Irrational exuberance is not to be addressed lightly. Nevertheless, after seeing so much misinformation about the possible therapeutic benefits of cannabidiol (CBD) being circulated, I thought that now would be a good time to list some of the established facts that we have about this interesting chemical.
- It is one of the 100+ cannabinoids found in the cannabis plant
- Its concentration in the plant is in inverse proportion to the concentration of THC, which is the primary psychoactive agent in cannabis
- It was first isolated from the cannabis plant in 1940. (THC was not isolated until 1964.)
- It does not cause euphoria and therefore is not addicting
- It counteracts the psychoactive properties of THC, including euphoria and anxiety
- A pharmaceutical preparation (Epidiolex) was approved this year by the FDA for the treatment of two rare childhood seizure disorders. It is generally used in combination with other anticonvulsant medication. The DEA allowed it to become legal by placing it in Schedule V instead of Schedule I of the Controlled Substance. Schedule V is the category for drugs with the least potential for abuse [https://www.dea.gov/drug-scheduling]. There is no evidence, however, that CBD has any potential for abuse.
- Almost all research on the therapeutic benefits of CBD have studied it using preparations in which it was combined with THC and other cannabinoids rather than as an isolated substance. The strongest evidence of a beneficial effect is for relief of chronic pain, especially of neuropathic origin. A pharmaceutical oral spray (Sativex), in which it is combined in a 1 to 1 ratio with THC, is available in many countries including Canada and the UK, but not in the U.S.
- The current commercially available non-pharmaceutical preparations sold as CBD are not only unregulated, they are illegal. With the exception of Epidiolex, the DEA continues to consider CBD to be a Schedule I substance because it is an ingredient in marijuana. Although its illegal status is clear, the on-the-ground situation is confusing because the DEA and local law enforcement agencies have chosen not to enforce the law regarding CBD.
- Kolmac patients who take CBD preparations are regularly found to have THC in their urine, which is why Kolmac has a policy against the use of CBD.
For those readers who want to know more about the way in which information in regard to CBD is being dominated by marketers rather than scientists, I would recommend this recent article.