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Paging Dr. Frischer: CBD

Not a day goes by in my medical practice that I’m not asked about CBD. CBD is one of the compounds from the cannabis plant. It is very popular and people choose to use it for a large variety of health issues, including pain management, arthritis, insomnia, anxiety, depression, Parkinson’s disease, headaches, smoking cessation, various neuropsychiatric and neurodegenerative disorders, cancer, type 1 diabetes, acne, dementia, and epilepsy.

 

If CBD can effectively treat all of these issues, it will truly be amazing.

 

The cannabis plant contains CBD, THC, and 120 other compounds as well. These compounds have very different effects. THC has been the best known of them and is the most active ingredient in marijuana. Over the years, marijuana farmers have selectively bred plants to contain high levels of THC. Hemp farmers, on the other hand, have rarely modified the plant, and it is these hemp plants that are used to create CBD products.

 

I find it fascinating that our body also produces its own natural cannabinoids. We have receptors throughout our body, including the brain, which bind to different cannabinoid compounds. Various cannabinoid compounds can even alter the levels of our own “naturally” produced cannabinoids.

 

CBD, unlike THC, is not psychoactive – it does not affect our state of mind. Nonetheless, it does produce significant changes in the body.

 

At this time, there is only one FDA approved use for CBD. In 2018, the prescription use of Epidiolex, a purified form of CBD oil, was approved for the treatment of some types of epilepsy. Epidiolex has had extensive scientific testing and evaluation.

 

What about all of the other possible uses for CBD? At this time, only preliminary studies have been conducted, and many are promising. So far, it appears that CBD causes no significant side effects on the central nervous system, vital signs, or mood. The most common side effects are tiredness, diarrhea and reduced appetite. Note that no addiction or dependency has been seen in CBD users.

 

At this time, cannabis products, whether CBD or THC based, are legal for medicinal and recreational use in California. However, their legality varies from state to state, and is in conflict with federal law. It is, at best, confusing for now.

 

Be aware that CBD comes in a variety of forms and in various doses. That, along with the lack of conclusive studies, makes it very difficult to give educated recommendations about its use. Still, it is clear that many preliminary studies show a lot of promise. When I compare it to, for example, high dose, potentially addictive narcotics for pain, or potentially addictive benzodiazepines for anxiety, CBD appears to be far safer. I remain open minded.

 

I encourage you to have a discussion with your doctor if you are considering giving CBD a try.

July 12, 2019

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