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.
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And then I woke up on the concrete, a worried crowd gathered around me. “You had a seizure,” my friend said gently as I blinked my eyes, trying to process this new information.  I remember it was warm that night because I was wearing a sundress, and when I finally regained consciousness my first worry was that my dress flew up and everyone could see my underwear.
Relevant studies are summarized in Table ​Table3.3. In a SPECT study of resting cerebral blood flow (rCBF) in normal subjects, CBD reduced rCBF in left medial temporal areas, including the amygdala and hippocampus, as well as the hypothalamus and left posterior cingulate gyrus, but increased rCBF in the left parahippocampal gyrus. These rCBF changes were not correlated with anxiolytic effects [102]. In a SPECT study, by the same authors, in patients with SAD, CBD reduced rCBF in overlapping, but distinct, limbic and paralimbic areas; again, with no correlations to anxiolytic effects [104].
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Typically, pharmaceutical companies making cannabis-based medicines have sought to isolate individual compounds from the plant. But Mechoulam strongly suspects that in some cases those chemicals would work much better in concert with other compounds found in marijuana. He calls this the entourage effect, and it’s just one of the many cannabis mysteries that he says require further study.
The cannabis plant is filled with hundreds of different compounds, several of which have been studied for decades for their therapeutic benefits. The cannabis compounds that have captured the most scientific interest are known as cannabinoids. Cannabinoids are now used in treatment for a broad—and growing—range of conditions and symptoms, from sleep and pain, to anxiety and inflammation, to Parkinson’s disease and cancer.
In a study whose findings have not yet been published, he and a colleague, Daniel Friedman, found that patients receiving CBD in addition to their usual medicines had 39 percent fewer convulsive seizures than patients who remained on their normal drug regimen. Given that the study included only the most treatment-resistant patients, this is an “excellent response,” Devinsky says.
As with a fermented food like kombucha, slight natural variations are normal and to be expected in a product such as CBD oil because it is made from living plants. Changes in the weather, soil, and water can all impact the biology of the source material. While we verify Certificates of Analysis (and take many other criteria into consideration during our review process), even the most reputable five-star companies have no way to control for every variable in this organic process.
But all was not well. Harper has continued to experience health issues related to her condition. And seven months after starting to use CBD oil, Harper’s seizures returned— although not as frequently as before. Penny uses eleven iPhone reminders to keep track of Harper’s daily regimen of medications and food, and she records all of Harper’s seizures in a thickly bound black book. But as her parents continue to closely monitor Harper’s health and adjust her medications accordingly, her doctors are tightly limited in the advice they can offer when it comes to CBD oil. “There’s no research on this product, so they don’t say it’s good or bad. They just say, ‘Don’t stop giving it,’” Penny told me.
However, Bonn-Miller told Live Science that he thinks cannabis research is on the upswing. "If we flash forward five years I think you'll see more studies," he said. Those studies could reveal more conditions that CBD may be helpful for and may also reveal that some of the reasons why people say they use CBD oil are not supported by the science but are instead a placebo effect. "And that's why we need to do the studies," he said.  

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