A case series of 47 people with multiple sclerosis reported improvements in pain, walking, and muscle spasms with a combination of CBD and THC. 15
Instead, CBD has been credited with relieving numerous medical conditions, such as epilepsy, anxiety, inflammation, insomnia, and pain. Although “credited” does not mean proven. Because of the historical regulatory landscape, there are hardly any well-conducted trials backing up those claims, although research is expected to ramp up now that laws distinguish between hemp and marijuana.
Unfortunately, few human trials investigating the use of CBD as a single agent to relieve pain exist, with most trials using a combination of CBD and THC to relieve pain. Notably, Health Canada has approved a combination medication that contains both THC and CBD in a 1:1 ratio for the relief of central nerve-related pain in multiple sclerosis, and cancer pain that is unresponsive to optimized opioid therapy.
Other research (both animal and human) has shown that CBD has anti-inflammatory effects, and it may relieve pain by this mechanism.
CBD can interact with other medications used to treat heart conditions or immunosuppressants so you should always talk with your doctor before taking CBD.
Beneficial effects on anxiety after taking CBD were reported in an observational study where 21 patients out of 400 had anxiety. 8
In June 2018, the U.S. Food and Drug Administration (FDA) approved Epidiolex, a CBD oral solution used for the treatment of certain rare forms of epilepsy in children under 2—Dravet syndrome and Lennox-Gastaut syndrome. Both are exceptionally rare genetic disorders causing lifelong catastrophic seizures that begin during the first year of life.
Many of these interactions are mild and require no adjustment to treatment. Others may require a drug substitution or the separation of doses by several hours.
There is currently no known “correct” dose of CBD oil. Depending on individual needs and what is being treated, the daily dose may range between 5 and 25 mg.
As CBD grows in popularity, so does the research on it but there are currently few clinical studies on the effects of CBD oil. As such, some of these claims are better supported by studies than others.
Since some CBD oils contain trace amounts of THC, you should avoid driving or using heavy machinery when taking CBD oil, particularly when first starting treatment or using a new brand.
To avoid interactions, tell your doctor and pharmacist about all prescription, over-the-counter, herbal, or recreational drugs you are taking.
According to a 2017 study in the Journal of the American Medical Association, only 30.95% of CBD products sold online were correctly labeled. Most contained less CBD than advertised, while 21.43% had significant amounts of THC.
CBD is advertised as providing relief for anxiety, depression and post-traumatic stress disorder. It is also marketed to promote sleep. Part of CBD’s popularity is that it purports to be “nonpsychoactive,” and that consumers can reap health benefits from the plant without the high (or the midnight pizza munchies).
The CBD industry is flourishing, conservatively projected to hit $16 billion in the United States by 2025. Already, the plant extract is being added to cheeseburgers, toothpicks and breath sprays. More than 60 percent of CBD users have taken it for anxiety, according to a survey of 5,000 people, conducted by the Brightfield Group, a cannabis market research firm. Chronic pain, insomnia and depression follow behind. Kim Kardashian West, for example, turned to the product when “freaking out” over the birth of her fourth baby. The professional golfer Bubba Watson drifts off to sleep with it. And Martha Stewart’s French bulldog partakes, too.
What are the claims?
But he cautions that the side effects could have been because of an interaction with other medications the children were taking to control the seizures. So far, there hasn’t been a randomized, placebo-controlled, double-blind trial (the gold standard) on sleep disorders and CBD.
“If you take pure CBD, it’s pretty safe,” said Marcel Bonn-Miller, an adjunct assistant professor at the University of Pennsylvania’s Perelman School of Medicine. Side effects in the Epidiolex trial included diarrhea, sleepiness, fatigue, weakness, rash, decreased appetite and elevated liver enzymes. Also, the safe amount to consume in a day, or at all during pregnancy, is still not known.
However, a double-blind study found healthy volunteers administered CBD had little to no change in their emotional reaction to unpleasant images or words, compared to the placebo group. “If it’s a calming drug, it should change their responses to the stimuli,” said Harriet de Wit, co-author of the study and a professor in the University of Chicago’s department of psychiatry and behavioral neuroscience. “But it didn’t.”