Dr Hazel Wallace breaks down the bold health claims of cannabinoids
In Dr Hazel Wallace’s latest column, she answers the question: will you get high taking CBD?
Cannabidiol aka CBD – it’s the product ingredient that’s currently causing quite a buzz in the wellness world. It can be found in many sources from oils to balms, and even coffee. Plus, word on the street is that GOOP, founded by Gwyneth Paltrow, is even bringing out CBD bath bombs. No wonder then that the market is currently worth $20.2bn globally and is expected to grow to $22bn by 2025.
Just last month, LloydsPharmacy become the first UK national pharmacy to offer customers a range of CBD oil products; leading supplement brand Healthspan have added CBD to their offering and, as of this month, cannabis-based products are even available on prescription.
Which begs the question: what actually is CBD oil and how is it different to weed?
CBD is a non-psychoactive compound (i.e. it won’t make you high) found in the cannabis plant. It is one of a number of cannabinoids, which also include tetrahydrocannabinol or THC, the compound most associated with recreational cannabis use and that euphoric feeling (better known as being stoned).
Some products may use 100% of the hemp plant in their formula; others may extract the CBD seed oil and place it into another carrier oil such as olive oil.
Cannabinoids can be broadly grouped into three categories:
1. Those which are found in the cannabis plant (eg CBD + THC)
2. Endogenous cannabinoids (the one’s we produce ourselves in the body)
3. Synthetic cannabinoids (those made in a lab)
Currently two cannabinoid receptors have been identified – CB1 and CB2 receptors. The CB1 receptor is found in the brain but also other tissues of the body, and it is believed that the mood-altering properties of cannabinoids is regulated by this receptor. CB2 receptors are expressed on cells involved in the immune system and inflammation. As it stands, we are are not entirely sure how CBD produces its physiological effects on the body as it doesn’t directly bind to these receptors, but rather works indirectly via these receptors and other targets in the body.
Is CBD legal?
Cannabis is classified as a class B controlled drug under the Misuse of Drugs Act 1971, which means it’s an offence to possess, supply, produce, import, export or grow this drug except under a Home Office license.
But things get complicated when it comes to CBD: in its pure form, without any THC (or less than 0.2% THC), CBD would not be considered a controlled drug under this act and is therefore allowed to be sold on the market. However, if a CBD product contained any controlled cannabinoids – such as THC – unintentionally or otherwise, then the product, too, would be controlled. Furthermore, if CBD products claim to offer medical benefits, then they need to be licensed as a medicine according to the Medicines and Healthcare products Regulatory Agency (MHRA).
Health stores get around this by selling CBD oils as food supplements.
Why is CBD available on prescription?
You may have heard that doctors in England, Wales and Scotland are now able to prescribe cannabis-based products for medicinal purposes. However, it’s not as simple as popping down to your local GP and picking up a script; your GP will need to refer you to a clinician, who is on a specialist register and able to prescribe. Currently there is not guidance on who can access cannabis use for medicinal purposes. The main priority, and urgency of this move, is to provide access for children with intractable epilepsy to cannabis based products.
Does CBD oil work?
In addition to its use in the treatment of epilepsy, there is a range of conditions for which CBD has shown some benefit – although the data is limited. This includes; brain-related disorders such as Alzheimer’s and Parkinson’s disease, Multiple Sclerosis (MS), pain, anxiety, cancer, depression and inflammatory diseases, including rheumatoid arthritis and inflammatory bowel disease.
Many people also choose to take CBD for disease prevention or health promotion on the basis that it has potential antioxidant and anti-inflammatory properties and neuro-protective effects.
Yet, while the science is interesting and the potential use of CBD for the treatment of debilitating diseases is exciting, we need to take a couple of things into consideration when weighing up the risks and benefits: many of these CBD studies are either done on rats, or on a small group of people who have a specific medical condition (which is very different to taking the same substance just to get the proposed benefits) and, as the trials are very short, we don’t know the long-term effects of these substances.
Is CBD safe?
In terms of its safety profile, so far CBD seems to be well tolerated and no significant adverse events have been reported. A recent review by the World Health Organization (WHO) concluded that ‘to date, there is no evidence of recreational use of CBD or any public health-related problems associated with the use of pure CBD’. One word of warning, though; CBD may interact with certain medications.
However, as CBD is not a controlled drug, and is also unregulated, we can’t be 100% sure about the quality of the product itself, or if it has the effective dose needed to achieve therapeutic effects or health benefits, nor do we know the purity and source of the product – which raises the question of safety.
The Doctor’s Verdict on CBD Oil
There is definitely growing evidence that CBD plays a role in the treatment of various medical conditions, but there is a still a lot of uncertainty, and we are yet to receive the official guidance from the National Institute for Health and Clinical Excellence (NICE) on the use of cannabis-based products for medicinal purposes.
For people interested in using it for the proposed health benefits such as sleep, performance, and recovery, beware that a) any health claims have not been authorised yet, and b) these products are not regulated as medicines or drugs so do not undergo rigorous checks.