CBD Basics

The New York Times Magazine recently published an article titled Can CBD Really Do All That? This article starts out with a truly terrifying situation that any parent can identify with: A child that suffers from debilitating seizures.

As the article points out, there are reasons to believe that CBD can help children who suffer from seizures. The article highlights the story of Catherine Jacobson, who has a Ph.D. in neuroscience and it is her son, Ben, who suffers from seizures. Their story grounds this article and explores the legitimate research that is being done on how CBD can help in this area (THC is not believed to offer the same benefits as CBD in this situation).

From the article (emphasis mine):

“Many of these products are vague about what exactly CBD can do. (The F.D.A. prohibits unproven health claims.) Yet promises abound on the internet, where numerous articles and testimonials suggest that CBD can effectively treat not just epilepsy but also anxiety, pain, sleeplessness, Crohn’s disease, arthritis and even anger. A confluence of factors has led to this strange moment. Plenty of legitimate, if still inconclusive, research is being done on CBD. Many scientists are truly excited about it. The laws governing cannabis and its chemical components have loosened up. And the anecdotes that have emerged from what Elizabeth Thiele, an epileptologist at Harvard, calls the “vernacular” cannabis movement have lent emotional force to the claims made for CBD.

“Amid the current deluge of products, it now seems almost quaint that, back in 2012, after deciding to try treating Ben with CBD, Jacobson couldn’t actually locate the stuff. Other parents of epileptic children were using D.I.Y. techniques to treat their children: tinctures; cannabis-infused butter in baked goods; crushed cannabis buds in capsule form; even cannabis suppositories. Some reported positive results. Over the years, Jacobson has had many of these products tested at labs; almost invariably they contained very little or no CBD and too much THC. It has psychoactive effects, and there wasn’t much science suggesting THC could treat seizures.”

We Don’t Know How CBD Works

From the article (emphasis mine, again):

“[F]or millenniums people have used cannabis itself with relatively few side effects. (These can include dry mouth, lethargy and paranoia.) THC hits CB1 and CB2 receptors, but how CBD works is less clear. It seems to interact with multiple systems: increasing the quantity of native cannabinoids in the human body; binding with serotonin receptors, part of the “feel good” molecular machinery targeted by conventional S.S.R.I.s; and stimulating GABA receptors, responsible for calming the nervous system. With more than 65 cellular targets, CBD may provide a kind of full-body massage at the molecular level.

“This biochemical promiscuity is one reason CBD seems so medically promising, according to Yasmin Hurd, a neuroscientist at Mount Sinai, in New York. Modern neuroscience often tries to target one pathway or receptor, Hurd told me; that approach is easier to study scientifically, but it may not address what are often network-wide problems. “The brain is about a symphony,” she says. And CBD, she suspects, can “bring the entire symphony into harmony.” “

This is why CBD Up Close recommends that companies in the CBD industry should not make any health claims. That, and you have to have FDA approval to legally make health claims (making health claims without FDA approval will definitely get you in serious trouble, don’t do that). Putting the law aside for a moment, it is amoral to make claims about your product that you cannot substantiate. This is tantamount to lying and it gives people false hope.

CBD May Help With Psychosis

As the article goes on to detail, there are researchers, mostly outside of America at the moment, who are working on this and they are discovering some interesting things.

“It’s reasonable to ask why the CBD naturally present in cannabis doesn’t protect recreational users from the negative effects of THC. In older varieties, where the CBD-to-THC ratio was closer to 1-to-1, maybe it did. But today’s strains typically contain about three times as much THC as the cannabis smoked recreationally even as recently as the 1990s, while CBD concentrations have fallen by about half in the same period, according to a recent University of Mississippi study on black-market marijuana. And precisely because the proportions between the two cannabinoids have become so skewed — the ratio of THC to CBD has risen to 80 to 1 from 14 to 1 in two decades — lots of modern cannabis is potentially much more toxic for the brain, says Hurd, who is the director of the Addiction Institute at Mount Sinai.”

There is even some early research that “indicates that CBD might help recovering opioid addicts avoid relapse.” If proven, that would be fantastic news.

Early Research Shows Promise of CBD and Cannabinoids

“Other possible applications of plant-derived cannabinoids could be just as groundbreaking. Scientists at New York University are studying CBD as a possible treatment for autism spectrum disorders. Spanish researchers are testing both THC and CBD on an aggressive brain cancer called glioblastoma. Israeli scientists have found that CBD can lessen the incidence of graft-versus-host disease in bone-marrow transplant patients, presumably because the cannabinoid calms the immune system and deters it from attacking the patient.

“How could one family of molecules help so many maladies? The most obvious response is that they might not; all this research is preliminary and might not pan out. But scientists often propose a counter-explanation: Many chronic disorders, even though they seem distinct, are characterized by dysfunction in the same few pathways. Inflammation and oxidative stress, for example, occur in schizophrenia, metabolic disorders, heart disease and other ailments. The therapeutic magic of CBD and, in some cases, THC — and maybe some of the more than 100 other cannabinoids in cannabis — may come from the ways that, by tweaking the endocannabinoid system, they push the body away from disease toward the unruffled state scientists call homeostasis.”

But CBD doesn’t always work as one doctor at a children’s hospital in Colorado says, “What’s lost on many… is that even if CBD helps, it’s still just another drug, and no drug works for everyone all the time.” CBD Up Close previously made this case, that the fact that CBD products do not work for everyone all the time is not dissimilar to how standard FDA-approved medicines work. Finding the right medication or medications is a process that can involve a good deal of trial and error.

Where Does CBD Stand Legally? The FDA Will Need To Weight In

“[C]onfusion about the federal legality of CBD-related commerce remains widespread. The 2018 Farm Bill legalized hemp, a low-THC, potentially high-CBD variety of cannabis, meaning that CBD from hemp is now theoretically legal nationwide. But there’s a wrinkle: The F.D.A. says that because CBD is also an approved drug (Epidiolex), the cannabinoid can’t be considered, as some argue it should be, a nutraceutical or dietary supplement. The companies that ship CBD products across state lines — an activity subject to F.D.A. enforcement — may be doing so illegally. Yet even though the F.D.A. has the authority to clamp down on CBD-related products and interstate commerce, it can choose not to do so. F.D.A. enforcement action depends on, among other things, available resources and the perceived threat to public health. (An F.D.A. spokesman declined to comment.)”

What the CBD industry needs is clarity. One option, as the article suggests, would be to place all CBD products under the purview of the FDA drug-approval pipeline. This would make all CBD products available through prescription only, which CBD Up Close thinks is rather draconian.

CBD may turn out to be a wonder drug that cures many different illnesses or it may turn out to only help sometimes. Whatever the case may be, for people who are suffering from intractable illnesses they should have the right to try.

CBD used specifically to treat illnesses or other medical maladies should go through the same drug-approval processes that any other drug goes through. But there should also be a space, a large space, left open for non-prescription CBD use as well. The side effects are seemingly low enough that any demonstrable upside would outweigh any risks.