Friday, Nov. 16, 2018 | 2 a.m.
Researchers say CBD, or Cannabidiol, has shown the most medical potential of all the chemical compounds in the marijuana plant. It has an antipsychotic effect and is touted as a potent anti-cancer, anti-inflammatory and anti-anxiety compound used primarily for pain relief, but also skin care, epilepsy and relaxation. “CBD is incredibly effective in treating various types of disorders, from those related to blood sugar, anxiety and seizures,” said Dr. William Troutt, a renowned Arizona neuropathic doctor who teaches free monthly education seminars at The Source Dispensary in Las Vegas. “The cannabinoid works to stabilize the electroactivity of our nervous system.” And unlike THC, CBD is nonpsychoactive, meaning users reap the medical benefits without feeling high or intoxicated.
CBD in medical studies
Dr. Sue Sisley, an internal medicine physician and psychiatrist from Scottsdale, Arizona, is 10 years into the first-ever DEA- and FDA-approved randomized controlled trial of whole-plant marijuana for post-traumatic stress disorder in U.S. veterans. The plants are grown by the National Institute of Drug Abuse. Sisley hopes to have concrete results by mid-2019.
While cannabis’s effect is widely praised by users of the plant, Sisley said weed’s status as a Schedule 1 federally controlled substance has restricted research. “Evidence” of its benefits is limited to anecdotal tales of patients.
Sisley warned that CBD and THC could merely be the result of a placebo effect, or part of a combined “entourage effect” that includes chemical influence from many of the other dozens of terpenes found in cannabis.
“Right now, we know that people who use the plant have some pain relief. It takes the edge off and people feel more functional,” Sisley said. “We think it’s CBD, but it’s just not clear.”
“We need controlled trials to answer that definitively,” she added.
How CBD works in the body
The human body produces cannabinoids naturally, which function to help reduce inflammation, Troutt explained. The body has two major types of receptors for cannabinoids: CB1 receptors—which are found mostly in the brain and affect coordination, movement, emotions, memory and appetite—and CB2 receptors, found mostly in the immune system, controlling inflammation and pain.
THC attaches to the CB1 receptors, affecting the way a person thinks and feels.
CBD, once thought to attach to the CB2 receptors, actually doesn’t attach to either. Instead, it boosts the body’s ability to use more of its own cannabinoids.
Will CBD show up on a drug test?
Most employers use a five- or 10-panel drug screen. The five-panel screen tests for THC, cocaine, opiates, PCP and methamphetamines. The 10-panel screen adds tests for barbiturates, propoxyphene, benzodiazepines, methadone and propoxyphene. Notably missing from those lists is CBD, which on its own won’t be flagged as part of a drug screening.
As hemp products legally contain up to 0.3 percent THC, a person who regularly consumes extremely high doses of CBD products could theoretically test positive for THC, Troutt said. But the chances of a positive THC test from legal CBD products is extremely unlikely.
To risk a positive THC test, a CBD user would have to consume more than 1,000 milligrams of CBD—a full 25-milliliter bottle of maximum-strength CBD oil—in a given day before being screened. The typical dose is around two droplets of oil, which give users between 50 and 100 milligrams of extract.
Researchers say side effects from overuse of CBD can include tiredness, gastroenteritis and occasional changes in appetite and weight. The compound does not have any significant side effects on the central nervous system, vital signs or mood.
• CBD Tinctures: While still a concentrated form of CBD, tinctures are available and include alcohol instead of oil. CBD tinctures aren’t fat-soluble like the oils and can’t be used as easily in cannabis butters or fat-based sauces. Cannabis tinctures can’t be used in vape pens, either. The main perk of a CBD tincture is its improved taste over oil-based products. At 30 servings per bottle, Select CBD's tincture is for edible and topical use via dropper.
• Healing cream: CBDNA Botanicals combines Hydrocortisone Cream, Mangosteen and CBD-infused Argan oil for this soothing topical.
• Disposable pen: For quick results, inhale the relaxing effects of Select CBD's compact vape pen. Offered in multiple varieties and flavors.
• Skin serums: Looking for cannabis-derived skin balancing products? CBDNA Botanicals offers a line of serums to be used for anti-aging, blemishes and more.
• Body balm: Nordic Goddess combines plant extracts and herbs in this moisturizing topical. For anti-inflammatory pain relief. Contains THC and CBD.
• Other products: Marijuana vendors, as well as a growing number of legal sellers outside the marijuana industry also sell topical CBD products, such as balms, lotions, muscle creams, gummy edibles and chewing gum infused with CBD.
The most reliable CBD products will include verification— from a third-party source not affiliated with the brand itself—of the products’ authenticity, Troutt said. High-quality brands of CBD will always provide third-party lab results to their consumers by request. Sisley and Troutt advised that buyers use extreme discretion before buying a CBD product from somewhere other than a licensed dispensary. Independent research of popular CBD sellers, such as balms, lotions and even beverages have found that some of the advertised CBD products found at convenience stores don’t actually contain any quantity of the cannabinoid.
Prescription interactions and diseases
CBD is said to interact with more than half of pharmaceutical drugs by obstructing the activity of cytochrome P450, a family of liver enzymes that metabolizes more than 60 percent of medications sold in the United States. Compounds in grapefruit impede the same function.
By blocking the enzymes, CBD can trigger an increase in the amount of cholesterol and blood pressure medications in users’ bodies, and a decrease in the absorption of anti-anxiety and allergy medications, according to a 2017 report by the FDA.
And while hundreds of cancer patients across the U.S. have touted an “entourage effect” of high doses of CBD, THC and other terpenes, medical professionals warn that too much cannabis, similar to any medicine, could be harmful.
Speaking at August’s Cannabis Science Conference, Kristin Wohlschlagel, a medical researcher from Hawaii, presented a study of more than 1,000 medical marijuana patients throughout the country. She researched the patients over a two-year period to monitor the effect of the plant’s interactions with other medications.
Wohlschlagel found that high doses of THC interacted with dozens of prescription medicines, causing irreparable liver harm.
She advised patients using hormone regulators and blood thinners to stay away from THC and CBD, and that individuals taking other prescription medications consume no more than 25 milligrams of THC and 75 milligrams of CBD daily.
“Marijuana is good at stopping seizures and spasms,” Wohlschlagel said. “But not every illness or medical problem is going to have the targets for THC and CBD.”
The FDA recommends CBD users talk with their health care providers before consuming the cannabinoid while using prescription drugs.
This story originally appeared in the Las Vegas Weekly.