Introducing CBD

Our thanks to Project CBD for providing constantly updated information on the wonders of CBD.

OVERVIEW

Over the past decade, cannabidiol, or CBD, has become the rock star of cannabis care. Its structure was first fully identified in 1963, yet it only recently has assumed a prominent place in both clinical practice and in state-by-state legalization. Why is CBD so popular? CBD doesn't get you "high." Therefore, the common public perception is that CBD is the "good" part of cannabis while THC is the "bad" part. This couldn't be further from the truth.

FIRST A LITTLE SCIENCE: WHAT IS CBD AND HOW DOES IT WORK?

CBD, along with other cannabinoids in the plant, interacts with a biochemical communication system in the human body, the Endocannabinoid System (ECS). The ECS's principal role is to maintain homeostasis, or balance, of all our body's biological systems. The ECS basically regulates our mood, physiology, and everyday experience of ill or good health.

The ECS consists of a group of cells, receptors and neurotransmitters. CBD fits into the ECS receptors (like space ships hitting a docking site), activating the receptors (like flipping on a light switch) and bringing the organism back into balance.

CBD works in the body along with many other chemical compounds derived from the cannabis plant including THC, CBN, CBG, THCA, THCV and others being studied. But one thing that has been confirmed is that these chemicals work together through a process called the entourage effect.

The entourage effect refers to the dynamic interaction of chemical compounds in plants and in our bodies.The key point is that the impact of the whole plant is greater than a single compound or even the sum of the plant's individual components. The entourage effect is lost when single molecules are isolated from the rest of the cannabinoids in the plant.

CBD IS EFFECTIVE CARE

While 24 states have legalized the medical use of cannabis, 15 states mandate limited access to "CBD only" strains, without the addition of its sister cannabinoid, THC. But clinicians believe that CBD works better when combined with THC and other cannabis components. Small doses of THC improve the power of CBD and, if micro-dosed correctly, will not get you "high."

HOW TO TAKE CBD

CBD is most effective when delivered directly into the body's blood stream, where it can locate and "dock" with ECS receptors. The most effective way to transmit the whole cannabinoid profile, thus benefitting from the full entourage effect, is through the oral mucosa, or membrane of the mouth. Here are some of the best choices for CBD delivery systems.

  • Tinctures – Tinctures, administered by swishing in the mouth, provide the most effective delivery method. The medicine absorbs into the bloodstream through the oral mucosa. When cannabinoids are absorbed into the blood stream, these chemical compounds work with the ECS to restore homeostasis, or balance, in the system.
  • Lozenges - Lozenges are best melted in the mouth before swallowing, making them as effective as tinctures in reaching the blood stream without breaking down in the digestive tract. Lozenges are also portable, allowing for discreet consumption on the go.
  • Suppositories – The speed of this method of delivery is similar to tinctures, but are most useful for patients who cannot tolerate anything in the mouth (e.g., infants, patients with oral cancers, etc.)
  • Vaporizers – Technically, this is the fastest delivery route, through the lung tissue. However, vaporizers provide the shortest relief window.
  • Topicals (oils, salves, creams, balms), transdermal patches – These products, applied directly to the skin, work locally on the affected body part.

CBD DOSING

CBD is non-psychotropic -- it doesn't get you "high." So, dosing your CBD doesn't have to be a scary thing. You can't overdose. The good news is that there are few, if any, side effects. The “bad” news is that because herbal products interact with you as a unique individual, one person's dose may not work for the next person. Your dose depends on how you feel, how you are experiencing improvement, how you and your health care provider are measuring that improvement to determine if balance is, or is not, being restored to your body.

Herbs work slowly, engaging the body's processes on a cellular level. It takes patience; and it doesn't happen overnight. Dosing, as well as delivery system and ratio of CBD to other cannabinoids, requires experimentation. Sometimes you just have to "change it up" to figure out what works best for you. [See general guidelines for Choosing and Using Your Cannabis Products Wisely below]

CBD FULL SPECTRUM EXTRACT VS SINGLE MOLECULE PRODUCTS

Studies have confirmed the greater effectiveness of whole plant CBD extracts, in comparison with single molecule, isolated extracts.

  • Published in September 2018, a Brazilian meta-analysis of CBD treatment of epilepsy shows that CBD is more effective in treating epilepsy than CBD isolates. The study focused specifically on three kinds of childhood seizures (Dravet, Lennox-Gastaut, and those caused by CDKL5 deficiency), and sought to describe the effectiveness, required doses, and side effects associated with cannabidiol. Researchers specifically compared dose requirements resulting in seizure reduction. They compared whole plant CBD with an FDA-approved pharmaceutical CBD isolate. The results showed a dramatic difference in outcomes for the 670 patients studied. Seventy-one percent of people using CBD-rich extracts had reduced seizure frequency, compared with 46% of those using CBD isolates. Researchers concluded that whole plant CBD offered a better therapeutic profile than purified CBD.
  • An Israeli study, published in the journal Pharmacology & Pharmacy (Feb. 2015), offered extensive evidence that lower amounts of whole plant CBD relative to single molecule CBD, produced better and more sustained benefits.
  • In June 2018, Spanish scientists documented the superior potency and anti-cancer efficacy of a full spectrum cannabis oil extract compared to a single molecule cannabinoid of THC in a breast cancer study. (Biochem Pharmacol. 2018 Nov;157:285-293. Epub 2018 Jun 27.)
  • A June 2018 Israeli study confirmed the relatively greater effectiveness of whole plant cannabis in the treatment of colorectal cancer, specifically due to the synergistic qualities of the various chemical compounds. (Cannabis Cannabinoid Res. 2018 Jun 1;3(1):120-135.) 2018.

Science is on the side of natural, whole plant products. Patients and providers both would do well to keep an eye on these continuing studies, as they will shape both the marketplace and patient outcomes for some time to come.

FIVE RULES ON HOW TO CHOOSE AND USE YOUR HEMP PRODUCTS WISELY

1. Quality of raw materials in the product

  • From organic whole plant (Not from isolate)
  • Non-GMO; No pesticides
  • Clean soil, without prior use of chemical nutrients
  • Contains full complement of cannabinoids, terpenes, flavanoids – not from isolates

2. What delivery system works best for you?

  • Absorb through the membrane of the mouth (tinctures, lozenges, melt in the mouth edibles, swish liquids)
  • Smoking is great for symptom management, but short-term
  • Edibles work well for some but know that they can degrade in stomach acids and digestive enzymes
  • Suppositories are a good option if you can't "swish"

3. What ratio of cannabinoids is best?

  • Cannabinoids like CBD and THC work best together
  • Patients often chose products with a high CBD to low THC ratio.
  • Experiment with different ratios to see what works best in your care.

4. What is your dose?

  • The best dose works for you based on how you feel

5. The Cardinal Rule of Herbal Products

  • Herbs are individuated – your body responds uniquely