Introduction to CBD oil

CBD Oil - Benefits, Applications and Considerations

Cannabidiol ( CBD ) oil has become increasingly popular in recent years. Claims that it can help with conditions like anxiety, depression, and insomnia have made it appealing to people looking for more natural treatments. However, as a relatively new treatment, it's important to familiarize yourself with the risks and benefits of CBD oil and how to use it.

What is cannabidiol (CBD) oil?

Cannabidiol, or CBD , is one of about 540 active compounds found in the cannabis plant. CBD oil can be extracted from all types of cannabis plants, but the CBD oil used in most over-the-counter (OTC) products is extracted from hemp. Hemp is a term used to describe any cannabis plant that contains less than 0.3% THC.

As of 2018, CBD products are no longer considered controlled substances if they are derived from hemp. However, some states still have restrictions on their sale and use. CBD is classified as a dietary supplement by the FDA. This means that although you can buy it without a prescription, its safety and purity are not regulated.

All CBD oils fall into one of three main categories:

CBD Oil - Full Spectrum: Full spectrum oil contains CBD along with all the other active ingredients found in the cannabis plant. This includes terpenes, flavonoids, and other cannabinoids, including THC. However, only full spectrum CBD products with less than 0.3% THC can be sold OTC.

CBD Oil - Broad Spectrum: These products are similar to full-spectrum CBD, but do not contain any THC. They may also contain other cannabinoids, such as CBG or CBN.

CBD Isolate: These products contain only CBD — without other active ingredients from the cannabis plant. Often, CBD isolate is artificially created, not extracted from cannabis or hemp plants.

CBD oil is used to make most CBD products. These can range from capsules, gummies, and brownies to creams, vape cartridges, and sublingual drops. Each of these products works differently in your body.

What does CBD do in the body?

It’s not entirely clear how CBD works in the body. It’s considered a “multi-target” compound, as it interacts with several different types of receptors in the body. It also has antioxidant and anti-inflammatory effects. This is part of the reason it seems to have such a wide range of uses.

But CBD doesn't interact with the body in the same way that THC does. Therefore, CBD doesn't produce the same intoxicating effects as THC. In fact, CBD appears to reduce the psychoactive effects of THC.

What are the benefits of CBD oil?

The most common conditions for which people use CBD include:

• Anxiety
• Insomnia
• Inflammation
• Neuropathic pain
• Substance use disorders
• Epileptic disorders that do not respond to prescribed medications

For some people, CBD can also cause a placebo effect. This is when a person expects a medication to work, even if it doesn’t actually have any effect in the body. Studies on anxiety and pain have shown that when people were told they were given CBD, their symptoms improved — even if they didn’t actually get CBD. So a positive approach to CBD can be just as helpful as the CBD itself.

What does the research say?

Studies are ongoing to understand how CBD works and what conditions it may help treat. Current research on CBD has found that it may help with the following conditions:

• Insomnia: Early research suggests that CBD may help improve sleep in people with insomnia.
• Substance Use Disorders: Studies have found that CBD can reduce cravings for alcohol, opioids, and stimulants. It may also help reduce symptoms of opioid withdrawal.
• Inflammation: CBD appears to have a powerful effect on inflammation, which may make it useful for conditions like rheumatoid arthritis.
• Chronic pain: CBD may also help with chronic pain. Not only can it help with the pain itself, but it may also improve sleep and quality of life for people living with chronic pain. However, the evidence for pain is mixed and more long-term research is needed.
• Neuropathic pain: A small study showed improvement in symptoms of neuropathic pain with topical CBD. Early research also suggests that oral CBD may help prevent neuropathic pain caused by certain types of chemotherapy. More in-depth research on CBD and neuropathic pain is ongoing.
• Anxiety: There is some evidence to suggest that CBD may help reduce anxiety related to pain, as well as social anxiety. A small study also showed that at certain doses, CBD may help with performance anxiety. But most of these studies are small and don’t look at long-term effects. So more information is needed.
• Depression: Preliminary research on CBD suggests that it may be helpful for depression. Like antidepressants, CBD appears to alter serotonin levels in the brain.
• Psychosis: Early clinical trials suggest that CBD alone (without THC) may help reduce symptoms of psychosis. It also causes fewer side effects than most other antipsychotic medications. But more long-term safety data is needed.
• Epilepsy: CBD is effective for treating seizures associated with certain forms of epilepsy that do not respond well to other medications.

CBD is also currently being studied for other conditions, such as post-traumatic stress disorder, Alzheimer's disease, and certain types of cancer. However, there is currently no clear evidence—one way or the other—that CBD is effective for these conditions.

Do health professionals recommend CBD oil?

Sometimes, but not always. There is only one form of CBD available by prescription. It’s called Epidiolex, and it’s only FDA-approved to treat two types of epilepsy in children: Lennox-Gastaut syndrome and Dravet syndrome. If your child has one of these conditions and isn’t responding to other medications, your healthcare provider may prescribe Epidiolex.

When it comes to CBD products sold over the counter, it depends on your healthcare provider. Some recommend CBD oil to their patients. But other healthcare providers are more cautious about recommending CBD. Many healthcare professionals believe that more research is needed to fully understand the risks and benefits of CBD.

However, it is a good practice to talk to your healthcare professional before starting CBD use. They can help make sure that CBD does not interact with other medications or health conditions.

What is the best way to take CBD oil?

CBD oil comes in several different dosage forms, and they work differently. The most common forms include:

• Inhalation (vaping or smoking): Inhaling CBD works the fastest, but the effects don’t last long. So people often choose to inhale CBD when they need quick relief, like for anxiety or muscle spasms. But inhaling CBD can be harmful to the lungs, so it’s not an ideal choice.
• Sublingual (under the tongue): Sublingual and oral forms of CBD take longer to work (1 to 2 hours or more), but they also last longer once they start working. So they may be better suited for ongoing symptoms that require long-term treatment, such as chronic pain.
• Oral (capsules or chewables): Oral and sublingual forms of CBD use a new technology called nanoformulation. This allows the body to absorb them more quickly, so they don’t take as long to work. But they also won’t last as long. These products can be a good alternative to inhaled CBD because they work relatively quickly and don’t last as long.
• Topical (cream or lotion): Most topical CBD products only work on the surface of the skin, so they’re best for skin-related conditions. But there are some patches, gels, and creams that are formulated to pass through the skin into the bloodstream (transdermal products). These may be helpful for muscle or joint pain when applied to the affected area, but there’s not much evidence to support their use.

What is the best dosage of CBD oil?

There are no universal dosage guidelines for how much CBD oil you should take (except in the case of the FDA-approved Epidiolex). Studies on CBD have looked at doses ranging from 16 mg to 1,000 mg.

For pain, a general dosing guideline is to start with 5 mg of CBD twice a day. You can increase your dose by 10 mg every 2 to 3 days up to 40 mg per day. Research suggests that higher doses of CBD (300 mg to 600 mg) may be better for anxiety. More high-quality human studies are needed to determine effective doses for other conditions.

Generally speaking, experts recommend starting with a low dose of CBD and slowly increasing it over time. This helps you find the dose that works for you and helps reduce the risk of negative side effects. But be sure to consult your healthcare professional first. They can help you choose the right dose for your needs.

What are the side effects of CBD oil?

CBD is generally well tolerated, but there are some side effects and risks you should be aware of. The most common are:

• Fatigue
• Diarrhea
• Nausea and vomiting
• Decreased appetite
• Weight changes

These side effects are more likely at higher doses and often go away over time as your body adjusts to CBD. But if they don’t, consider reducing the amount of CBD you’re taking. You can also talk to your healthcare professional for guidance.

In rare cases, CBD can cause liver enzyme levels to increase. This seems to be more likely with high doses of CBD or when taken with certain medications.

The Epidiolex package insert states that CBD may also increase the risk of suicidal thoughts or behaviors, although this is not clearly understood. If you notice a negative change in your mood after starting CBD, contact your healthcare professional immediately.

Can CBD oil have harmful interactions with other medications?

Yes, CBD can interact with some medications, so it’s best to review your medication list with your healthcare professional before taking it. We’ve listed a few possible interactions of CBD below. But keep in mind that this is not a complete list of medications that can interact with CBD. The best way to prevent interactions is to talk to your healthcare professional before you start taking it.

• Anti-seizure medications: The prescribing information for Epidiolex recommends a lower dosage of clobazam (Onfi) and valproic acid (Depakene) when taken with CBD. This is because CBD can increase the levels of these medications in the body. This interaction can also occur with other anti-seizure medications, but it is not well documented. One reason for this is that Epidiolex is only intended for people who have not responded to anti-seizure medications. So it is likely that they will be discontinued when Epidiolex is started. This makes interactions more difficult to identify.
• Antidepressants: CBD may also increase the levels of certain antidepressants in the body when taken together. This includes selective serotonin reuptake inhibitors, such as sertraline (Zoloft). It also includes tricyclic antidepressants, such as amitriptyline, and monoamine oxidase inhibitors, such as phenelzine (Nardil).
• Sedative medications: CBD can cause drowsiness, so combining it with other medications that cause drowsiness can increase this side effect. This includes some antihistamines, muscle relaxants, and beta-blockers. Be careful when taking CBD with other medications that cause drowsiness. And don’t drive until you know how the combination affects you.
• Warfarin (Coumadin): One study showed evidence that CBD may increase warfarin levels in some people. It’s not well understood how likely this interaction is, but it’s good to know. If you’re taking warfarin, let your healthcare professional know before you start taking CBD. They may want to check your blood more often to watch for signs of an interaction.
• Caffeine: CBD can also slow down the body’s processing of caffeine. This can lead to higher levels of caffeine in the body, which can make you feel jittery. It may be a good idea to reduce your caffeine intake if you start taking CBD.

Is CBD safe for children?

Epidiolex is the only form of CBD that has been studied and approved for treating seizures in children. But that doesn’t mean that all CBD products are safe for children. As mentioned, CBD products sold OTC are not well-regulated and may contain pesticides and heavy metals that are harmful to children. There’s also not enough research to know how CBD might affect the developing brain.

There is a lot of interest in CBD as a possible treatment for children with anxiety, autism spectrum disorders, and certain types of brain cancer. But until more information is available, it is unclear whether CBD is safe or effective for these conditions.

If you are interested in CBD as a treatment option for your child, it is best to consult a medical professional for guidance.

Conclusion

CBD oil is FDA-approved for certain types of epilepsy in children. It is also widely available OTC in several different dosage forms. There is some evidence that CBD can help with anxiety, pain, and sleep. It may also be helpful for depression and substance use disorders. But there is not much clinical data to show what dosage or forms of CBD work best.

CBD products sold over the counter are not well regulated, so use caution when purchasing them. It’s best to talk to your healthcare professional before starting CBD. They can help you find the right dosage for your needs and check for possible drug interactions.