CBD vs Prescription Drugs - what does the future hold?

One of the big questions that will be answered over the next few decades is just how many illnesses and conditions cannabidiol (CBD) treatment will replace prescription drugs for. CBD appears to have lots of medical potential for mental health disorders such as depression and anxiety, and physical conditions including chronic pain. CBD products are currently sold as dietary supplements, enhancing general wellness by boosting the endocannabinoid system (ECS).

Our understanding of CBD's true therapeutic value, in consideration of its beneficial properties and side effects, compared to existing prescription drugs is set to grow. Demand for high-quality clinical trials is at an all-time high, as CBD consumption across America and around the world goes through the roof. The Food and Drug Administration (FDA) is slowing starting to get its act together. But as of July 2019, the only FDA-approved CBD drug is Epidiolex, an epilepsy treatment made by GW Pharmaceuticals of the United Kingdom.

This post will focus on a few areas where CBD has demonstrated promise as a medicine. We’ll look particularly at fields where current drugs are not up to standard. We'll look at how CBD could be used, discussing the most suitable forms of administration, and the most effective doses.

Our analysis will look at:

• CBD's antipsychotic potential for psychosis and schizophrenia


• Why CBD may be better than opioids for pain


• The promise of CBD for anxiety and depression 


• Cannabis and CBD's medicinal value for migraines 


• Why CBD may be a preferable anti-inflammatory drug to NSAIDs

Why it's vital to seek professional advice 

We get it. You are super excited to try CBD, a derivative of the cannabis plant that doesn't produce a high. Perhaps your friends have tried it and are having great results. Maybe you've been reading up on the medical benefits the cannabinoid has to offer. Are you ready to get in on the growing trend, and try out some of these innovative products yourself?

But if you are planning to start taking CBD alongside - or instead of - you should definitely seek a doctor's advice first. The drug interactions between CBD and other substances have not been thoroughly studied, and certainly don't get the attention they should. But there is some evidence that CBD can slow activity in the cytochrome P450 system. This means that CBD interferes with the metabolization of some drugs, affecting how much of the dose becomes active. Typically, this leads to a dosage increase of the prescription drug, even if you are taking the same amount as usual. 

CBD doesn't affect all drugs in this way, hence why it is perfectly fine to combine CBD hemp oil and other products with your current medication. But you'll only know for sure if you make contact with your doctor, who can give you the full information related to your situation. And most importantly, they'll put your mind at rest.

What drugs interact with CBD oil? 

So far, we know that the following drugs interact with CBD oil: steroids, immune modulators, HIV antivirals, calcium channel blockers, prokinetics, antihistamines and benzodiazepines. 

CBD for psychosis and schizophrenia 

Scientific research has found it harder to penetrate the brain and its workings than other organs in the body. Indeed, the human brain is commonly accepted as the most complicated object in the known universe. This has made deciphering the causes and finding safe and suitable treatments for illnesses such as psychosis and schizophrenia very, very difficult. Moreover, use and abuse of recreational marijuana high in THC has been linked to these disorders.

But with antipsychotics failing to help patients enough, new drugs are necessary. CBD is intriguing because of its moderating role on THC. With both indica and sativa strains of marijuana, the richer the CBD content, the less of an overall high the user receives. It is through this CB1 receptor mechanism that CBD has antipsychotic promise. 

Should CBD treatment mark a new era for psychosis and schizophrenia medicine, it would almost certainly be CBD-infused products only. Any amount of THC would probably have a negative effect due to its psychoactive nature.

CBD for chronic pain 

The United States is just one of many countries around the world where healthcare systems are experiencing serious problems in treating chronic pain. Prescription opioid painkillers have demonstrated analgesic effectiveness, but are held back by side effects and overdose risks. Patients who are put on chronic pain treatment plans often end up having to manage an opioid addiction as well. More than 10,000 Americans die annually from prescription overdoses. It is paramount that researchers find a new painkiller medication. And ideally, one that is equally effective, and crucially much safer.

Cannabis is a natural area of research. Medical marijuana has been used for pain relief by patients in legal states for many years, and cannabis has a painkiller history that dates back millennia. However, tetrahydrocannabinol (THC) has always been considered the key ingredient to the pain relief provided by marijuana. Its psychoactive properties have rankled with medical professionals, politicians and patients. Anti-marijuana arguments center around how the intoxicating effects can have damaging short and long-term impacts on mental health. The debate, in the context of opioids, on whether the upsides of THC outweigh the downsides for pain relief will continue. But could CBD, a distinctly non-intoxicating cannabinoid, have serious potential as a natural, low-risk painkiller? And if so, could it quickly become adopted widely in the US?

CBD research gives cause for optimism

The evidence is uncertain, but highlights the real need for extensive research. More people are using CBD for pain than anything else, according to a recent survey. However, this does not equate to clinical evidence, and could perhaps be the result of a significant placebo effect. The small studies that have been conducted on CBD and pain are inconclusive, but show some promise, in particular for neuropathic pain. 

Full-spectrum CBD products would likely be best for pain management, as these produce the 'entourage effect'. This is an interaction between cannabinoids that makes them more therapeutic than if consumed as a single substance. The wide array of CBD products - such as hemp flower, creams, vape juices and edibles - is also exciting. This suggests there are many ways that CBD could be beneficial. Patients may get better results from using two products together (e.g. a cream with a vape juice). 

CBD for anxiety and depression

As explained in the 'psychosis and schizophrenia' section, any cannabis-based treatment for mental illness tends to divide opinion. But non-intoxicating CBD must be explored for anxiety and depression. For one, because patients are already taking CBD capsules and other products. But also since existing drugs are showing diminishing returns. Selective serotonin reuptake inhibitors (SSRIs) the primary class of drug for both since the late 1980s, work at a snail's pace, and some patients receive no benefits. This indicates that simply tweaking serotonin levels doesn't solve the problem, and perhaps that these illnesses - and depression especially - are even more complex than they appear.

CBD's popularity for anxiety and depression is backed up by a few studies which show it can have a therapeutic effect. Granted, this is not the same as hard, clinical evidence. But the bar is set low for new drugs. Any CBD treatment that can be shown to work would perhaps be preferable to SSRIs, since there is much less of a problem with side effects. SSRIs are notorious for making users tired, dizzy, nervous and even nauseous. In contrast, sleepiness only seems to occur with CBD after taking a large dose. 

Which CBD products are most effective

Finding the right type of CBD and medication plans that work for patients is the next step. With anxiety, it seems that the more rapidly a treatment kicks in, the better. This brings tincture oils to the fore, and also vape juices and CBD joints for those who are less concerned about the health risks.

For depression, any product will likely have a potent antidepressant effect. Research suggests that one dose can remain effective for several days. It's possible that full-spectrum CBD is a more valuable antidepressant than CBD-isolate product. Other cannabinoids have shown potential as promoting neurogenesis and reducing inflammation. Tackling neuroinflammation may be critical to dealing with depression.

CBD for migraines 

Migraines are very painful headaches, and make some patients more vulnerable to sound and light. These are the 'aura' symptoms that people talk about regarding migraines. Researchers have developed drugs that manage the condition, without nailing down the root cause. However, new studies related to marijuana and hemp propose that the very ECS that cannabis works in could be to blame.

The idea that a dysregulated ECS is responsible for migraines comes under a theory called 'Clinical Endocannabinoid Deficiency'. Proponents argue that those who suffer from migraines and certain other illnesses may not be generating the required levels of endocannabinoids to bind with and regulate cannabinoid receptors. Cannabinoids from hemp and cannabis act as substitutes to endocannabinoids. It's perfectly feasible that the unique compounds from these plants are essential for treating migraines.

Small investigations have highlighted how cannabis is comparable with current migraine drugs in terms of benefits, and that it outperforms them in regard to side effects. The question is whether a pure non-intoxicating CBD solution is therapeutic in its own right, or if the added influence of THC is vital, or merely helpful.

CBD for inflammatory illnesses 

A future crisis with anti-inflammatory drugs may be looming. Aspirin, ibuprofen and other over-the-counter and prescription non-steroidal anti-inflammatory drugs (NSAIDs) have dominated the market for dealing with arthritis, inflammatory bowel disease (IBD) and other inflammatory illnesses for decades. But recent reports have questioned just how effective and safe they are, in older patients especially. 

CBD research - and studies on other cannabinoids - have found that anti-inflammatory effects can be produced via the ECS. Cannabinoids nurture the immune system to find balance between pro and anti-inflammatory signals. THC does this by binding to CB2 receptors; CBD is more nuanced in boosting endocannabinoid presence so this role can be fulfilled naturally.

This link between the ECS and the immune system is a recent discovery. Cannabinoid science has historically been stunted due to prohibition. Many of the most important finds regarding CBD have come since that discovery in the early 1990s. With that in mind, it isn’t such a shock that CBD may treat conditions much more efficiently than drugs which have been used for many years do.

Final thoughts  

Various schools of medicine are going to need to pay much closer attention to cannabis and hemp plants going forward. The potential for CBD as a medicine looks enormous. Exactly what mental and physical conditions CBD is great for is, however, not crystal clear. But in 10 to 20 years' time, it's quite likely doctors will be prescribing cannabis and non-intoxicating CBD solutions for common ailments, that affect millions of us.