For information on using prescription CBD, a product called Epidiolex, speak with a healthcare provider.
Pertwee RG. The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delat9-tetrahydrocannabivarin. Br J Pharmacol 2008;153:199-215. View abstract.
How does it work ?
Kavia RB, De Ridder D, Constantinescu CS, et al. Randomized controlled trial of Sativex to treat detrusor overactivity in multiple sclerosis. Mult Scler 2010;16(11):1349-59. View abstract.
Yamaori S, Kushihara M, Yamamoto I, Watanabe K. Characterization of major phytocannabinoids, cannabidiol and cannabinol, as isoform-selective potent inhibitors of human CYP1 enzymes. Biochem Pharmacol 2010;79(11):1691-8. View abstract.
Chesney E, Oliver D, Green A, et al. Adverse effects of cannabidiol: a systematic review and meta-analysis of randomized clinical trials. Neuropsychopharmacology. 2020. View abstract.
Nearly 43 percent of the products contained too little CBD, while about 26 percent contained too much, Bonn-Miller said.
And Welty said the studies that have featured humans for these other CBD uses have either been case reports or studies that did not compare results against a control group that did not use the oil.
Welty recommends that people interested in CBD seek out a doctor who has read up on the extract and its potential uses.
“There’s no control, so it’s basically how do you know if we’re dealing with the true effect of the drug or just simply a placebo effect because somebody thinks they’ve been given a drug that will be beneficial?” Welty said.
Strong Evidence for Treating Epilepsy
“CBD is kind of a tricky drug because it’s not very well absorbed orally,” Welty explained. “Less than 20 percent of the drug is absorbed orally. If it isn’t made in the right way, you may not be getting much drug into your systemic circulation.”
“There have been clinical trials in adults, but a lot smaller than the epilepsy studies that have been done in kids,” Bonn-Miller said.
“There is published evidence that CBD does decrease anxiety,” Hurd said. “That’s another indication where I can say I can believe the data; however, we still don’t know the dosing regimen that would be effective for anxiety. Those are studies that are ongoing.”
To date, there’s only one use for CBD that has significant scientific evidence behind it — curbing the symptoms of rare forms of epilepsy.
Welty is much less sure of the “artisanal products” containing CBD that are available in stores and dispensaries, and for good reason — studies have shown that most of these products fail tests for content and purity.
Companies have falsely claimed that CBD can stop cancer cells, slow the progression of Alzheimer’s disease, ease nerve pain and fibromyalgia, and curb withdrawal symptoms for people undergoing substance abuse treatment, the FDA letters state.
All of these products contain cannabidiol but not THC, the ingredient in pot that provides a “high.”
Other uses — as an anti-inflammatory, an aid for substance withdrawal, a sleep aid, a pain reliever — haven’t been conclusively proven.
“You have a flood of CBD products that are coming from hemp that are going out onto the market, and you’ve got all sorts of claims being made about those from people who are trying to sell them,” said Timothy Welty, chair of the department of clinical sciences at Drake University’s College of Pharmacy and Health Sciences, in Des Moines, Iowa.