and REM sleep. Typically, during REM, the body is largely paralyzed, a state known as REM atonia. This immobilization keeps sleepers from reacting physically to their dreams. In REM behavior disorder, this paralysis doesn’t occur, leaving people free to move—which can lead to disruptive sleep and to injuring themselves or their sleeping partners. Cannabis may also work to reduce pain and improve sleep quality in people with Parkinson’s disease.
So Mechoulam called the Israeli national police and scored five kilos of confiscated Lebanese hashish. He and his research group isolated—and in some cases also synthesized—an array of substances, which he injected separately into rhesus monkeys. Only one had any observable effect. “Normally the rhesus monkey is quite an aggressive individual,” he says. But when injected with this compound, the monkeys became emphatically calm. “Sedated, I would say,” he recalls with a chuckle.
It was the seizures that tipped Penny off that something wasn’t right with Harper after she and her husband Dustin brought her home from the hospital as a newborn. Several months later, having tried a battery of epilepsy medications and still without a diagnosis, Penny and Dustin flew to Boston with Harper to see an expert in infant seizures. It was there they first heard of CDKL5. “This is the point where life changed significantly,” Penny said, “because now we had this diagnosis. You know, this abnormality in our family that we cannot fix.”
In general, the preparation methods for unregulated cannabis oil are relatively simple. They do not entail highly specialised equipment, and use easily accessible solvents such as petroleum ether, naphtha, alcohol and olive oil. For this reason, people who have access to cannabis plant material, from either legal or illegal sources, may prepare it at home by themselves.
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