Still, as the saying goes, absence of evidence isn’t necessarily evidence of absence, and there’s a reason we don’t have a ton of solid research on CBDs yet — “to study it, we need a good source, ” said Ziva Cooper, who is an associate professor at Columbia University and was on the National Academies committee. CBD is hard to get because it’s still technically a Schedule I drug, which limits its availability, Cooper said.
Right now, there’s a good chance that you don’t really know what you’re getting from any source. Testing and labeling rules vary by state, but many states that allow legal cannabis also require some kind of testing to verify that the THC and CBD levels listed on the label are accurate. However, this testing is controversial, and results can vary widely between labs, Jikomes said. A study published in March found measurable variations in test results, with some labs consistently reporting higher or lower levels of cannabinoids than others. There are no guarantees that the label accurately reflects what’s in the product. For a 2015 study published in JAMA, researchers tested 75 products purchased in San Francisco, Los Angeles and Seattle and found that only 17 percent were accurately labeled. More than half of the products contained significantly lower levels of cannabinoids than the label promised, and some of them contained only negligible amounts of the compounds. “We need to come up with ways to confidently verify the composition of cannabis products and make this information available to consumers,” Jikomes said.
In the meantime, some physicians are forging ahead — and cashing in. Joe Cohen is a doctor at Holos Health, a medical marijuana clinic in Boulder. I asked him what CBD is good for, and he read me a long list of conditions: pain, inflammation, nausea, vomiting, intestinal cramping, anxiety, psychosis, muscle spasms, hyperactive immune systems, nervous system degeneration, elevated blood sugar and more. He also claimed that CBD has anti-cancer properties and can regenerate brain cells and reduce the brain’s levels of amyloid beta — a kind of protein that’s been linked to Alzheimer’s disease. I asked for references, noting that most of these weren’t listed in the Academies report or a similar review published in the Journal of the American Medical Association. “I think you just have to Google search it,” he said. It’s true that a preliminary study found hints that cannabinoids might reduce beta amyloid proteins in human brain cells, but the study was done in cells grown in a lab, not in people. As for cancer, the FDA sent warning letters last year to four companies that were selling products that claimed to “prevent, diagnose, treat or cure” cancer.
But, uh, what is it that CBD is supposed to do? I visited a cannabis dispensary in Boulder to find out what the hype was all about. After passing an ID check, I was introduced to a “budtender” who pointed me to an impressive array of CBD products — tinctures, skin patches, drink powders, candies, salves, massage oil, lotions, “sexy time personal intimacy oil” and even vaginal suppositories to treat menstrual cramps.
Cooper recently got funding from the National Institutes of Health for a study looking at cannabinoids — including CBD in isolation — as a substitute for opioids, and numerous other 2 come from products that contain THC as well as CBD, Cooper said, but we need to do more studies to find out for sure whether CBD has fewer risks. Studies are also needed to identify the best way to administer and dose CBD. “I get emails from people asking me what dose of CBD to use, and the truth is, we really don’t know,” Cooper said.
What makes CBD so appealing is that it’s non-intoxicating, so it won’t get you high, though it “is technically psychoactive, because it can influence things like anxiety,” Jikomes said. Although much of the marketing blitz around CBD centers on the fact that you can take it without getting stoned, there isn’t much research looking at the effects of CBD when used in isolation, with a couple of exceptions. One is the use of CBD to treat seizures: CBD is the active ingredient in the only cannabis product that the Food and Drug Administration has signed off on — a drug called Epidiolex, which is approved for treating two rare forms of epilepsy. Animal models and a few human studies suggest that CBD can help with anxiety, but those are the only conditions with much research on CBD in isolation.
Cannabinoids are a class of compounds that interact with receptors throughout your body. CBD is just one of dozens of cannabinoids found in cannabis, including tetrahydrocannabinol (THC), which is the one responsible for marijuana’s famous high. Medical cannabis is technically any cannabis product used for medicinal purposes, and these can contain THC or CBD or both, said Nick Jikomes, a neuroscientist at Leafly, a website that provides information about legal cannabis. “A common mistake people make is to think that CBD is ‘the medical cannabinoid’ and THC is ‘the recreational cannabinoid.’” That’s inaccurate, he said, because THC is a potent anti-inflammatory and can be helpful for pain.
In recent years, cannabidiol (CBD) oil has skyrocketed in popularity. Knowledge about how it works in the human body, however, has accelerated at a snail’s pace. If you’ve ever wondered, “How long does it take for CBD oil to work?” or “How long will the effects of CBD oil last?” you’re not alone.
Body fat influences the amount of CBD you need to feel an effect. The larger the body mass, the more CBD required to feel potential effects. Bodyweight and mass also affect how long CBD will remain in your system. Like THC, CBD is stored in fat cells and gradually eliminated from the body through urine and feces.
How does CBD interact with the body?
CBD interacts with the brain and body through a number of mechanisms. Upon ingestion, CBD interacts with a wide range of proteins in the body and central nervous system. A key part of this interaction takes place within the endocannabinoid system (ECS) — specifically the CB1 and CB2 cannabinoid receptors.
Topical CBD is applied directly to and can be absorbed through the surface of the skin. Photo by: Gina Coleman/Weedmaps
CBD also interacts with other receptor proteins not directly related to the ECS, such as the serotonin receptor 5-HT1A and vanilloid receptor TRPV1. Any potential anti-inflammatory and pain-relieving properties of CBD could stem from the activation of these additional biological pathways.
You can’t OD on CBD, but dosage is personal. “More does not necessarily mean better,” warns Capano. “The response dose curve looks like a bell, so you want to hit the top of the bell without going over.” When figuring out your optimal dose, add a bit more every three days or so and see how you respond. If you get to a point where you don’t feel any extra benefit (or feel worse), you’ve gone too far; dial it back a bit the next day.
You bet. CBD can help clear up and calm down your skin in a few ways. For one, it works by relieving stress, which happens whether you take CBD orally or topically, says Capano: “We know that mood, especially stress, can influence skin irritation—so this is kind of a one-two punch.”
How do I use CBD?
If you use CBD daily for preventative reasons and don’t need quick relief, an oral product might be for you. They take the longest to onset (read: at least an hour or two), but, says Capano, “they’re a good option for people who don’t like the taste of tinctures and want the convenience of capsules.”
Making it more complicated: Some states have restricted CBD sales, so even if your product was derived from federally legal hemp, it’s legality where you live does vary by state. There’s a chance, Capano says, that you might run into law enforcement who’s not up-to-date on the bill and arrest you for possessing it—but it’s unlikely.
Though they’re both found in a cannabis plant—meaning either hemp or marijuana—using CBD (full name: cannabidiol) is a far cry from smoking weed. Like THC (or delta-9-tetrahydrocannabinol), CBD is a cannabinoid—a molecule that helps the functioning of our endocannabinoid system, which regulates our mood, sleep cycle, inflammation, immune response, and more. But unlike THC, CBD isn’t intoxicating. “In other words, CBD can’t get you high,” says Alex Capano, chief science officer for Ananda Hemp, a Kentucky-based health and wellness brand specializing in CBD products.