Cannabidiol (CBD) is extracted from hemp ( Cannabis sativa L), also known as marijuana. Hemp is a plant that originated in Asia and has been used for more than 10000 years by various cultures of the world for religious, nutritional and medicinal purposes.In the 16th century, it was a constant part of any medical kit, mainly for its analgesic and anti-inflammatory effects.
The psychoactive qualities of the plant only became known to Europeans in the nineteenth century, and products obtained from the whole plant tended to be of a psychoactive nature. The cannabis industry has grown and evolved so fast that we can now separate the psychoactive components of the plant – the ones that get you "high" – from the non-psychoactive ones, such as CBD.
CBD is a cannabinoid that accounts for up to 40% of the marijuana plant's extract, and it is not related to its psychoactive counterpart tetrahydrocannabinol (THC). It is essential to clarify the distinction between high THC cannabis oil and CBD oil; terms that are often used interchangeably. Cannabis oil can be produced at home (from cannabis plants) or bought illegally, and it contains psychoactive THC.
CBD oil, however, does not contain tetrahydrocannabinol, and it is currently legal as a general nutritional supplement in many countries. There are varieties of plants (industrial hemp) whose cannabinoid content is high in CBD and low in THC. Low THC strains are currently the most widely used for medical research purposes.
Science always seeks to advance and to understand areas never explored before. It is due to this spirit of scientific curiosity that CBD research has exploded in Universities and medical research labs.
CBD is being researched in an attempt to find effective cures and treatment options for a number of diseases. Scientists are always searching for new molecules and compounds that could be used for multiple conditions, and in their quest, are now focussing significant research efforts on discovering the potential of cannabinoids. CBD is an extremely versatile compound derived from various types of cannabis, it is one of over 110 cannabinoids known to be present in hemp (Cannabis sativa L).
The increase in research on phytocannabinoids (plant cannabinoids) is driven by the expectations for possible therapeutic applications of these substances, a subject of obvious importance and which in fact goes beyond the frontier of the strictly scientific or clinical.
Currently, CBD has limited regulatory status, and the reclassification to a medicinal compound in the UK may produce a more honest and transparent market for all hemp-derived products. Now CBD oil has a medicinal product classification, its potential medical benefits could soon be made available to all, with prescriptions possibly becoming available in the future for many conditions from hypertension and diabetes to epilepsy.
Although there have been numerous studies from all over the world within the past decade that show CBD may have potential medical benefits, it needs further research to provide more robust human trial evidence, which could legitimise and promote CBD products even more
With this change in regulatory frameworks, more health care professionals may encourage the prescription and use of CBD products. There will likely be more widespread access to cannabidiol, but currently, it is unknown how this will be implemented and whether any pharmacies will be able to sell the products, or whether it will be available as a prescription medication only.
As of today, there is an upsurge in unsanctioned use and many CBD-derived products (gums, oils, and highly concentrated extracts) are available online for anyone hoping to self-medicate their own conditions. It is essential that a GP or health professional should be consulted before any new supplement use. Some side effects have been reported, although the reported side effects are usually due to interactions with an existing medication; on the whole, however, CBD is mostly well tolerated.
Animal research and some small-scale human trials have been undertaken to determine if CBD might be useful for a wide range of disorders, such as anxiety, asthma, neurodegenerative diseases, and ischemia-related conditions (inadequate blood supply to an organ). It is important to state that most of these research reports come from pre-clinical evidence.
CBD has also currently being studied for the possible treatment of epilepsy with several clinical trials underway, one pure CBD product is currently in Phase 3 trials.
Another potential therapeutic application that has been widely studied is the use of CBD to treat drug addiction. Recent research has focussed on whether CBD could have a positive therapeutic effect on cocaine, opioid, and psychostimulant dependence. However, there needs to be more research before considering CBD as a potential treatment.
The endocannabinoid system and Cannabinoids
To the casual observer, these two terms might look similar. This is because cannabinoids contained in cannabis (hemp) are very similar to those produced by the human body. "Endo" is the abbreviation for "endogenous", which means "acting from within". Cannabinoids interact with the endocannabinoid system. Humans naturally produce our own cannabinoids, and the interest in cannabinoid supplements is spearheaded by those wishing to increase the level of cannabinoids in their own endocannabinoid system.
Cannabinoids and nociceptive control
Nociceptive pain (pain arising from the stimulation of nerve cells) is a major area of research. Pharmacological research in recent years has focused on studying known compounds as an alternative to creating new drugs. This is the primary motivation for the increase in cannabinoid research, phytocannabinoids may potentially offer high efficacy combined with minimal undesirable side effects.
Cannabidiol v Opioids
In recent years, endogenous (internal origin) cannabinoids have been acknowledged as a new system of central and peripheral neuromodulation thanks to their action on receptors CB1 and CB2.
The synthesis of synthetic cannabinoid agonists has been used to show an analgesic action comparable to that of opiates, which has increased the level of interest in the investigation of these compounds in the treatment of pain (cancer, migraine, postoperative pain acute/multiple Sclerosis)
The most important effect is the one that implies the opioid system. There is evidence that the cannabinoid and opioid system work in a similar way, for example, both neuromodulation systems possess endogenous ligands and a descending analgesic system. When both systems are activated, similar processes are observed that are described as analgesia, development of tolerance and dependence, hypothermia, sedation, hypotension. We have an advantage with the cannabinoid system that additional cannabinoids do not produce the side effects of opioids such as nausea, constipation, itching, respiratory depression, physical dependence, addiction and hormonal alterations.
The most common opioids include hydrocodone (Vicodin), oxycodone (Oxycontin and Percocet), morphine (Kadian and Avinza), codeine, and other related medications. Opiates have become the first line of pain treatment in cancer patients, and at the same time, they are increasingly being used in the treatment of other types of pain. Examples of this include patients with back pain who do not improve with physiotherapy, analgesics, or anti-inflammatory injections, and who are also not candidates for surgery or have not improved after this intervention.
Some studies claim not to have been able to block the anti-nociceptive effects induced by cannabinoids (Welch, 1993). The biochemical mechanisms that explain the synergistic interaction between the cannabinoid and opioid system can be related to the communication at the level of the translation of the signals caused by the opioid agonist and cannabinoid and the release or not of various mediators associated with the modulation of nociception and inflammation.
Other relationships between cannabis and nociception modulatory substances involve the neuropeptide CGRP (calcitonin gene-related peptide), a neuropeptide with algica function (Richardson et al., 1998). Cannabinoids modulate neurogenic inflammation by inhibiting neurosecretion of CGRP in central and peripheral terminations of primary afferent fibres. Cannabinoids inhibit the production of eicosanoids, thus facilitating antinocicepción by acting on inflammation mediators (Martin, 1986).
From an experimental point of view, the analgesic activity of cannabinoid receptors is similar to opioids. The potency depends on three factors: the structure, the dose (higher doses, more significant effect), and the liposolubility (the Antinociceptive potency of the cannabinoid administered spinally correlates negatively with the liposolubility).
Pain relief is more pronounced in chronic pain and allodynia (extreme sensitivity to stimuli) than in acute pain induced in healthy tissue (Pertwee, 2001). This can be explained because cannabinoids act by inhibiting or releasing a series of modulators from neurons or from neuronal membranes so the antinociception will be faster and more intense if the tissues are injured or inflamed (mediators are in relatively high amounts). In the management of neuropathic pain, cannabinoids exert better function than opiates, this is due to the presence of cannabinoid receptors in the primary afferent fibres of large diameter. In summary, it is interesting to note that in clinical studies, results show that cannabinoids are analgesic substances with potency similar to opiates such as codeine (Cambell et al., 2001)
Short and long-term effects
In the short and long-term, CBD exhibits very few side effects, mild nausea and stomach upset are usually only experienced (at very high doses). Compare this to THC, the side effects of this cannabinoid are related to central nervous system depression, it can produce obtundation, disorientation, ataxia, dizziness, disconnection, dry mouth, blurred vision, and memory disturbances.
In the long term, cannabidiol shows very little negative side effects apart from mild sedation.
Cannabinoids present very low toxicity
No human deaths associated with cannabis use have been published.
What is the position of CBD oil concerning brain tumours?
A brain tumour is a growth of abnormal cells in the brain tissue. Tumours can be benign (noncancerous) or malignant (with cancer cells that grow very fast). Some are primary, that is, they start in the brain. Others are metastatic, that is, they started in some other part of the body and reached the brain.
Recent studies made in animals have indicated that cannabis extracts can potentially help kill specific cancer cells and reduce the size of some tumours. The evidence suggests that cannabis could be used in the future to reduce the size and growth of some grade types of brain tumours. Research in mice suggests that these extracts, along with the use of radiotherapy, increase the effects of radiation in their use against cancer.
The available clinical evidence on the antiemetic efficacy of cannabinoids in cancer patients receiving antineoplastic chemotherapy has been reviewed by Tramèr et al. These authors have conducted a systematic quantitative review of 30 clinical trials with 1,366 patients, whose results show that for 144 patients undergoing chemotherapy, cannabis extract has an antiemetic efficacy superior to that of other first-generation Antiemetics (Prochlorperazine and Metoclopramide).
Today we can find many products that contain CBD, from oils to capsules, to creams. Cannabidiol can be consumed with a vaporiser, by ingesting CBD oil, or by eating food with added CBD. Because of the little publicity that CBD oil has received, it can be difficult to determine the correct dosage needed to obtain maximum benefits. Starting with about 2 or 3 drops of oil in the form of oil or capsules is wise to determine if you experience any side effects. You can then gradually increase the dose until you experience the desired effects.
Cannabidiol and mental health
Interest in low THC cannabis oil has already begun to emerge due to the interest in preventive measures against health disorders. Knowing the concentration, the recommended dosage and the variety of products available is the first step. On this site and other useful sites on the web, you will discover some basic information. Anyone affected by a mental health issue is strongly advised to visit their GP to benefit from professional advice. In the fight against ill health, the most elegant victory can sometimes be a natural cure.
Cannabis oil can be one of the most effective options when it comes to using cannabis therapeutically. Its consumption can be discreet, which makes it a real possibility for patients that don't want to be judged or even for parents considering natural, low toxicity supplements to improve the quality of life of their children with neurodegenerative problems. And also, being made from low THC cannabis (hemp oil), it can be taken with different types of foods or used sublingually (under the tongue).
Human studies with CBD oil
A 2007 study carried out by the universities of Nottingham and Reading, in the United Kingdom, demonstrated the functioning of the cannabinoid compounds as inhibitors of the proliferation of keratinocytes (predominant cells in the epidermis), an interesting outcome for those researches studying therapy options for psoriasis.
A study in the British Journal of Clinical Pharmacology states that the "CBD has a direct effect on the isolated arteries, causing a relaxation both acute and temporal... A common occurrence in these studies is the anti-inflammatory and antioxidant effect of the CBD. It is also said that the CBD plays an essential role in the health of the blood, by assisting the white blood cells, platelet aggregation, and even maintaining a constant level of blood sugar.
The results of five clinical trials with a total of 703 AIDS patients and anorexia-cachexia syndrome sufferers suggest that dronabinol and smoked marijuana are superior to placebo, but not to megestrol, to increase appetite and maintain weight. Patients with AIDS and cancer could benefit from various pharmacological effects of cannabinoids, such as orexigenic, analgesic, antiemetic and sedative. However, it is not clear if the immunosuppressive effects of the chronic use of cannabinoids could limit their use in this group of patients.