Still, it’s important to proceed cautiously until more randomized controlled trials are underway. The rate and scale of research has not kept pace with the interest, says Hill, who believes there is little motivation to invest in studies because people are buying the products regardless.
CBD is everywhere these days, with celebrities like Kristen Bell touting its anti-inflammatory benefits, Tamra Judge selling a supplement line for healthy functioning and Michael J. Fox using it to alleviate medical conditions.
That can be problematic when so many people are taking it. “While the compound itself appears to be relatively safe, we need to know more,” he says. “It’s not a great scenario to have millions of people using cannabidiol when we don’t have the level of evidence that we need about its long-term effects or interaction with other medications.”
So is there any truth to the hype?
Another tip: Buy it in a state where recreational or medical cannabis is legal. Theoretically the products in a brick-and-mortar store should be tested in laboratories, says Hill, allowing you to feel more confident about your purchase than than if you were to buy it online.
Short for cannabidiol, CBD is a non-intoxicating chemical in the cannabis plant. Unlike THC (tetrahydrocannabinol), CBD does not make you high. But CBD is gaining a reputation as as a magical elixir to treat everything from anxiety to depression, inflammation to acne. Some researchers are even looking into whether it could be used as an adjunct treatment for opioid addiction.
But the lack of knowledge surrounding CBD — even among the medical community — can lead to misinformation and misuse. Take the claim that CBD oil can ease pain. “If you rub it on your skin, topical CBD is not going to be absorbed in the bloodstream,” says Hill. “It’s going to treat local inflammation as much as products like Bengay or Icy Hot — but will be much more expensive. People are being taken advantage of, and that concerns me.”
Donald Abrams was a member of the committee that reviewed the evidence that went into producing the report, and he said that the studies they reviewed overwhelmingly used pharmaceutically available preparations that contain THC, including dronabinol, nabilone and the whole-plant extract spray nabiximols, which contains equal parts CBD and THC. It’s impossible to know whether the benefits of cannabis can also be obtained from CBD alone, Abrams said, because CBD is just one of 400 chemicals present in the plant. So far, CBD in isolation has been studied in only a handful of randomized, placebo-controlled trials (considered the gold standard of evidence in medical research), and the evidence remains sparse.
What makes CBD so appealing is that it’s non-intoxicating, so it won’t get you high, though it “is technically psychoactive, because it can influence things like anxiety,” Jikomes said. Although much of the marketing blitz around CBD centers on the fact that you can take it without getting stoned, there isn’t much research looking at the effects of CBD when used in isolation, with a couple of exceptions. One is the use of CBD to treat seizures: CBD is the active ingredient in the only cannabis product that the Food and Drug Administration has signed off on — a drug called Epidiolex, which is approved for treating two rare forms of epilepsy. Animal models and a few human studies suggest that CBD can help with anxiety, but those are the only conditions with much research on CBD in isolation.
Those warning letters aside, there’s not a lot of federal oversight right now over the claims being made or the products that are being sold. Cohen warned against buying CBD products online, because “there’s a lot of scams out there.” Yet his clinic sells CBD, and he admits, “I say ‘Don’t buy online,’ but ours is worth doing, because we know what we’re doing. We ship all over.”
Right now, there’s a good chance that you don’t really know what you’re getting from any source. Testing and labeling rules vary by state, but many states that allow legal cannabis also require some kind of testing to verify that the THC and CBD levels listed on the label are accurate. However, this testing is controversial, and results can vary widely between labs, Jikomes said. A study published in March found measurable variations in test results, with some labs consistently reporting higher or lower levels of cannabinoids than others. There are no guarantees that the label accurately reflects what’s in the product. For a 2015 study published in JAMA, researchers tested 75 products purchased in San Francisco, Los Angeles and Seattle and found that only 17 percent were accurately labeled. More than half of the products contained significantly lower levels of cannabinoids than the label promised, and some of them contained only negligible amounts of the compounds. “We need to come up with ways to confidently verify the composition of cannabis products and make this information available to consumers,” Jikomes said.
But, uh, what is it that CBD is supposed to do? I visited a cannabis dispensary in Boulder to find out what the hype was all about. After passing an ID check, I was introduced to a “budtender” who pointed me to an impressive array of CBD products — tinctures, skin patches, drink powders, candies, salves, massage oil, lotions, “sexy time personal intimacy oil” and even vaginal suppositories to treat menstrual cramps.
Most of these products promised to relieve pain or otherwise enhance well-being, and none of it was cheap. (Prices started at about $30.) But I wanted to know: Does any of this stuff really work? After a deep dive into the scientific research, I learned that the answer was a big fat maybe.
Although there’s enticing evidence that good ol’ cannabis can ease chronic pain and possibly treat some medical conditions, whether CBD alone can deliver the same benefits remains an open question. What is clear, at this point, is that the marketing has gotten way ahead of the science.
Yeah, actually. It’s entirely possible that it could.
It stands to reason that the aforementioned possible reductions of stress, anxiety, and pain, combined with improved sleep, might help a person to unwind. Ditto for easing many menstrual symptoms.
In humans, Cooper emphasized that oft-cited studies regarding CBD’s pain-relieving properties looked at it in combination with THC. For example, one 2010 study of 177 patients suffering from cancer-related pain found an extract containing CBD and THC to be about twice as likely to provide relief as an extract of THC alone.
Could CBD help my migraine?
Another study looked at how CBD gel affects rats induced with arthritic knee joints, and showed that it reduced swelling and pain.
In short: not much.
Are you a rat or a mouse? If so, chances are good that CBD administered in moderate doses—10 mg/kg is too low; 100 mg/kg is too high—could have an anti-anxiety effect, particularly if you’re feeling anxious because you’ve been placed in a maze or are panicking because a snake has been introduced to your environment.
“There really isn’t very much evidence in humans with respect to its effectiveness,” says Ziva Cooper, the research director at the University of California-Los Angeles Cannabis Research Initiative. “And when I say evidence in humans, I’m really talking about rigorous, double-blind placebo-controlled studies.” On the other hand, Cooper says, there’s also not much research showing that cannabidiol doesn’t work for things. “There is just a general lack of studies—period.”