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Documenting the arrival of CBD as mainstream medication

CBD and THC have always been the cannabinoids that have sparked scientists’ interest, but more recently it’s CBD that has been focused on from a medical perspective, not its psychoactive cousin which was crucial to the original arguments for medical marijuana.

Indeed, a fantastic new review published in the July 2017 edition of Pharmacology and Therapeutics, authored by a dozen respected figures (most notably Simona Pisanti and Anna Maria Malfitano) has only served to highlight how topics of interest have changed in the medical cannabis community.

There are more than 90 different compounds in the marijuana plant, with tetrahydrocannabinol (THC) and cannabidiol (CBD) the most well-known. THC’s psychoactive effects were determined early into THC research, once scientists were able to isolate the compound from the rest of the plant. Despite other cannabinoids having a similar structural composition to THC, their reactions in the body are different because they bind differently to the cannabinoid receptors in the endocannabinoid system.

But let’s hear more about CBD

CBD doesn’t have any psychoactive traits, nor does it negatively influence memory, body temperature or cognitive functions. It’s typically found in hemp, a strain of cannabis sativa, but there are many CBD-dominant strains around nowadays.

Furthermore, research has shown that CBD can help to control the psychoactive effects of THC, making whole-plant medication an improved alternative to THC-isolate. It’s the reason why CBD is often labelled the “entourage molecule”.

The new review called CBD “undoubtedly the more interesting cannabinoid,” noting the compound’s pharmacological qualities, from being an anti-inflammatory to potentially helping to slow down neurodegenerative diseases. CBD is already being prescribed as the number one treatment for epilepsy (even more so in children who experience rare forms of the debilitating condition). CBD is also used to deal with chronic pain, anxiety, depression and also a health-promoting agent.

The body has an endogenous cannabinoid system in the body (shortened to endocannabinoid system), which has receptors. These control a range of feelings and actions within the body, from the perception of pain to appetite, which are reduced or enhance when cannabinoids from marijuana interact with said receptors.

The effects of the cannabinoid receptors vary depending on where they are in the body. For example, cannabinoid receptors in the brain are what encourage psychoactive effects when activated by the THC compound.

CBD, on the other hand, doesn’t act as drastically, but serves to modulate the effects of receptors and other cannabis compounds. The review says that CBD lowers “receptor affinity with respect to” THC. Hence, we can glean that CBD controls and manages ailments such as enhanced appetite and anxiety, as well as increased heart rate (tachycardia).

From a marketing perspective, medical marijuana involving CBD is much more presentable than pure THC medication, with the reduced psychoactive effects making the experience safer and therefore more appealing to those who wouldn’t naturally consider medicating with marijuana.

Zoning in on CBD

CBD also acts independently of THC in the body, perhaps explaining its long list of therapeutic effects, which are as follows (claims made on published research):

Analgesic: CBD has pain-relieving traits, so is perfect for chronic pain and arthritis

Anti-nausea: chemotherapy patients are sometimes prescribed CBD to deal with the nauseous symptoms

Anticonvulsant: the anticonvulsant properties of CBD are why the compound is so effective in treating epileptic seizures

Anti-inflammatory: its anti-inflammatory properties hints at CBD as a viable treatment for Crohn’s Disease, although more studies are needed

The federal prohibition of marijuana has made research difficult and slow, although we are now learning more about the plant than ever. We already know about the pharmacokinetics of CBD (how it moves in the body). Next up for scientists is to understand its pharmacodynamics. However, we do know that CBD is just like other cannabinoids in having remarkably low toxicity levels.

The anti-inflammatory features extend to slowing down other ailments. Recent studies showed that lung functionality was enhanced when CBD interacted with various receptor systems in the body. Hence, CBD becomes a theoretical medication for inflammatory lung diseases.

The same is the case for neurodegenerative diseases such as Alzheimer’s, multiple sclerosis and Parkinson’s – although we must stress that CBD has not been approved as medicine for Alzheimer’s, with no scientific research on humans to prove it. However, anecdotal evidence on CBD’s power is encouraging. If nothing else, it shows why marijuana research is crucial – so we can conclusively realize what CBD and other compounds are and are not able to treat.

The anxiolytic, anti-psychotic, antioxidant and neuroprotective effects are not activated through the CB1 receptors, but “other targets that may be relevant”, according to the Pharmacology and Therapeutics study.

In addition to the aforementioned, CBD is also useful in combatting protein aggregation, excitotoxicity, iron accumulation and other symptoms which are signals of neurodegeneration.

Research has greatly bettered our knowledge on why CBD has the effects it does. Less understood, however, is why CBD has analgesic properties.

CBD is considered by some to be a substitute antipsychotic drug, because it isn’t lumbered with the side effects that traditional antipsychotic meds are. CBD’s effect on a crucial receptor hypofunction is what gives the compound its antipsychotic traits, and patients with schizophrenia and depression are becoming more open to the idea of medicating with CBD.

CBD is helpful in treating insomnia and generally improving sleeping habits, by stopping REM (rapid eye movement) sleep suppression brought on by anxiety. What’s more, non-REM (NREM) sleep is not affected at all by taking CBD.

REM sleeping issues are common in patients with PTSD and anxiety and depression issues. The availability of a safe, herbal treatment such as CBD is a fantastic development to all afflicted, who have been stuck with strong – and often addictive – pharmaceutical meds.

Primitive research suggests that CBD may be of use in treating cardiovascular conditions, although nothing has been confirmed yet and some dispute the findings. However, as an antioxidant and anti-inflammatory, CBD is still a potential medication for heart conditions which are defined by oxidative stress and inflammation symptoms.

Wide-ranging medical possibilities of CBD

The review in Pharmacology and Therapeutics reviewed the biological effects in the first half of the paper, before expanding on the wide-ranging medical possibilities of CBD in the second half. Let’s look further into the notion that CBD could treat Alzheimer’s, multiple sclerosis, Parkinson’s and other neurodegenerative diseases, and assess the validity of these claims.

Inflammation is thought to be one of the biggest causes of neurodegenerative diseases, even more so in the development and speed of them. With CBD known to reduce inflammation, and to have neuroprotective and antioxidant qualities, the signs look good.

Alzheimer’s is caused by a build-up of beta-amyloid peptide deposits in the brain. These deposits are neurotoxic and cause oxidation. The early indications are that CBD may inhibit the “neuroinflammatory and neurodegenerative responses” brought on by this plaque build-up. Another piece of research argues that social recognition impairment can be reversed with CBD treatment.

A breakdown in the body’s motor system is caused by Parkinson’s disease, as the nigrostriatal dopaminergic neurons die off. There is no cure for Parkinson’s, with no drugs recognized to slow down the process, without side effects (Levodopa can tackle symptoms, but long-term use brings its own problems).

What CBD activists hope for is that the compound can encourage a fresh pharmacological take. If it’s proven that CBD can improve overall well-being by protecting neurons which produce dopamine, then it may have a medically beneficial role to play. What needs to happen next is for a comprehensive study to be conducted on Parkinson’s in humans, and how patients respond when administered CBD.

The review describes multiple sclerosis as destroying the myelin sheath surrounding the brain’s axons, which leads to “irreversible disability” and the production of “recurrent episodes of neurological dysfunction.”

Much of the research carried out on marijuana being a treatment for MS symptoms such as tremors, spasticity and pain would have been using cannabis with THC. This psychoactive element means we cannot really tell how good CBD is on its own, but with what we know about the cannabinoid, CBD-isolate may be better than whole-plant treatment.

This is largely down to the neuroprotective and anti-inflammatory properties of the CBD, but also thanks to the non-psychoactive nature of the compound. When medicating with THC, dosage limits are important as too much psychoactivity could be uncomfortable for the user. However, CBD is safe, non-addictive and overdosing is impossible, so larger doses can be taken with more peace of mind.

And the early data makes a tangible link between CBD controlling the inflammation that leads to MS and its progression.

If you watched the CNN documentary Weed, you’ll be aware of CBD’s effectiveness in treating seizures, in particular those where pharmaceutical medication hasn’t worked. An unacceptable 30 percent of seizure patients say that they have “inadequate control” over their condition.

But why is CBD a miracle compound for epileptic seizures, to the extent that it’s even been recognized by legislators and medical experts?

It’s all down to the anticonvulsant effects of CBD, which have been confirmed by multiple studies. GW Pharmaceuticals has developed an oral CBD which is reducing seizure frequency. Furthermore, the “sufficient safety profile” of CBD means it’s perfectly safe for children and adults to use on a regular basis.

Pisanti, Malfitano and the rest of the team state that CBD has “multifaceted pharmacological effects”. These include: relieving pain and anxiety, being an anti-infalmmatory, anti-oxidant, and analgesic and neuroprotective compound.

They also point to the increased accessibility of medical marijuana in the United States and the rest of the world, but that medical professionals and national regulatory agencies have not kept up with the developments, creating confusion on whether marijuana can be used as alternative medicine.

Moreover, with the CBD market still finding its feet, the industry is unregulated and therefore it’s up to companies to meet ethical standards with their products, be transparent about their manufacturing processes, correctly label the ingredients of their products and provide appropriate directions for use.

Once cannabis users and prospective patients are better informed about medical marijuana and how various intake methods work (from CBD e-liquid to CBD edibles), the industry will surely flourish and become more respected and widely-used at home and abroad

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