As CBD has risen in popularity over the last few years, more and more people have touted the substance — more formally known as cannabidiol, a non-intoxicating compound in cannabis — for its ability to treat everything from anxiety to epilepsy to chronic pain. Some users have even gone as far as to deem it a miracle drug. Yet when you look into how effective CBD has been proven to be so far, it’s unclear whether it’s the holy grail of healing or just another wellness trend.
A recent poll of 2,000 Americans found that 86 percent of respondents had heard of CBD, and investment researchers predict CBD sales will top $20 billion over the next few years — but research on it is still developing. The few studies that do speak to the potential of CBD as a safe and effective treatment option for a number of conditions almost universally conclude that further research is needed to verify the findings.
“A lot of the research has been sort of these pre-clinical animal studies, and it's only for a few conditions have they even got to clinical trials,” explains Dr. Jonathan Stea, a clinical psychologist who specializes in concurrent addictive/psychiatric disorders and has published articles about cannabis and mental health.
Even more, some of the "conclusive" studies done so far contradict each other, says Stea. While a few tests have found that CBD can help treat depression, for instance, others have shown that cannabis overall can exacerbate the condition over time. According to Stea, all that's really known for sure about CBD's effects on the body is that the human endocannabinoid system plays a role in mood regulation, and cannabis acts upon that system. And since CBD is currently not regulated by the FDA, users may not even be getting the advertised quantity in products. Multiple instances of independent testing of products sold as containing CBD found that they contained a different amount than stated on the packaging.
Thankfully, the U.S. Food and Drug Administration (FDA) is starting to look into CBD more thoroughly. On May 31, the FDA held its first hearing on the safety and efficacy of CBD products, featuring more than 100 scientists, manufacturers, health professionals, and both CBD advocates and opponents. The information gathered during the hearing will hopefully lead to more decisions and regulations regarding CBD made by the FDA in the coming months.
In the meantime, "a lot of the research is promising," says Stea. So while you should keep in mind that the science is in early stages and not totally replace existing medicinal remedies with cannabis-based treatment just yet, there's no problem with taking note of what's known so far about CBD and the ailments it’s most commonly said to treat.
The human body’s endocannabinoid system can stimulate the nerve cells that increase or decrease pain, and so CBD's apparent ability to reduce different types of pain for some people is not surprising. Currently, there are many CBD-infused wellness products on the market that claim they help reduce pain and inflammation in users, including Kiehl’s Cannabis Sativa Seed Oil Herbal Concentrate (said to reduce redness and clear acne), Saint Jane’s Luxury Beauty Serum (said to brighten and calm skin), and Y7’s After Flow CBD Bath Soak (said to reduce pain after exercise). Although there’s not yet much research proving that CBD does indeed have anti-inflammatory effects, some dermatologists and patients have found it helpful and support its use in this regard nonetheless.
A 2008 summary of research on cannabinoids concluded that in addition to being able to relieve pain without adverse side effects, they could also treat insomnia related to chronic pain. More recently, a preclinical animal study from the European Journal of Pain showed that the topical application of CBD helped relieve chronic pain and inflammation specifically due to rheumatoid arthritis. This study was done on rats, however, not humans, so it's not promised that CBD can have the same effects on people.
In May, a study published by the Addiction Institute of Mount Sinai found that CBD helped reduce cravings for patients addicted to heroin. Participants in the trial that were given CBD had a two- to three-fold reduction in cravings compared to a placebo group and showed a reduction in their physiological manifestations of stress, according to the report.
Historically, opioid addiction has been treated using opioid-based medicines like methadone and buprenorphine, but because of these drugs’ high abuse potential, doctors are limited in how much or how often they can prescribe them, and patients are required to make multiple doctor visits to get them. As a result, the National Institute on Drug Abuse has said that just one-third of people with opioid addictions are on those medications.
This is where CBD could help. So far, CBD has not been found to be addictive. Dr. Julie Holland, a psychiatrist and former assistant professor of psychiatry at the New York University School of Medicine, told CNN that while the substance can indeed reduce opioid cravings, “it doesn’t get you high.” So while more clinical study is needed, it's no wonder that doctors and pharmacists are paying attention to the evolving research in this area.
Anxiety and depression
One recent study by the National Library of Medicine found that a single dose of CBD (600 mg, per the study) can reduce anxiety for some people, before a stressful event like public speaking. Another concluded that the substance might help users with falling and staying asleep. As always, more research needs to be done, but given the minimal risk of adverse effects with CBD and its low potential for abuse in comparison to common anxiety and depression medications, this is another area with great promise.
"The benefit of CBD is that it could work very quickly, but it wouldn't have any of the abuse issues or dependent issues like the benzos [Xanax, Valium, etc.] have," says Dr. Dustin Sulak, a Maine-based physician and founder and medical director for Healer.com, who advocates for CBD and cannabis. "It's also not impairing your driving a car or having you making bad decisions” like THC-containing marijuana or anxiety medication with side effects that can cloud your judgment, he adds.
Similarly, the National Library of Medicine study stated that “the substantial burden of anxiety-related disorders and the limitations of current treatments place a high priority on developing novel pharmaceutical treatments” — including CBD. “We found that existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive–compulsive disorder, and post-traumatic stress disorder when administered acutely,” the study states.
There is sound clinical evidence showing that CBD works as an anticonvulsant for people with a rare and severe form of epilepsy called Dravet syndrome, and parents of children suffering from the debilitating seizures claim that CBD is the only thing that provides their kids any relief. Yet these parents essentially had to go rogue to procure and administer CBD themselves before the FDA signed off on a clinically-tested product, Epidiolex, in 2018. Currently, the medication is the only CBD-based drug that has received FDA approval.
While tests have shown that not all epilepsy patients respond to CBD treatment and that more research is needed to determine exactly how wide its application could be, the FDA's approval of Epidiolex is promising for anyone hoping to see more CBD products on the health market soon.
In addition to the conditions listed above, research has shown that CBD could help treat Crohn’s Disease, autism, psychosis, and even acne. But the underlying theme throughout is that we need more and better research to move from potential to proven — a difficult task, seeing that the U.S. government still considers cannabis to be a dangerous Schedule I illicit substance, putting it on par with ecstasy, LSD, and heroin. Unfortunately, it could take years before enough tests are done to allow a large number of CBD-based health products on the market.
In the meantime, many people will continue to experiment with CBD on their own. Just remember that CBD shouldn't be used in place of treatment prescribed by a medical professional—we've only just begun to comprehend what the substance is and can do.
“We need to study the hell out of this stuff because it's cool and promising, but we need to respect it because it's so complex,” Dr. Stea says. “Black and white thinking on it is counter-productive.”
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