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Cannabidiol (CBD) was first isolated from Minnesota wild hemp in 1940. It was not until 1963 that the exact structure was discovered by Raphael Mechoulam, the father of cannabis research. Much less research was initially done on CBD than THC because of its relative lack of psychoactive properties compared to THC’s dominant role in producing marijuana’s psychoactive powers.
THC and CBD are the two most abundant cannabinoid molecules in marijuana. Both come from the same nonpsychoactive precursor cannabigerol (CBG). The amounts of THC and CBD produced by any given cannabis strain are inversely related. High THC means low CBD, and vice versa. The ratio of THC and CBD depends on the relative abundance of enzymes any strain has for synthesizing each from the limited pool of CBG. Horticulturists have bred strains with high proportions of THC (Skunk) for maximum psychoactive effect and high CBD (Charlotte’s Web) for treating rare forms of childhood epilepsy.
It is unfortunate that many, if not most, studies of medical marijuana have not reported the ratio of THC and CBD. It was only after recognizing different samples of marijuana produce varying results for different research laboratories despite containing equal amounts of THC that attention turned to CBD as a modifier of THC’s effects. Research on CBD now shows that CBD’s activation of the natural cannabinoid CB1 and CB2 receptors is almost negligible. So, how does CBD work? What does CBD do? What is it good for?
1. Smoothing THC’s High
CBD modifies the impact of THC and the brain’s natural THC-like chemistry. When THC is balanced with CBD, many of its potentially negative effects are reduced. CBD combats the anxiety that THC alone can produce. Balancing THC with CBD creates a “softer” experience with less likelihood of paranoia. Very high THC strains such as Skunk, with its very low CBD, are known to trigger psychotic reactions more often. Consuming marijuana with a balanced THC/CBD ratio is safer.
2. Reducing Anxiety and Stress Response
CBD ineracts with a subset of serotonin receptors to provide a mild anti-anxiety effect and to reduce our autonomic nervous system’s stress response. At lower doses, CBD is calming without producing a sense of being drug-affected or intoxicated. Some research indicates CBD is best at relieving “excess” anxiety, such as that experienced before giving a speech. Functional MRIs show that administering CBD before being exposed to anxiety-producing facial expressions reduces activation in the amygdala’s “fight or flight” centers.
Although some people swear by CBD as an effective sleep aid, controlled research has found mixed results and its sleep benefits may be more related to reductions in anxiety.
3. Relieving Inflammation and Pain
CBD interacts with other lesser-known receptors such as TRPV, located in peripheral nerves and causing heat, inflammation, and pain with injury or infection. CBD desensitizes these transient receptors, thereby reducing inflammatory and neuropathic pain. This may be why many athletes believe taking CBD after a strenuous workout speeds physical recovery. These anecdotal reports have not been scientifically proven yet and deserve to be rigorously tested.
4. 2 FDA-Approved CBD Medications
In 2018, the FDA approved the first CBD preparation, Epidiolex (>99% CBD) for the treatment of rare forms of severe pediatric epilepsy—Lennox-Gastaut and Dravet syndromes. The vast majority of studies confirm that adding CBD to current anticonvulsant medications significantly reduces the frequency of catastrophic seizures and increases the quality of life for children suffering from these rare forms of pediatric epilepsy.
The FDA also gave the green light to a second CBD preparation in 2018 for use specifically with organs being transported for transplantation. CBD reduces damage from low oxygen, thereby decreasing the rate of organ rejection. These benefits to transplant organs mirror the protection against ischemic damage CBD provides in animal experiments that temporarily block blood flow to the brain and heart. I would not be surprised if CBD-like medication became front line treatment for stroke and heart attack patients on the way to the hospital.
5. Making Money
Large segments of the public are gravitating toward CBD’s use, both for good reasons and in response to overpromising anecdotes circulating on the Internet and promoted by industry marketing. CBD is a fad and I almost expect unscrupulous entrepreneurs to declare CBD an essential vitamin.
It is strange when the same cannabinoid molecule is marketed as both legitimate medication and snake oil medicine. CBD is useful, but there are limits to its benefits. But, for the time being there seem to be no limits to the financial benefits being reaped by clever marketers. Buyer beware.
While the question of CBD’s safety can never be answered with a definitive guarantee (science can never prove a null hypothesis), reliable reviews of the medical literature are quite reassuring regarding CBD’s safety and side effects for adults. Safety for children, adolescents, and pregnant people, during which babies' brains are still developing structurally, is an unanswered question and caution should be the rule. Very importantly, the World Health Organization has concluded CBD exhibits no effects indicative of any abuse or dependence potential. This opinion is confirmed by Alan Budney, who delineated the criteria for THC dependence and withdrawal.
