This observational study validated some well-established facts about CBD – namely that it has a strong safety profile1 and is extraordinarily effective at ameliorating pain2 and anxiety.3 Participants reported significant improvements in pain and mood regardless of the underlying medical condition.
That said, the study also showed that CBD is not a panacea – as some would claim – for all that ails us. Some symptoms were decidedly less responsive to CBD products. For example, CBD was not particularly useful in helping people with gastrointestinal diseases maintain a healthy weight. Nor did it have much of an impact on PMS- related bloating, cancer-related diarrhea and constipation, or low sex drive during menopause.
Nonetheless, it was astonishingly effective at simply making people feel better – most likely because of its impact on pain, mood, and sleep.
The survey also found that there were few adverse effects, which is consistent with studies showing that CBD is safe and well-tolerated even at high doses.4
Who Is Using CBD?
The first question we set out to answer was who is using CBD? Based on this survey, it appears that the typical CBD user is white, well-educated, over 45, female, and living in the US.
To some extent, this skewing towards females may reflect their greater utilization of healthcare services in general5, and alternative medicines in particular5. It may also reflect the fact that the two most prevalent conditions for which participants reported using CBD – pain and anxiety – affect women disproportionately.78
Regarding ethnicity, as mentioned, the vast majority of survey participants were white. In the US, which is where the majority of participants were located, this may be due to the high costs of CBD therapeutics, the greater utilization of alternative therapies by Caucasians9 and/or a wariness of cannabis on the part of communities of color that have borne the brunt of the US drug war.
CBD users in this survey also skewed older. Almost two-thirds were over the age of 44, and almost 20% were seniors over the age of 64. This finding may be explained by CBD’s popularity for treating pain and sleep problems, ailments that are common among the elderly, particularly in the US where half of older adults report suffering from chronic “bothersome” pain10 and half report regular sleep disturbances.
What Types of Products Are People Using?
Participants were more likely to be using CBD from hemp rather than cannabis. (This is unsurprising given that the latter is still illegal in most of the world.) They tended to favor CBD tinctures and topicals over traditional modes of taking cannabis, i.e. smoking and edibles. They typically used CBD products multiple times per day and used more than one type of product (most often a tincture with a topical).
Few participants were able to say how much CBD (or THC) they were taking, suggesting an urgent need for both better product labeling and consumer education. Almost half of participants had been using CBD for under six months.
What Are People Using CBD For?
The vast majority of participants reported using CBD to alleviate pain (particularly inflammatory pain), to improve mood and sleep, and/or for general wellness.
Around 10% reported using CBD products to treat severe, debilitating, treatment-resistant conditions, including brain injuries, epilepsy, multiple sclerosis, autism spectrum disorder, Parkinson’s disease, and Alzheimer’s disease.
Most participants were using CBD for more than one condition, and there was a notable clustering of certain conditions.11 Pain, mood issues, and sleep problems correlated closely. A significant number of participants using CBD for pain reported suffering from fibromyalgia and/or arthritis though we had not asked specifically about these conditions. There was also a notable correlation between addiction and ADD/ADHD, and addiction and PTSD; participants who were using CBD for ADD/ADHD or PTSD were three times more likely than the average participant to be using CBD for alcoholism or addiction.
CBD’s Impact & Efficacy
The survey asked about CBD’s impact on six quality of life measurements: Pain, mood, sleep, physical function, energy or motivation, and the ability to socialize. A majority of participants reported some improvement across all measures, but the most significant were in the areas of pain and mood.
Forty percent of participants reported having one or more side effects. These were typically mild. The most common side effects were dry mouth, tiredness, dry or bloodshot eyes, and increased appetite.
Of great interest were the efficacy reports for specific conditions. The survey asked about 17 different conditions for which CBD is sometimes used, including alcoholism/addiction, ADD or ADHD, Alzheimer’s disease, autism spectrum disorder, brain injury (e.g. stroke, TBI, tumor), cancer, diabetes, epilepsy and other seizure disorders, gastrointestinal disease (e.g. Colitis, Crohn’s, IBS), depression, anxiety and other mood disorders, motion sickness, pain, Parkinson’s disease, hormonal conditions (e.g. PMS, menopause), multiple sclerosis, PTSD, and sleep problems. The survey asked what type or stage of disease the person had (e.g. type 1 or type 2 diabetes), and how they felt CBD impacted the common symptoms of that disease.
Here are some of the findings regarding the efficacy of CBD for specific conditions:
CBD for Pain: Most participants taking CBD for pain indicated that they got meaningful relief. Just under 90% of participants of this group reported some improvement in the frequency and duration of their pain, with 60% reporting that CBD made these aspects “much better.” Most significant though was CBD’s impact on the perception of pain intensity: Before taking CBD, the average pain score was 6.85; when taking CBD, the average pain score was 2.76, representing a 60% decrease in intensity.
CBD for Sleep: Participants taking CBD for sleep were more likely to report having problems staying asleep than getting to sleep though most people reported having difficulty with both. Participants reported that CBD helped them get to sleep more quickly, reducing the average time from about an hour to 20 minutes. They also reported waking up much less often – 1.4 times per night versus 4.3 or about a third as many times. Without CBD, almost three-quarters of participants reported waking up tired; with CBD, 9% reported waking up tired. The reported improvements in how people reported feeling upon waking is likely explained by improvements in the ability to stay asleep. People taking CBD for sleep were somewhat more likely to also use some THC than the average participant.
CBD for Anxiety, Depression & Other Mood Disorders: Almost 90% of participants using CBD for a mood disorder reported that they had anxiety. For most, anxiety went hand-in-hand with depression. Participants reported that CBD had significant effect as both an anti-anxiety agent and anti- depressant. It performed especially well at mitigating feelings of nervousness; 92% of participants experienced some relief from this symptom, and 68% reported that feelings of nervousness were “much better” with CBD. CBD also performed well at relieving panic attacks, mitigating mood swings, and quelling feelings of agitation, irritability, and sadness. CBD was less effective at mitigating difficulties concentrating, a lack of interest in activities, and digestive upset; almost a fifth of people report no change in these symptoms. Moreover, 3% of people using CBD for a mood disorder reported that the ability to concentrate worsened with CBD.
CBD for Hormonal Issues: Among people taking CBD for PMS, menopause, or other female hormonal conditions, CBD appears to be highly effective in addressing mood disturbances and pain. It also appears to help mitigate night sweats and, to a lesser degree, hot flashes associated with menopause. CBD was less effective at ameliorating bloating common to menstruation; and it was less effective at mitigating sexual discomfort, low sex drive, and dry skin associated with menopause. About 5% of people reported that their CBD product made PMS-related food cravings worse, an effect that may be attributable to THC’s well-known tendency to cause the “munchies.”
CBD for PTSD: Among people taking CBD for PTSD, CBD appears to be highly effective in addressing a range of symptoms, particularly anxiety, anger, irritability, depression, mood swings, and panic attacks. CBD also appears helpful, though less so, in mitigating unwanted thoughts, nightmares, and heart palpitations in people with PTSD.
CBD for Gastrointestinal (GI) Diseases: Among people taking CBD for GI diseases, particularly IBS (Irritable Bowel Syndrome), CBD appears to be extremely helpful for relieving abdominal cramps or pain, nausea or vomiting, and indigestion. Many participants also found it helpful for fatigue though some found it made them more tired. CBD appears to be less effective at helping people with GI diseases maintain a healthy weight; half of participants in this group reported either no change or a worsening of this symptom.
CBD for ADD / ADHD (Attention Deficit Disorder / Attention Deficit Hyperactivity Disorder): Among people with ADD/ADHD, CBD appears most helpful with staying on task, minimizing distractibility, and mitigating agitation or irritability. It appears less effective at minimizing the tendency to lose things and procrastinate (common to ADD/ADHD) and sometimes made those symptoms worse.
CBD for Cancer: Among people taking CBD for cancer, CBD was most helpful with ameliorating nausea and vomiting. Many participants also found it helpful for appetite, neuropathy (numbness or tingling), and weakness. As mentioned earlier, CBD was markedly less likely to help with cancer-related constipation and diarrhea. The most significant side effects were with memory and concentration issues. People taking CBD for cancer were more likely than the average participant to be taking some THC. This may be due to THC’s efficacy as a pain reliever13 or to well-publicized preclinical data suggesting that both THC and CBD may have tumor-fighting properties.14
CBD for Diabetes: Participants taking CBD for diabetes were asked their average blood sugar levels before and after they started taking CBD. Though average blood sugar levels with CBD were still high, they showed significant improvements over the pre-CBD levels, decreasing from 178 to 130 on average. Participants also reported significant improvements in neuropathy-type symptoms (i.e. nerve pain, tingling or numbness), and some improvements in their ability to maintain a healthy weight.
CBD for Alcoholism / Addiction: Among people using CBD for addiction, most (70%) were seeking to abstain from their substance of abuse (as opposed to using less or getting through withdrawal). CBD appeared to be extremely helpful for getting and staying off opiates. This is consistent with observational studies that have noted that many patients voluntarily decrease the number of opiates they are using—or go off opiates completely—when they use them in conjunction with cannabis, as well with animal and preclinical studies suggesting that cannabis and CBD may reduce the risk of relapse.xv CBD was also reportedly helpful for reducing or eliminating alcohol consumption. It was comparatively less helpful as a smoking cessation aid. Twenty-four percent of tobacco users experienced no change, and 4% report using more tobacco after introducing CBD.
CBD for Brain Injury: Among people using CBD for a brain injury (typically a TBI), CBD proved most helpful for relieving headaches, irritability, and agitation. CBD was less helpful for balance issues. In a small percentage of participants, CBD seemed to make issues with memory, concentration, and self- expression worse.