"GM" wrote in message
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https://fivethirtyeight.com/features...pYVpXTQVFac2Fk
"Does CBD Really Do Anything?
As marijuana is legalized in more and more states, the wellness world has
whipped itself into a frenzy over a non-intoxicating cannabis derivative
called cannabidiol. CBD products can be found on the internet and in
health-food stores, wellness catalogs and even bookstores. (A bookstore in
downtown Boulder, Colorado, displays a case of CBD products between the cash
register and the stacks of new releases.) Celebrities like Gwyneth Paltrow,
disgraced cyclist1 Floyd Landis and former Denver Broncos quarterback Jake
Plummer are all touting CBD products, and according to Bon Appétit,
CBD-infused lattes have become the wellness worlds new favorite drink.
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.
Most of these products promised to relieve pain or otherwise enhance
well-being, and none of it was cheap. (Prices started at about $30.) But I
wanted to know: Does any of this stuff really work? After a deep dive into
the scientific research, I learned that the answer was a big fat maybe.
Although theres enticing evidence that good ol cannabis can ease chronic
pain and possibly treat some medical conditions, whether CBD alone can
deliver the same benefits remains an open question. What is clear, at this
point, is that the marketing has gotten way ahead of the science.
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 marijuanas 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. Thats inaccurate, he said, because THC is a potent
anti-inflammatory and can be helpful for pain.
What makes CBD so appealing is that its non-intoxicating, so it wont 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 isnt 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.
Last year, the National Academies of Sciences, Engineering and Medicine
released a nearly 500-page report on the health effects of cannabis and
cannabinoids. A committee of 16 experts from a variety of scientific and
medical fields analyzed the available evidence more than 10,000 scientific
abstracts in all. Because so few studies examine the effects of CBD on its
own, the panel did not issue any findings about CBD specifically, but it did
reach some conclusions about cannabis and cannabinoids more generally. The
researchers determined that there is conclusive or substantial evidence
supporting the use of cannabis or cannabinoids for chronic pain in adults,
multiple sclerosis-related spasticity (a kind of stiffness and muscle
spasms), and chemotherapy-induced nausea and vomiting. The committee also
found moderate evidence that cannabis or cannabinoids can reduce sleep
disturbances in people with obstructive sleep apnea, fibromyalgia, chronic
pain and multiple sclerosis, as well as limited evidence that these
substances can improve symptoms of Tourettes syndrome, increase appetite
and stem weight loss in people with HIV/AIDs, and improve symptoms of PTSD
and anxiety.
Donald Abrams was a member of the committee that reviewed the evidence that
went into producing the report, and he said that the studies they reviewed
overwhelmingly used pharmaceutically available preparations that contain
THC, including dronabinol, nabilone and the whole-plant extract spray
nabiximols, which contains equal parts CBD and THC. Its impossible to know
whether the benefits of cannabis can also be obtained from CBD alone, Abrams
said, because CBD is just one of 400 chemicals present in the plant. So far,
CBD in isolation has been studied in only a handful of randomized,
placebo-controlled trials (considered the gold standard of evidence in
medical research), and the evidence remains sparse.
Still, as the saying goes, absence of evidence isnt necessarily evidence of
absence, and theres a reason we dont 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 its still technically a Schedule I
drug, which limits its availability, Cooper said.
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 clinical trials of CBD are underway. It will
be several years before results are available, but these studies should help
clarify both what benefits the substance may provide and any side effects it
may come with. Most of the adverse effects so far associated with cannabis,
such as impairments in short-term memory, coordination and judgment,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 dont know, Cooper 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 brains
levels of amyloid beta a kind of protein thats been linked to Alzheimers
disease. I asked for references, noting that most of these werent 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. Its 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.
Those warning letters aside, theres not a lot of federal oversight right
now over the claims being made or the products that are being sold. Cohen
warned against buying CBD products online, because theres a lot of scams
out there. Yet his clinic sells CBD, and he admits, I say "Dont buy
online, but ours is worth doing, because we know what were doing. We ship
all over.
Right now, theres a good chance that you dont really know what youre
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 whats 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.
All these people are making claims, Abrams said, but right now, theres
little verification. Its the Wild West..."
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Thanks for posting that, Greg. I have seen CBD oil in my local health food
shop and I was wondering what it was for!