Cannabidiol (CBD)

What is CBD?

CBD (cannabidiol) is the second most abundant cannabinoid in cannabis, after THC (tetrahydrocannabinol). Unlike THC, CBD won’t get you high; it’s typically used medicinally, not recreationally, with the four most commonly targeted conditions being pain, anxiety, depression, and sleep disorders.

What are CBD’s main benefits?

Human research on CBD has focused on two rare forms of epilepsy: Dravet syndrome and Lennox-Gastaut syndrome. In humans and animals, CBD has shown promise as a treatment for a wide variety of ailments, notably anxiety, depression, pain, inflammation, and cancer. Unlike cannabis and THC, CBD doesn’t impair coordination, judgment, or memory.

What are CBD’s main drawbacks?

CBD’s adverse effects are usually minor, but they include lethargy, fatigue, sleepiness, fever, diarrhea, vomiting, decreased appetite, and increased levels of alanine aminotransferase (a marker of liver damage). Other drawbacks include a paucity of human evidence, the unreliability of most CBD products on the market, and the “gray area” legality of CBD products.

Aren’t CBD products legal?

In the U.S., CBD products with less than 0.3% of THC aren’t technically illegal, but they inhabit a gray area. This helps explain some of the other drawbacks of CBD, such as the lack of long-term human trials and the lack of reliable supplements with standardized CBD content.

What makes CBD products unreliable?

The only CBD pharmaceutical approved in the U.S. (Epidiolex®) is approved only for two rare types of epilepsy. Nonpharmaceutical CBD products are widely available, but they often contain a lot more or less CBD than stated on the label, and even sometimes some THC. CBD products might also contain some of the same contaminants frequently found in cannabis: metals, molds, bacteria, pesticides, aflatoxins, synthetic cannabinoids, and residual solvents from the production process.

What makes CBD evidence poor?

A 2019 review noted that human trials were few, and they still are few in 2022. Most studies are in animals, and animal studies often translate poorly to humans. Moreover, what human trials we have didn’t last very long, so we don’t know much about the long-term effects of CBD.

How does CBD work?

CBD works in myriad ways, which are still being explored. For instance, it may reduce pain and stress via the TRPV1 receptor, stress and depression via the 5HTI-alpha receptor, and inflammation via the A2A receptors. Unfortunately, CBD seems to work better in combination with THC.