CBD, made from hemp, is being hyped as treatment for pain, nausea and a variety of maladies. But studies so far do not show benefit in humans. ElRoi/Shutterstock.com
Cannabidiol, or CBD, has become a household name. On many social media sites, people suggest â€śbut have you tried CBD oil?â€ť on posts pertaining to any health-related issue.
CBD, a minor constituent of marijuana, is widely touted as natureâ€™s miracle by CBD enthusiasts. It does not get people high, unlike marijuanaâ€™s main constituent, delta-9-tetrahydrocannabinol (THC). However, given the recent surge in its popularity, youâ€™d think the molecule is magic.
We are behavioral pharmacology scientists, and we study how drugs act on the body. Specifically, we have an interest in developing new drugs for the treatment of pain that possess lessened drug abuse potential, and therapeutic interventions for drug abuse. Although there is scientific interest in the use of CBD for both pain and drug addiction, as well as many other medical indications, there is a lot that we still do not know about CBD.
Drugs affect the body by binding and acting at various protein molecules, usually on the surface of the cells in the body, called receptors. These receptors then send signals that can impact bodily functions.
Marijuana has an effect on the body because many animals have receptors termed â€ścannabinoid receptors.â€ť There are two known cannabinoid receptors that are responsible for the effects of marijuana. Only one of them, the cannabinoid type 1 receptor (CB1R), is responsible for the high from marijuana. These cannabinoid receptors are predominately found on nerve cells located throughout the body, including the brain.
Studies indicate that CBD does, however, act on several other types of receptors. These include the serotonin 5-HT1A receptor, which can help regulate sleep, mood, anxiety and pain. CBD may also indirectly alter the bodyâ€™s own cannabinoid receptor activity.
However, scientists do not yet understand the exact manner in which CBD acts on the body. Likewise, many health-related anecdotal claims pertaining to CBD are not founded on solid scientific evidence, and may be due to well-documented placebo effects.
There is strong evidence, however, that CBD has enduring health benefits in the treatment of intractable epilepsy.
It has been nearly six years since the story of the Charlotteâ€™s Web strain of marijuana broke into national and international media. This strain of marijuana was named after Charlotte Figi, who struggled with intractable pediatric epilepsy until she was given oil extracted from the strain, which contains a higher CBD-to-THC content.
Charlotteâ€™s father saw an online video of a child from California with seizures who was being treated successfully with marijuana. As it turns out, the active compound that was helping Charlotte was not THC but CBD.
Based upon clinical evidence, GW Pharmaceuticals developed and licensed its own CBD extract, a drug now called Epidiolex. Clinical trials with Epidiolex for the indications of Dravet syndrome and Lennox Gastaut syndrome, two forms of pediatric epilepsy, were resoundingly positive.
In June 2018, the Food and Drug Administration approved Epidiolex for treatment of these two forms of epilepsy in children that have not responded to other treatments.
Meanwhile, as the clinical trials for Epidiolex were underway, a landmark study from Indiana University demonstrated a possible mechanism for CBDâ€™s astounding effects on Dravet and Lennox Gastaut syndromes. These two syndromes are associated with genetic mutations in two genes that are important in the regulation of sodium ions.
Nerve cells regulate the way they send signals by how ions, or molecules with either an overall positive or negative electric charge, flow in and out of their cells. The most common ions that regulate nerve cell signaling are sodium, potassium, calcium and chloride. These ions move in and out of the cell via pores known as ion channels.
In many forms of epilepsy, however, the movement of ions is not properly controlled. This leads to aberrant firing of the brainâ€™s nerve cells and seizure activity.