Cannabidiol and CBD oil seem to be everywhere these days, despite the confusing legal status of this prolific compound. But how much do we actually know about CBD?
Opioids leave much to be desired in medical treatment. They are highly addictive, very lethal, and not all that effective for treating chronic pain. Cannabis, particularly THC, is promising for its opiate-sparing properties: preclinical work indicates that cannabis synergizes with the painkilling effects of opioids and reduces the development of tolerance (perhaps because of this synergy) but does not increase opioid-induced respiratory depression which leads to death. Moreover, states that legalize cannabis see a decrease in opioid prescriptions.
The elderly are the fastest growing population of cannabis users. But how do hospice workers feel about their patients using cannabis? A recent survey by pharmacists at the University of Maryland asked palliative care practitioners about their opinions on cannabis use among hospice patients. Over 90% of workers support the use of cannabis, but most physicians did not recommend cannabis to their patients. This may be due to a lack of knowledge about safe use of cannabis — over 80% of respondents wanted standardized protocols on the use of cannabis in palliative care.
Phytocannabinoids consistently confuse scientists because of the multiplicity of their actions. CBD, for example, binds to a handful of neurotransmitter receptors, as well as hormone receptors, ion channels, and a variety of enzymes. Receptors without a known endogenous ligand are called “orphan” receptors. GPR18 is involved in ocular-pressure (and hence glaucoma treatment) as well as cardiovascular function.
Many prohibitionist arguments are being flipped on their heads. CBD’s anti-anxiety effects have replaced much of the reefer madness mentality. Rather than causing lung cancer, marijuana appears to have anti-cancer activity, if anything. And in spite of the gateway theory, whereby casual cannabis use supposedly escalates to heroin, we find that cannabis helps to treat pain and reduce opiate use. An animal study out of the Scripps Research Institute reaffirms that THC generally reduces the addictiveness of opioids.
Throughout history, cannabis has been described as a treatment for hundreds of different conditions. If scientists find it hard to believe cannabis can do so much, they may chalk up the results as just a placebo. But the placebo effect is powerful. It accounts for roughly half of the efficacy of opioids and antidepressants. And, ironically, the placebo effect actually functions in part through the endocannabinoid system.
THE ESSENTIAL GUIDE TO CBD
By the Editors of Reader’s Digest & Project CBD: Everything You Need to Know About What It Helps, Where to Buy It, and How to Take It.