The Sober Cannabinoid: CBD Explained
Cannabinoids are chemical compounds found in cannabis plants that stimulate cannabinoid receptors of the body and brain.[1] According to a consensus of industry practitioners, there are at least 100 cannabinoids, all of which have different effects on users. Among these include the ubiquitous tetrahydrocannabinol (THC) and cannabidiol (CDB).
Cannabidiol’s molecular structure (Source: United Patients Alliance)[2]
THC is the psychoactive ingredient that causes the “high” or feeling of intoxication experienced by cannabis users, whereas CBD is a non-psychoactive agent derived from hemp plants that offers a variety of reported therapeutic benefits including pain relief, preventing inflammation, and mitigating psychological ailments such as depression.[3] Cannabinoids can be consumed in various ways, most commonly via smoking or eating edibles. With jurisdictions around the world becoming increasingly open to legalizing cannabis for recreational and/or medical purposes, research projects regarding cannabinoids and their physiological effects are gaining significant traction.
Charlotte’s Web
CBD was brought into the spotlight in 2013 when Dr. Sanjay Gupta reported in a CNN documentary the case of a girl from Colorado named Charlotte who suffered from Dravet syndrome, a rare and potentially lethal form of epilepsy. At five years old, she suffered up to 300 severe seizures a week and was at a constant risk of medical emergencies. Out of desperation, Charlotte’s parents resorted to treating her condition with CBD – a decision that met with controversy given her age.
Charlotte Figi underwent successful treatment for symptoms of Dravet syndrome using CBD extracts. (Source CNN)[4]
Remarkably, Charlotte’s seizures almost completely stopped after she was given a CBD extract. The success of her treatment inspired hundreds of families with children suffering from similar ailments to relocate to Colorado in order to obtain CBD treatment for their children. Others, particularly in U.S. states with stricter cannabis regulations, opted to procure CBD extracts via illegal distribution networks.[5]
The results of Charlotte’s case have been supported by a study conducted by the European Pharmaceutical Review claiming that the substance can mitigate “drop seizures,” which cause severe muscle control loss and balance, by 41.9%.
“This new study adds rigorous evidence of cannabidiol’s effectiveness in reducing seizure burden in a severe form of epilepsy and, importantly, is the first study of its kind to offer more information on proper dosing,” says Dr. Orrin Devinsky, NYU Professor of Neurology, Neurosurgery, and Psychiatry, who co-authored the study.
However, while CBD has exemplified promising benefits to users so far, researchers have pointed out that definitive findings regarding CBD’s full effects, particularly those derived from human studies, are still far from conclusive and will require further research. They have also pointed out that several CBD manufacturers have come under scrutiny from authorities for making unfounded claims about CBD such as assertions that it might be a cure for cancer which, according to Harvard Health Publishing, is not the case.[6]
US Perspective: States vs. The Feds
Cannabis remains illegal on a federal level in the United States in spite of individual states, notably Colorado and California, legalizing the substance for medical and recreational purposes. For now, cannabis, and therefore CBD, is classified as a Schedule 1 drug alongside substances such as heroin and LSD. However, federal agencies such as the US Food and Drug Administration (FDA) have outlined strict provisions allowing for the distribution of cannabis-based medicines as well as scientific research into the medical uses of cannabis. In fact, the FDA has already deemed certain drugs such as Epidiolex, which treats seizures using CBD, and Marinol, used to treat anorexia and weight loss in AIDS patients, as “safe and effective for its intended indication.”[7]
With regard to the federal government’s approach towards states that have legalized cannabis for medical and recreational use, the U.S. Department of Justice (DOJ) stated that while the substance remains illegal on a federal level, they expect states such as California and Colorado to create “strong, state-based enforcement efforts”[8] to “defer the right to challenge their legalization laws.”[9] However, the DOJ warned that it “also reserves the right to challenge the states at any time they feel it’s necessary.”[10]
One major development in the realm of cannabis regulation in the U.S. is a new policy recently signed by President Donald Trump that legalized the commercial production of hemp in the country as an agricultural commodity. The bill would essentially allow researchers to apply for federal grants as well as crop insurance which regulators hope would stimulate the U.S. agricultural sector.[11] With the legalization of hemp, it is likely that the extraction of CBD and the production of CBD-based products could grow significantly in the country.
Beyond Uncle Sam
Regulations surrounding cannabis around the world vary dramatically, with Canada recently joining Uruguay in legalizing recreational cannabis use, while others such as Indonesia retain draconian laws for cultivators and those found to have cannabis in their possession. Since the success of legalization efforts in Canada and Uruguay, lawmakers in those countries have developed legal frameworks to regulate the consumption of cannabis and cannabis-based products in their respective jurisdictions. Both require cultivators and producers to possess licenses and have set out guidelines on the sale of cannabis-derived medicines, including those that use CBD as their active ingredient.[12]
On December 24, 2018, Thailand’s National Legislative Assembly unanimously passed new legislation to legalize cannabis for medical use and research, making it the first country in Southeast Asia to do so. While the legislation is waiting to be fully implemented as of the beginning of 2019, Thailand’s Justice Minister Prajin Juntong has reassured stakeholders that guidelines will be provided.[13]
CBD’s Future
As further awareness grows about CBD and its reported therapeutic effects, further interest in conducting research about the compound will continue to grow. Given that research about its effects has been hindered by the hostile regulatory posture of many countries, this relaxation may create opportunities to collect data from human trials, in contrast with prior lab data showing only the substance’s effects on mice. This is expected to provide a boost not only to the burgeoning cannabis industry, but also science and academia.[14] Entrepreneurs and corporations are likewise becoming more open to the idea of researching ways to incorporate CBD into their products and offering more ways to enrich their consumers. While the cannabis industry, and therefore the proliferation of CBD-based products, remains in its infancy at this time, it is certain that the attention it is receiving is anything but sober.
[1] “What are cannabinoids? Where can cannabinoids be found?” Fundacion Canna (available at https://www.fundacion-canna.es/en/cannabinoids).
[2] “An Introduction to CBD,” United Patients Alliance (attained on Jan.21, 2019) (available at https://www.upalliance.org/medical-information/cannabidiol-cbd/)
[3] “What is CBD?”, Project CBD (available at https://www.projectcbd.org/about/what-cbd).
[4] “Marijuana stops child’s severe seizures,” Sandra Young, CNN (Aug. 7, 2013) (available at https://edition.cnn.com/2013/08/07/health/charlotte-child-medical-marijuana/index.html).
[5] “What is CBD? The ‘miracle’ cannabis compound that doesn’t get you high,” Alex Halperin, The Guardian (May. 28, 2018) (available at https://www.theguardian.com/society/2018/may/28/what-is-cbd-cannabidiol-cannabis-medical-uses).
[6] “Cannabidiol (CBD) – what we know and what we don’t,” Peter Grinspoon, Harvard Health Publishing (2018) (available at https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476).
[7] “FDA and Marijuana: Questions and Answers,” US Food & Drug Administration (available at https://www.fda.gov/newsevents/publichealthfocus/ucm421168.htm#use).
[8] “State Marijuana Laws,” National Conference of State Legislatures (2018) (available at http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx)
[9] Ibid.
[10] Ibid.
[11] “Why the US Cannabis Industry May Witness a $20 Billion Boom,” Fortune (Dec 13, 2018) (available at http://fortune.com/2018/12/13/farm-bill-legalized-hemp/)
[12] “Regulations to support coming into force of the Cannabis Act,” Government of Canada (2018) (available at https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/laws-regulations/regulations-support-cannabis-act.html). See also “Ley de cannabis uruguaya: pionera de un nuevo paradigma,” John Hudak, Geoff Ramsey, and John Walsh, Governance Studies at Brookings (2018) (available at https://www.brookings.edu/wp-content/uploads/2018/03/GS_06142018_Cannabis-Uruguay_Spanish.pdf)
[13] “Cannabis growers will be given guidelines,” The Nation (Dec. 25, 2018) (available at http://www.nationmultimedia.com/detail/national/303610630).
[14] “Not Everybody Must Get Stoned: Pot’s Nonintoxicating Future,” Amanda Chicago Lewis, The Wall Street Journal (Oct 25, 2018) (available at https://www.wsj.com/articles/prepare-for-a-wave-of-cannabis-productsbeyond-cbd-1540479300)