As physicians, we often see patients suffering from chronic conditions who are willing to try anything to help with their symptoms. In the last year, more and more patients have asked for my thoughts on the use of marijuana or hemp derived products like CBD oil. In all honesty, I had to previously tell them I did not know if these products were helpful or even safe to use.
Unfortunately, no real peer-reviewed research studies have been done on the effectiveness or safety of these products, and as physicians, we depend on FDA approved studies to give our patients recommendations. This article intends to inform you about the information available on CBD products, but it is in no way an endorsement of their use. Anyone taking a supplement that is not FDA reviewed takes the risk of experiencing adverse side effects. Before beginning a new supplement, please discuss it with your physician.
What is CBD?
If you have watched the news lately, frequented social media or have friends with chronic ailments like arthritis, there is a good chance that you have heard about the existence of CBD oil. CBD oil, or cannabidiol, is a derivative of hemp, a plant related to marijuana. CBD oil does not contain the chemical THC, which is the compound in marijuana that creates its intoxicating effect. There have been claims that CBD can help patients with problems like epilepsy, sleep disorders, arthritis, chronic pain and stress as well as many other ailments. With claims like these, it’s easy to see why this product has garnered a lot of attention.
How does it work?
The cannabidiol in CBD can attach to special receptors called cannabinoid receptors, which are present throughout the human body. These receptors are believed to be where the reported positive effects of CBD occur. The exact mechanism is not fully understood, partially because research into these compounds has been difficult, with the federal government looking at cannabis and hemp as controlled substances.
The popularity of CBD oil has increased in recent years as more states have decriminalized marijuana and hemp products, opening the door for its production and sale. While some states have legalized the sale of marijuana products, the federal government still view marijuana and hemp as controlled substances. Only recently, when the Agricultural Improvement Act of 2018 was signed in December of 2018, did the door open to complete decriminalization of these products.
With the recent decriminalization of hemp as an agricultural product, numerous companies have moved forward with the production of CBD oil extracts for ingestion and creams to apply to areas of chronic pain. As production of these products increase, more and more broad claims of their effectiveness have been made.
What is CBD oil used for?
- Appetite improvement or suppression
- Epilepsy (FDA approved drug for epilepsy derived from marijuana currently exists)
- Chronic nerve pain
What are the concerns?
The concerns with new supplements like CBD oil is safety, effectiveness and proper dosing. Without FDA reviewed studies, there is no data on what the safe dose of this new supplement is or if it is effective to treat the condition it is purported to improve. People should always use caution when beginning a new supplement. It has been shown that CBD prolonged the breakdown of the blood thinner warfarin (Coumadin) and people taking this medication should take great caution. If your doctor has told you not to take grapefruit juice with your medications, it is important to avoid CDB as well. These products can interact with your medication in a similar way as grapefruit.
How is CBD taken?
CBD is an oil, which means absorption can be difficult. Several companies have found ways to modify these compounds to make them more easily digestible. Most people take their CBD by using a small dropper directly into the mouth and under the tongue and then hold in place for about 30 seconds. For people with chronic pain, a cream can be applied directly to the area of pain.
With limited data available on the safety and effectiveness of CBD oil, a medical recommendation is not able to be made at this time on if you should partake in this product. However, if you decide to take this or any other supplement, make sure you do your research. Some products may contain THC if derived from the marijuana plant, making it illegal in most states. Also, some may not contain CBD at all, even though they claim to. A simple internet search can usually determine if you have chosen a reputable company and product. Remember, always consult your physician before starting any new supplements.