Dr. Cohen has found that chronic conditions including autoimmune diseases and pain syndromes can be helped with a 6-mg under-the-tongue tincture (the fastest delivery system) or a 25-mg capsule taken twice a day. Dosages for topical products like lotions are especially hard to determine—there’s no clarity on how much CBD gets into the system through the skin.
Most human studies of CBD have been done on people who have seizures, and the FDA recently approved the first CBD-based drug, Epidiolex, for rare forms of epilepsy. Clinical trials for other conditions are promising, but tiny. In one Brazilian study published in 2011 of people with generalized social anxiety disorder, for example, taking a 600-mg dose of CBD (higher than a typical dose from a tincture) lessened discomfort more than a placebo, but only a dozen people were given the pill.
CBD works by attaching itself to specific receptors of the body’s own endocannabinoid system. The human body is known to produce cannabinoids of its own, which affect the cannabinoid receptors CB1 and CB2. The CB1 receptors are generally found in the brain, and deal with pain, mood and emotions, movement, appetite, among others. THC acts upon the CB1 receptors. Meanwhile, CB2 receptors are more commonly found throughout the immune system, affecting inflammation and thus pain. CBD is thought to act upon these receptors, by influencing the body to produce its own cannabinoids in order to rebalance itself.
A study from 2016 worked with 214 people with epilepsy. The study participants added oral doses of 2 to 5mg of CBD per day to their existing anti-epilepsy medications. The study’s researchers monitored the participants for 12 weeks, recording any negative side effects and checking on the frequency of their seizures. Overall, participants had 36.5 percent fewer seizures per month. However, severe adverse effects were recorded in 12 percent of the participants.
The reason so many people are interested in cannabis products that don’t make them high, proponents say, is that CBD helps with everything from pain and nausea to rheumatoid arthritis, cancer, Crohn’s disease, and dementia. CBD is anti-inflammatory, anti-anxiety, antibacterial, immunosuppressive, and more, says Joseph Cohen, DO, a cannabis doctor in Boulder, CO.
Currently, the only CBD product approved by the Food and Drug Administration is a prescription oil called Epidiolex. It's approved to treat two types of epilepsy. Aside from Epidiolex, state laws on the use of CBD vary. While CBD is being studied as a treatment for a wide range of conditions, including Parkinson's disease, schizophrenia, diabetes, multiple sclerosis and anxiety, research supporting the drug's benefits is still limited.
CBD was also found to disrupt the consolidation of generalized fear memories when administered immediately after the acquisition of such fear memory. Interestingly, the timing of the administration of CBD was vital as the results demonstrated that delayed administration of the CBD dose did not have the same effective result that immediate administration did.
CBD derived from marijuana is a different story, and the law varies from state to state. But as long as you’re using CBD oil that contains less than 0.3 percent THC, you have nothing to be concerned about anywhere in the United States. On the other hand, if you want to take your CBD on a trip outside the country, definitely look into local laws to avoid getting into awkward situations while you’re away.