cbd oil usersDecember 15, 2021
CBD is legal in some states and not others. In 2018, the Agriculture Improvement Act of 2018 (aka that year's Farm Bill), legalized CBD derived from hemp — the plant that, remember, can contain only .3 percent of THC by dry weight to be grown legally. This kind of CBD is legal in every state except Idaho, South Dakota, and Mississippi. Plants with more than 0.3 percent of THC are considered marijuana, which is legal in only 10 states.
With so much CBD noise out there, we’re feeling a little PTSD about CBD. (If there were only something we could take for that …) We wanted to know the real deal. For starters, is CBD marijuana? Should we spend our hard-earned money on the stuff, or is it a scam? Is there any science to back up the claims that CBD is helping people sleep better, feel better, look better, or be an all-around better human? If so, is that in the form of CBD oil, tinctures, lotions, or should we vape it? But wait — isn’t vaping bad for you?
Not only does CBD not get you high, studies suggest that it may work to counteract some of the more negative THC effects, like paranoia and heightened anxiety. As far as the ratio goes, however, “it very much depends on what you’re aiming for,” says Margaret Haney, PhD, a professor of neurobiology at Columbia University Medical Center in New York City. “If you’re trying to treat your appetite, I’d say you’d want a higher THC ratio.” (That’s because THC induces the munchies.)
Put that in your pipe and smoke it.
“As with any other product you would ingest, you have to be smart,” says Jahan Marcu, PhD, the editor in chief of the American Journal of Endocannabinoid Medicine , and the cofounder and chief science officer at the International Research Center on Cannabis and Mental Health.
What Are the Legal Implications of Using CBD?
CBD contains compounds that are thought to relieve depression, anxiety, insomnia, and PTSD. A report, also from the Brightfield Group, found that 59 percent of CBD users say they use it for insomnia and 66 percent for anxiety, while 44 percent have taken it for depression and 49 for joint pain and inflammation.
Now that that’s out of the way, let’s get into the nitty-gritty.
In an ideal world, you’d get your product through a licensed distributor, for whom an accredited lab would test it for heavy metals and potency. The problem is that dispensaries aren't on every corner. This often leads people to their local gas station or 7-Eleven, where “life-changing” CBD products sit next to Lifesavers. Also, every state where medical or recreational marijuana is legal has its own testing rules and regulations, so something that passes muster in Massachusetts might not in California.
Cannabis contains more than 100 compounds, known as cannabinoids (pronounced can-NA-binoids). Each one of those compounds — among them CBD, THC, THCA, CBN, CBC, and CBG — do different things in the body (see our CBD glossary for details). CBD, short for cannabidiol, is one of them. Unlike THC, CBD won’t get you high. Depending on your goals, this is either a good or a bad thing.
Only one cannabis-derived drug product has been FDA approved: Epidiolex, which contains a purified form of CBD to treat a rare kind of epilepsy in children age 2 and up.
Some people have failed drug tests because they’ve unwittingly taken THC that was in a product that was supposed to contain only CBD. A study published in the J ournal of the American Medical Association (JAMA) in November 2017 found that 21 percent of CBD products derived from hemp and sold online contained THC, even though THC wasn’t listed on the packaging.
That’s a question worthy of a Talmudic scholar, because the CBD world is complicated.
What’s more, he says, every product should have a certificate of analysis, or COA — a document generated by a laboratory certifying its legitimacy and also listing the ingredients.
Hemp is typically thought of as the non-intoxicating plant grown specifically for fiber and seed. In the United States, the legal definition of hemp is any cannabis plant whose delta 9 THC is below .3 percent.
What’s the Endocannabinoid System and How Does It Work?
The Drug Enforcement Administration (DEA) classifies marijuana as a Schedule 1 drug: “substances or chemicals [that] are defined as drugs with no currently accepted medical use and a high potential for abuse.” Marijuana is illegal on a federal level, but states have different laws regarding marijuana and CBD.
Short answer: You don’t, unless you’re getting it legally. And that’s where the fun begins.
But does CBD work?
The type of cannabis that gets you high is known as “marijuana,” and it contains something called delta-9-tetrahydrocannabinol, or THC. “Hemp” refers to non-intoxicating varieties that can be high fiber or high seed yielding and are often used for rope, clothing, or sails. (Cocktail party fact: “The word ‘canvas’ comes from ‘cannabis,’ as it was made from cannabis fiber varietals,” says Kleidon.)
According to the Brightfield Group, a market research firm, CBD sales are expected to exceed $5 billion by the end of this year. By 2023, the industry’s total market value could reach more than $23 billion.
Others believe CBD is unproven and risky. In early December, for instance, the U.S. Food and Drug Administration (FDA) issued a consumer update outlining its safety concerns about CBD being marketed as supplements. (According to the FDA, THC and CBD products do not fit the definition of a dietary supplement.) “Some CBD products are being marketed with unproven medical claims and are of unknown quality,” wrote the FDA in its statement, noting that it’s illegal to market CBD by adding it to a food or labeling it as a dietary supplement.
Does It Matter if the CBD Is Organic ?
I n case you haven’t heard, CBD is a cure for whatever ails you, from insomnia and inflammation to pandemic angst. Or at least that’s what retailers, supermarkets, mini-marts, beauty stores, and coffee and smoothie shops across America would have you believe. There are CBD-infused creams. CBD-infused oils. CBD-infused tinctures, gummies, juices, lollipops, lattes, nutritional supplements, and even a CBD oil–infused pillow at Bed, Bath & Beyond (a steal at $29.99!) What’s next, CBD-infused tampons? (Actually, that already exists. Really.)
Some believe it’s a miracle cure. Raphael Mechoulam, PhD, a professor of medicinal chemistry at Hebrew University in Jerusalem, has been studying the health benefits of cannabis and CBD since the early 1960s. Long considered the grand poobah of cannabis research, Dr. Mechoulam and his team recently developed a process for synthesizing certain acids found in the cannabis plant. The acids are available for licensing, and could, in theory, be used to develop new drugs for everything from arthritis and anxiety to inflammatory bowel disease and psoriasis.
Cannabinoid receptors are laced throughout the body, brain, and nerves. CB1 receptors are mainly located in the brain, kidneys, liver, and lungs, while CB2s are found mostly in the immune system and in hematopoietic (blood-related) cells. Both categories of receptors are activated by cannabinoids, which are generated naturally inside the body or can be introduced through a form of cannabis.
Cannabis sativa is the botanical name for all types of cannabis, “from intoxicating high-THC flower varietals to non-intoxicating high-CBD flower varietals to the types grown for fiber or seed,” says Will Kleidon, the CEO of Ojai Energetics in California.
Among a number of problems with CBD, the FDA says, is that it can cause liver damage and diarrhea, it may impact the metabolism of other drugs, and it may cause male reproductive toxicity in humans, as has been found in animal studies.
Even more worrisome, a study published in January 2019 in Forensic Science International examined nine liquids that were advertised as 100 percent natural CBD extract and found they contained potentially problematic compounds. One contained dextromethorphan, which is used in over-the counter cough medication and is considered addictive when abused. Four others had a synthetic cannabinoid that can cause, among other things, anxiety, psychosis, and even death.
The endocannabinoid system (ECS), is a biological system first described in the 1990s, and it plays a big role in brain, endocrine, and immune function. Its main role, however, is to maintain homeostasis, the internal biological balancing mechanism of the brain and body. Two main elements of the system are endocannabinoid receptors classified as CB1 and CB2. The body makes its own cannabinoids, known as endocannabinoids, that can act upon these receptors. But other varieties of cannabinoids, such as CBD, can interact with them, too.
A few drops of CBD oil in a mocha or smoothie are not likely to do anything, researchers contend. Doctors say another force may also be at play in people feeling good: the placebo effect. That’s when someone believes a drug is working and symptoms seem to improve.
Earlier research found fewer than a third of 84 products studied contained the amount of CBD on their labels. Some users of CBD have also failed drug tests when the product contained more THC than indicated.
The CBD industry is flourishing, conservatively projected to hit $16 billion in the United States by 2025. Already, the plant extract is being added to cheeseburgers, toothpicks and breath sprays. More than 60 percent of CBD users have taken it for anxiety, according to a survey of 5,000 people, conducted by the Brightfield Group, a cannabis market research firm. Chronic pain, insomnia and depression follow behind. Kim Kardashian West, for example, turned to the product when “freaking out” over the birth of her fourth baby. The professional golfer Bubba Watson drifts off to sleep with it. And Martha Stewart’s French bulldog partakes, too.
Last year, the F.D.A. approved Epidiolex, a purified CBD extract, to treat rare seizure disorders in patients 2 years or older after three randomized, double-blind and placebo-controlled clinical trials with 516 patients that showed the drug, taken along with other medications, helped to reduce seizures. These types of studies are the gold standard in medicine, in which participants are divided by chance, and neither the subject nor the investigator knows which group is taking the placebo or the medication.
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Is CBD harmful?
“It’s promising in a lot of different therapeutic avenues because it’s relatively safe,” said James MacKillop, co-director of McMaster University’s Michael G. DeGroote Center for Medicinal Cannabis Research in Hamilton, Ontario.
Sleep can be disrupted for many reasons, including depression. Rodents seemed to adapt better to stressful conditions and exhibited less depressive-like behavior after taking CBD, according to a review in Journal of Chemical Neuroanatomy. “Surprisingly, CBD seems to act faster than conventional antidepressants,” wrote one of the authors of a new review, Sâmia Joca, a fellow at the Aarhus Institute of Advanced Studies in Denmark and an associate professor at the University of São Paulo in Brazil, in an email interview. Of course, it’s difficult to detect depression in animals, but the studies that Ms. Joca and her colleagues reviewed suggested that in models of chronic stress exposure, the mice and rats treated with CBD were more resilient.
A recent chart review of 72 psychiatric patients treated with CBD found that anxiety improved, but not sleep. “Over all, we did not find that it panned out as a useful treatment for sleep,” said Dr. Scott Shannon, assistant clinical professor of psychiatry at the University of Colorado, Denver and the lead author of the review in The Permanente Journal.
An At-Home Face-Lift.
However, a double-blind study found healthy volunteers administered CBD had little to no change in their emotional reaction to unpleasant images or words, compared to the placebo group. “If it’s a calming drug, it should change their responses to the stimuli,” said Harriet de Wit, co-author of the study and a professor in the University of Chicago’s department of psychiatry and behavioral neuroscience. “But it didn’t.”
For students with generalized social anxiety, a four-minute talk, with minimal time to prepare, can be debilitating. Yet a small experiment in the journal Neuropsychopharmacology found that CBD seemed to reduce nervousness and cognitive impairment in patients with social anxiety in a simulated public speaking task.
Up in the wee hours of the night, stuck watching videos of puppies? CBD may be promising as a sleep aid; one of the side effects of the Epidiolex trials for epilepsy was drowsiness, according to Mr. MacKillop, a co-author of a review on cannabinoids and sleep. “If you are looking for new treatments for sleep, that may be a clue,” he said.
Dr. Smita Das, chair of the American Psychiatric Association’s Council on Addiction Psychiatry’s cannabis work group, does not recommend CBD for anxiety, PTSD, sleep or depression. With patients turning to these to unproven products, she is worried that they may delay seeking appropriate mental health care: “I’m dually concerned with how exposure to CBD products can lead somebody into continuing to cannabis products.”
“If you take pure CBD, it’s pretty safe,” said Marcel Bonn-Miller, an adjunct assistant professor at the University of Pennsylvania’s Perelman School of Medicine. Side effects in the Epidiolex trial included diarrhea, sleepiness, fatigue, weakness, rash, decreased appetite and elevated liver enzymes. Also, the safe amount to consume in a day, or at all during pregnancy, is still not known.
Recently, the F.D.A. sent a warning letter to Curaleaf Inc. about its “unsubstantiated claims” that the plant extract treats a variety of conditions from pet anxiety and depression to cancer and opioid withdrawal. (In a statement, the company said that some of the products in question had been discontinued and that it was working with the F.D.A.)
Does CBD help sleep and depression?
Many soldiers return home haunted by war and PTSD and often avoid certain activities, places or people associated with their traumatic events. The Department of Veterans Affairs is funding its first study on CBD, pairing it with psychotherapy.
Some CBD products may contain unwanted surprises. Forensic toxicologists at Virginia Commonwealth University examined nine e-liquids advertised as being 100 percent natural CBD extracts. They found one with dextromethorphan, or DXM, used in over-the counter cough medications and considered addictive when abused; and four with a synthetic cannabinoid, sometimes called Spice, that can cause anxiety, psychosis, tachycardia and death, according to a study last year in Forensic Science International.
CBD is advertised as providing relief for anxiety, depression and post-traumatic stress disorder. It is also marketed to promote sleep. Part of CBD’s popularity is that it purports to be “nonpsychoactive,” and that consumers can reap health benefits from the plant without the high (or the midnight pizza munchies).
Will these trends change your life — or.
Cannabidiol and THC are just two of the plant’s more than 100 cannabinoids. THC is psychoactive, and CBD may or may not be, which is a matter of debate. THC can increase anxiety; it is not clear what effect CBD is having, if any, in reducing it. THC can lead to addiction and cravings; CBD is being studied to help those in recovery.
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This year, 1,090 people have contacted poison control centers about CBD, according to the American Association of Poison Control Centers. Over a third are estimated to have received medical attention, and 46 were admitted into a critical care unit, possibly because of exposure to other products, or drug interactions. In addition, concern over 318 animals poured into the American Society for the Prevention of Cruelty to Animals’ Animal Poison Control Center.
What are the claims?
By Dawn MacKeen.
But he cautions that the side effects could have been because of an interaction with other medications the children were taking to control the seizures. So far, there hasn’t been a randomized, placebo-controlled, double-blind trial (the gold standard) on sleep disorders and CBD.
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But without clinical trials in humans, psychologists say CBD’s effect on depression is still a hypothesis , and not an evidence-based treatment.
“Our top therapies attempt to break the association between reminders of the trauma and the fear response,” said Mallory Loflin, an assistant adjunct professor at the University of California, San Diego and the study’s principal investigator. “We think that CBD, at least in animal models, can help that process happen a lot faster.” While large clinical trials are underway, psychologists say there isn’t compelling evidence yet as to whether this is a viable treatment.
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Facts about wellness.
While there is hope for treating other conditions with the plant extract, Epidiolex remains the only CBD-derived drug approved by the F.D.A. Most of the research on cannabidiol has been in animals, and its current popularity has outpaced science. “We don’t have the 101 course on CBD quite figured out yet,” said Ryan Vandrey, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.
Marijuana and hemp each contain both compounds but in different ratios. Hemp has much lower levels of THC and larger amounts of CBD, which is why it’s often used for CBD products. Marijuana, on the other hand, has significantly more THC.
But is CBD a wonder drug, or just another health fad? There’s no shortage of opinions out there, but we can discern a lot from CBD statistics. We’ve compiled reliable research and conducted a CBD survey to put the prevalence of CBD use and its potential health benefits into perspective.
Additionally, the FDA has not approved products that contain cannabis or cannabis-derived compounds for medical use. In fact, at the federal level, all marijuana is illegal (medical or otherwise). It’s still classified as a Schedule I substance (along with heroin and LSD) by the DEA under the Controlled Substances Act . However, 33 states have legalized it for medical purposes, and 11 of those have approved recreational use for adults 21 and older. Technically, federal law supersedes state law, but the federal government has not chosen to prosecute businesses and/or individuals selling or using cannabis in states where it’s been legalized.
How common is CBD use?
Let’s take a step back. Both hemp and marijuana fall into the cannabis genus. Cannabis plants contain two naturally-occurring compounds: cannabidiol (CBD) and tetrahydrocannabinol (THC). CBD and THC are both cannabinoids but have different effects on the body. Most prominently, THC has psychoactive effects and CBD doesn’t, which is why CBD doesn’t make you feel high.
When some people hear “CBD,” their minds immediately jump to marijuana. And while there is a connection, it’s not as close as one might think. Since recreational and medical cannabis is available in several states now, it’s important to note the differences. CBD is primarily a hemp derivative, which is like a cousin to marijuana, but not the same plant.
A recent study by Penn Medicine revealed that almost 70% of cannabidiol products sold online are mislabeled. So, products from online retailers that haven’t been properly vetted could contain higher levels of THC or other compounds. Our survey found that 22% of people won’t try CBD because they don’t trust the product or manufacturer.
Typically, these effects aren’t dire, but they can be inconvenient and disruptive to a person’s everyday routine.
According to our SingleCare survey, nearly half of CBD users prefer oils/tinctures, lotions/balms, and gummies. But there’s a growing market for CBD edibles.
CBD user demographics skew young. Of all age groups, Americans age 18-29 are most likely to use CBD consistently, and its popularity decreases with age. (Gallup, 2019):
What is CBD?
The CBD market exceeded $4 billion in 2019, according to a study by the Brightfield Group, and they expect the industry to top $25 billion by 2025.
People tout CBD as a miracle treatment for heart disease, cancer, autoimmune diseases, Alzheimer’s, acne, and much more. Researchers haven’t found substantial evidence that it can effectively treat any of these conditions, but we also know that inflammation and stress can be contributing factors to these conditions. So, there may be some truth to the claims that CBD is beneficial to everyday health. Whether it’s in a morning smoothie, part of a skincare routine, or something else entirely, regular CBD use can potentially be beneficial for some people, although it comes with risks too.
In a recent Gallup poll, 64% of U.S. adults said that they were familiar with CBD and/or CBD products. In a 2020 SingleCare survey, we found that one-third of Americans have used CBD.
That said, it has shown efficacy in treating chronic pain and anxiety (two of its most common uses), as well as insomnia and arthritis. And the only FDA-approved medication that contains cannabidiol so far is Epidiolex , which treats childhood seizures associated with Dravet Syndrome or Lennox-Gastaut Syndrome in patients two years of age and older.
Why do people use CBD?
CBD use is most common in populations ages 18-34, according to a recent SingleCare survey.
“CBD can have varying strengths depending on if it is used in isolation or if used in conjunction with THC for entourage effects,” says Dr. Singal. And some people want these compound effects. However, there are a ton of CBD producers and retailers out there, and not all of them are reliable. Although 47% of the Americans that we surveyed think the government regulates CBD, it does not.
There’s no getting around it: CBD is officially everywhere . Its popularity has skyrocketed. What started as a niche alternative health treatment has become a nationwide craze. And it doesn’t just show up as oils and tinctures anymore. There is whole array of curious CBD products, including lattes, makeup, bedsheets, bath bombs, and even dog treats.
People claim that CBD can treat everything from acne to cancer. But the most common uses are for pain, inflammation, anxiety, and insomnia.
Like other medications, CBD can have side effects, too. In one study , one-third of CBD users reported a non-serious side effect, including dry mouth, euphoria, hunger, irritated eyes, and/or fatigue. And according to Michael Hall, MD, the founder of the Hall Longevity Clinic , the spectrum of side effects is even broader.