What is Cannabidiol? A Complete Guide to CBD
In 2013, the world watched as a cannabis extract high in a compound called cannabidiol (CBD) successfully transformed a young girl once catatonic from seizure into a bright and lively child. That little girl was Charlotte Figi, and she was the starring figure in the pivotal CNN documentary, Weed.
Prior to treatment with a high-CBD cannabis product, Charlotte had up to 300 seizures per week. After CBD? Her seizures dropped to just a few per month.
Charlotte’s story blew up across the globe, inspiring a new wave of popular interest in the compound.
Now, CBD supplements and oils can be purchased online for everyday consumers. Pharmaceutical companies are introducing new CBD-based medicines to pharmacy shelves. CBD is even being added to skin creams and cosmetics.
But, what exactly is CBD and why is it so beneficial to the body? To paint a clearer picture of this miraculous molecule here is a complete guide to help you better understand how CBD works.
What is cannabidiol (CBD)?
The cannabis plant is capable of producing over 400 different chemical constituents. Like other herbs, cannabis is a superfood that produces a variety of compounds that can have beneficial effects in the human body.
Cannabidiol (CBD) is one of these nutrients. The chemical is one of at least 113 chemical compounds in the cannabis plant called cannabinoids.
A growing body of evidence suggests that cannabis has a wide array of health benefits. This includes potential uses as a general wellness and preventative aid as well as uses for pharmaceutical medicine.
Since cannabinoids like CBD are produced by cannabis alone, access to the plant is extremely valuable for both personal health and wellness as well as continued pharmaceutical research.
How does CBD work?
Researchers are still uncovering all of the many ways as far as how CBD works in the body. Though the cannabinoid was first identified in the 1940s, research on the topic has only recently accelerated.
Yet, over the past eight decades, scientists have uncovered many basic findings of how CBD may function in the body. Thus far, researchers know that CBD acts as a regulator of the endocannabinoid system (ECS).
The ECS is a large neurotransmitter network that helps the body and brain communicate with each other.
In many ways, the ECS is a bridge that helps the conscious mind make sense of the surrounding environment. The ECS plays a role in a variety of bodily functions, including:
The ECS is made up of cell receptors that sit on the surface of cells (cannabinoid receptors) and the molecules that connect with these receptors (endocannabinoids).
Endocannabinoids are like the body’s own cannabis. In this case, Endo- refers to internal. The active compounds in cannabis are phytocannabinoids. Phyto- refers to plants.
CBD and the endocannabinoid system
CBD works by tapping into the ECS, modulating its effects. It is a compound that can alter concentrations of neurotransmitters in the nervous system. It can also affect the immune system and other bodily functions, like bone growth.
CBD calms communication between excited brain cells, which is one of the reasons it is thought to be so beneficial for conditions like epilepsy and anxiety. In both of these conditions, cells in certain regions of the brain become overstimulated. CBD works by calming this overstimulation.
Research suggests that the cannabis chemical can also boost or enhance levels of the body’s naturally occurring endocannabinoids. It does this by blocking enzyme proteins that would normally break down these compounds.
Thus far, scientists have identified two primary endocannabinoids. These molecules are anandamide (AEA) and 2-Arachidonoylglycerol (2-AG). Of the two, anandamide is the most famous.
Commonly known as “the bliss molecule”, AEA can be compared to the body’s own cannabis.
One of the ways CBD works is by preventing these blissful molecules from being quickly disassembled by the body. This improves the circulation of these compounds, acting as a natural enhancer for the endocannabinoid system.
How is CBD different from THC?
CBD and THC are different in many ways, but one difference stands above all others. Tetrahydrocannabinol (THC) is the primary psychoactive in the cannabis plant.
CBD, on the other hand, does not cause a psychotropic “high” or euphoria at all. Instead, CBD promotes a sense of calmness and ease without distorting cognition or causing you to feel out of the ordinary.
THC and CBD produce unique effects because they work differently in the body.
THC has psychotropic effects because of the way it engages certain receptor sites on brain cells.
Specifically, the compound engages the CB1 cell receptor, which is highly concentrated in the brain and spinal cord.
The CB1 receptor is one of two primary cannabinoid receptors in the endocannabinoid system. The second cannabinoid receptor is called the CB2 receptor and it is more heavily concentrated on immune cells.
THC has psychoactive effects because it directly engages the CB1 receptor in the brain. The psychoactive hijacks the landing places for the body’s own endocannabinoids.
This contributes to the skewed sense of time, temporarily impaired short-term memory, and altered cognition typically experienced after consuming high-THC cannabis products.
CBD, on the other hand, still exerts therapeutic benefits without causing these changes in cognition. Rather than directly engaging the CB1 receptor, CBD interacts with the receptor by connecting with what is known as the allosteric site on the receptor protein.
The “allosteric site” is more or less a side pocket on the cell receptor. This simply means that CBD has the ability to alter how other compounds engage with this receptor rather than producing direct effects on its own.
In many ways, CBD is a modulator. It acts as a traffic cop or a director that changes the balance of the endocannabinoid system. It alters the levels endocannabinoid molecules and changes how they interact with the body.
THC is more like a direct replacement for endocannabinoid compounds, while CBD can be considered a natural enhancer.
Is CBD psychoactive?
While CBD does not cause a psychotropic “high”, it does have an effect in the brain. It would not be technically correct to call CBD “nonpsychoactive.”
Research has discovered that CBD engages one of the same cell receptors in the brain and body as common antidepressant drugs. The cell receptor in question is called the 5-HT1A serotonin receptor.
Engaging this cell receptor is thought to have a calming effect, reducing excitability in the brain. Through its interaction with this receptor, CBD increases the amount of serotonin present in the brain.
Researchers speculate that this boosts mood and promotes a positive sense of well-being. While CBD may not cause the same euphoric rush that THC does, the compound still does affect thinking and behavior by improving mood and quelling anxiety.
In this sense, CBD is psychoactive.
Preclinical research in rodents has also found that CBD is fast acting, boosting serotonin levels within seconds after application. Antidepressant drugs, on the other hand, can take up to several weeks before the beneficial effects present themselves.
The therapeutic potential of CBD
It has been mentioned several times that cannabis compounds have therapeutic potential. But, what sort of benefits does CBD actually have? What qualities make the cannabinoid beneficial for health?
Research suggests that CBD is:
CBD has also been found to be beneficial for the skin, potentially reducing oil buildup that contributes to acne.
The compound can also have a mild energizing effect in small doses, while perhaps providing more sedative effects in larger doses.
What medical conditions respond to CBD?
In the recent decade, researchers have made some major discoveries about CBD. The compound is currently being investigated in the following seven medical conditions.
However, it’s important to keep in mind that the therapeutic potential of CBD is far-reaching, and these few conditions only represent the tip of the iceberg when it comes to the value of the cannabis compound. Here are seven medical conditions that may respond to CBD:
Research on CBD for epilepsy is by far some of the most advanced in terms of clinical research. Already, one biopharmaceutical company has created a CBD-based anti-epileptic drug called Epidiolex.
Invented by Britain's GW Pharmaceuticals, Epidiolex contains isolated CBD. Thus far, it has been successful in phase 3 clinical trials in both Dravet’s Syndrome and Lennox-Gastaut Syndrome.
Both conditions affect pediatric patients and are often unresponsive to conventional pharmaceutical treatments. These conditions often lead to premature death and can cause dozens of seizures each day.
Successful phase 3 trials are the final steps in approving new epilepsy drugs for medical use.
In one trial, researchers tested the effects of CBD on 120 children aged two to 18. The peer-reviewed study was published in 2017 in the New England Journal of Medicine.
The trial found that CBD successfully reduced seizures in 43 percent of the test subjects by greater than half. On average, those given CBD experienced a seizure reduction from 12.6 to 5.9 per month.
Those given placebo went from 14.9 to 14.1 per month.
Five percent of patients given CBD had their seizures disappear completely. This did not happen at all with the placebo group.
A growing body of preclinical evidence and one early trial suggests that CBD has potent anti-cancer properties. In laboratory and rodent models of breast cancer, the cannabis compound has successfully caused tumor cells to self-destruct.
This occurs through a process called apoptosis, which can be described as “cell suicide”.
Normal cells will undergo apoptosis naturally if they are damaged or diseased. However, for some reason, cancer cells stop responding to signals that trigger cell suicide. This means that cancer cells can continue to grow and proliferate.
CBD is expected to be most effective for breast cancer cells, though several other types of cancer cells have responded to the cannabinoid in preclinical research.
In early 2017, GW Pharmaceuticals again tested the effects of a cannabis-based drug on 21 patients with glioblastoma multiforme, an aggressive form of brain cancer. The participants were treated with a drug that contained both psychoactive THC and CBD.
Patients in the study also received chemotherapy.
The phase 2 clinical trial found that those treated with the cannabis-based drug had a one-year survival rate of 83 percent. Those given a placebo had a one-year survival rate of 53 percent.
Patients treated with the cannabis medicine survived a median number of 550 days compared with only 369 days for those given placebo.
3. Psychiatric disorders
Feeling blue or overly anxious? CBD might help.
Research suggests that CBD may be a useful tool in the treatment of psychiatric disorders. Preclinical studies have found that CBD has anti-anxiety and antidepressant properties.
However, early clinical trials have also found that CBD-based medications have shown signs of success in treatment-resistant schizophrenia.
While psychoactive THC is not considered helpful for those with psychotic disorders, CBD is non-psychotropic. In fact, preclinical research suggests that CBD may actually dampen the psychoactive properties of THC.
These same characteristics are perhaps what makes CBD a compound of interest in schizophrenia research.
Yet again, GW Pharmaceuticals has successfully completed a phase 2 clinical trial testing the effects of CBD in 88 patients with schizophrenia. CBD was given as an adjunct treatment along with conventional antipsychotic medications.
The trials found that the CBD-based drug successfully reduced both positive and negative symptoms of the disorder, as well as improved cognition when paired with conventional treatments.
4. Inflammatory disorders
Inflammation is a culprit in a wide variety of diseases, yet it is particularly problematic in autoimmune disease. Ample preclinical research suggests that CBD may be useful in the treatment of various inflammatory disorders.
Experimental research suggests that the endocannabinoid system is an emerging player in the area of inflammation.
While researchers are still unraveling the complex entanglements between the ECS and the immune system, the preliminary evidence provides positive signs that CBD may successfully reduce inflammation that contributes to several different diseases, including:
A phase 2 trial published in Diabetes Care tested the effects of cannabinoid-based drugs in 62 patients with type 2 diabetes. The drugs contained both CBD and another cannabis compound, tetrahydrocannabivarin (THCV).
Researchers found that CBD reduced resistin, which is a compound that contributes to the buildup of belly fat.
CBD also increased levels of a compound called glucose-dependent insulinotropic peptide. This peptide is thought to boost insulin secretion. In type 2 diabetes, cells stop responding to insulin and patients need to supplement with the hormone in order to maintain blood sugar levels.
The overall results of the study did not reach the clinical goals. However, these findings suggest that there is still reason to continue to explore CBD in diabetes research.
In rodent models, CBD treatment has been found to lower insulin resistance in non-obese mice, as well as halt the development of autoimmune diabetes in non-obese mice.
6. Neurological conditions
The stress-fighting and anti-inflammatory effects of CBD may make it particularly useful for neurological conditions and diseases of aging.
Preclinical research suggests that CBD may be helpful in slowing the progression and treating symptoms of neurological and degenerative conditions like Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis (MS).
Already, a prescription drug containing both psychoactive THC and CBD is available for multiple sclerosis patients in many countries. The drug is Sativex and it was developed by GW Pharmaceuticals.
Sativex has been found to be effective in easing pain and reducing spasticity and tremors associated with MS. MS is a degenerative disorder that causes the fatty lining of nerve cells in the brain to deteriorate.
Research suggests that CBD may provide long-lasting protection against the deterioration of nerve cells by reducing inflammation.
7. Brain trauma
Believe it or not, the U.S. government has a patent (US6630507) on the use of cannabinoids as neuroprotective antioxidants. Antioxidants are compounds that prevent damage to cells and DNA.
As a neuroprotective antioxidant, CBD may be useful in checking back damage caused by brain injuries. These neuroprotective qualities also make the compound useful in the treatment of the neurodegenerative disorders mentioned above.
Currently, the biopharmaceutical company Kannalife Science has exclusive rights to the U.S. patent and hopes to develop therapies to both prevent and help patients recover after brain damage.
While investigations are still underway, preclinical evidence suggests that pretreatment with CBD may reduce the damage caused by traumatic brain injury. Additional evidence suggests that CBD treatment post-stroke may improve recovery after the event.
Does CBD have side effects?
In all of the studies mentioned above, CBD was found to be generally well tolerated. Cannabis itself is non-toxic and there has yet to be a single reported death from cannabis overdose, even the psychoactive varieties.
Still, if you want to learn how CBD works, you'll want to know the potential for minor side effects. Some of the side effects reported with high doses of CBD (in the form of the pharmaceutical Epidiolex tested in patients with epilepsy) include:
Lack of appetite
Raised body temperature
These side effects are generally considered mild. In lower doses taken simply for wellness purposes, these side effects are less likely to occur.
Does CBD interact with pharmaceutical drugs?
If there is one major caveat to CBD, it’s that it may be risky to mix with pharmaceutical drugs. As it turns out, CBD may prevent the liver from effectively detoxing prescription medications.
It does this by blocking the action of enzymes that break down and clear out an estimated 70 to 80 percent of medications currently used in clinical practice.
As a result, some pharmaceutical drugs may build up to unsafe levels in the body. This puts patients at a greater risk of pharmaceutical toxicity, so be sure to check with your doctor or a cannabis-specialized physician.