Hemp Derived Cannabinoid
Also known as: CBD, hemp extract, hemp oil, Cannabidiol
Overview
Hemp-derived cannabinoids are compounds extracted primarily from the industrial hemp plant, Cannabis sativa L., which contains low THC levels (<0.3%) and higher levels of non-psychoactive cannabinoids such as Cannabidiol (CBD). CBD is chemically identified as C21H30O2. These compounds are used for their potential therapeutic effects, including pain relief, anti-inflammatory, anxiolytic, anti-epileptic, and neuroprotective applications. CBD is non-intoxicating, interacts with the endocannabinoid system, and generally has a favorable safety profile. The research maturity level for CBD is moderate to advanced, with numerous randomized controlled trials (RCTs) and systematic reviews/meta-analyses available. High-quality evidence exists for certain indications, such as epilepsy, while moderate evidence supports its use for pain and spasticity, with emerging evidence for other applications. It is classified as a botanical supplement with bioactive cannabinoids.
Benefits
CBD has demonstrated clinically significant benefits, particularly in epilepsy, where it is effective in reducing seizure frequency in treatment-resistant epilepsy syndromes, with meta-analyses showing significant reductions compared to placebo. For pain and spasticity, moderate evidence supports cannabinoids for chronic pain and spasticity reduction, with effect sizes indicating clinically meaningful improvements in some patients. These benefits are well-documented in pediatric and adult epilepsy patients, and there is some evidence in multiple sclerosis-related spasticity and chronic pain populations. Meta-analyses report odds ratios and standardized mean differences favoring CBD over placebo with p-values <0.05, indicating statistically significant effects. Potential anxiolytic and anti-inflammatory effects are also reported, though these require further high-quality trials. Benefits in epilepsy are typically observed within weeks, while improvements in pain and spasticity may require longer treatment durations.
How it works
CBD primarily modulates the endocannabinoid system indirectly, influencing both CB1 and CB2 receptors. Beyond the endocannabinoid system, CBD also interacts with other receptors, including transient receptor potential channels (such as TRPV1), serotonin 5-HT1A receptors, and GPR55. Through these interactions, CBD modulates neuronal excitability, inflammation, and neurotransmitter release within the body. When taken orally, CBD's bioavailability is relatively low, ranging from approximately 6-19%, and is significantly influenced by the formulation and the presence of food. It is primarily metabolized in the liver by cytochrome P450 enzymes.
Side effects
CBD is generally well tolerated with a favorable safety profile in clinical trials. Common side effects, occurring in more than 5% of users, include fatigue, diarrhea, and changes in appetite or weight. Uncommon side effects, affecting 1-5% of users, include somnolence and elevated liver enzymes. Rare side effects, occurring in less than 1% of users, include potential drug interactions, though serious adverse events are rare. CBD inhibits CYP3A4 and CYP2C19 enzymes, which can potentially alter the metabolism of other drugs, leading to increased or decreased drug levels. Therefore, caution is advised in patients with liver impairment or those taking medications metabolized by these cytochrome P450 enzymes. While pediatric use is established for epilepsy, the safety of CBD during pregnancy and breastfeeding is not well established.
Dosage
The minimum effective dose for epilepsy typically starts at 5 mg/kg/day, which can be titrated up to 20 mg/kg/day or higher as tolerated, depending on the patient's response and side effects. Optimal dosage ranges vary by indication; for pain studies, doses typically range from 2.5-20 mg/kg/day, while epilepsy generally requires higher doses. The maximum safe dose studied is up to 50 mg/kg/day; however, higher doses increase the risk of adverse effects. Doses are often divided and taken with food, as food intake, especially high-fat meals, significantly improves CBD's absorption and bioavailability. Common forms include oral oils, capsules, and purified isolates, with formulations impacting bioavailability. No specific cofactors are required, but monitoring liver function is recommended during treatment.
FAQs
Is hemp-derived CBD psychoactive?
No, CBD is non-intoxicating and does not produce a “high” or any psychoactive effects commonly associated with THC.
How soon can benefits be expected?
Benefits for epilepsy may appear within weeks of treatment initiation, while pain relief and other effects may take longer to become noticeable.
Is it safe long-term?
Current evidence supports the safety of CBD with monitored use; however, comprehensive long-term safety data are still emerging and being collected.
Can CBD cause positive drug tests?
Hemp-derived CBD products may contain trace amounts of THC (<0.3%), which could potentially lead to a positive drug test for THC, depending on the test sensitivity and product purity.
Are all hemp products equal?
No, the cannabinoid content and purity can vary significantly between different hemp products. Pharmaceutical-grade CBD products offer standardized dosing and verified purity.
Research Sources
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7608221/ – This systematic review and meta-analysis of RCTs on CBD's safety and efficacy found CBD to be well-tolerated and significantly effective in reducing seizure frequency in epilepsy, with few serious adverse effects. The study highlighted statistically significant odds ratios favoring CBD over placebo, primarily focusing on epilepsy outcomes.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5964405/ – This systematic review examined medical cannabinoids for pain, spasticity, and nausea. It found moderate evidence supporting pain and spasticity relief, noting that adverse events were mostly mild. The review concluded that cannabinoids were superior to placebo for certain outcomes, despite some variability in formulations and study sizes.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8216112/ – This systematic review and meta-analysis investigated the antinociceptive effects of cannabinoids, including both animal and human studies. It reported significant analgesic effects with moderate effect sizes, particularly in neuropathic pain models, while acknowledging translational gaps and heterogeneity in outcomes.
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