What are the Benefits of CBD?
When something “non-traditional” undergoes a study, the number of necessary studies seems to be 10-fold in comparison to conventional pharmaceuticals. CBD oil benefits appear to be clear in some areas and murky in others. However, healthcare professionals are touting CBD benefits for everything from anxiety to schizophrenia. In this case, I’ll only address the benefits of CBD supported specifically by adequate data which includes the following:
- Nausea control for cancer patients receiving chemotherapy
- Possible (future) anti-metastatic effects for cancer patients
- Help for pain and inflammation
- Help for spasticity in Multiple Sclerosis
- Decreased seizure activity
- Decreased anxiety
- Improved neuroplasticity in neurodegenerative disorders
Nausea and Vomiting in Cancer patients
Modern scientific literature documents that one of the initial uses of cannabinoids was to control nausea and vomiting. In fact, a comprehensive study from 1975 revealed CBD could control nausea associated with chemotherapy and almost eliminate emesis. Since then, several larger studies including placebo-controlled randomized studies using not just CBD but nabilone, dronabinol, and actual cannabis extracts have been performed, with two reviews demonstrating clear benefits of CBD.
Although chemotherapy-induced emesis is fairly well controlled in most patients by conventional pharmaceuticals, nausea (anticipatory, delayed and acute) continues to be a significant problem. This very distressing symptom of chemotherapy can become so severe that up to 20% of patients discontinue their treatment. Specifically, this is the real role for CBD and other cannabinoids. And then there’s cancer itself. So, what about a role in treatment?
CBD for Cancer Therapy
All cancer patients are looking for “magic bullets” as are those of us who treat cancer patients. I work with Oncologists to use metabolic therapies for patients, along with reduced amounts of chemotherapy and radiation. These alternative treatments for cancer might (at some point) start to include CBD oil. In one of the first reports of cannabinoids having antitumor effects, extracts of cannabis show to inhibit the growth of lung cancer cells in test tubes. In addition, several studies have investigated cannabinoid activity in several cancer types including skin, lung, breast, prostate, and pancreas, demonstrating anti-growth and anti-metastatic effects.
However, we cannot yet “take this to the bank.” Some older test tube studies demonstrated quite the opposite; cancer cell proliferation and loss of immune-mediated cancer suppressor cell activity after treatment with cannabinoids. Some studies have shown discordant results depending on the concentration of cannabinoids used, with low doses stimulating cancer proliferation, and higher doses suppressing it. In short, ongoing clinical trials will be necessary to sort out these conflicting reports. Now, let’s discuss an area of much promise.
CBD for Pain and Inflammation
Unfortunately, there were inconsistent findings of four systematic reviews on the efficacy of cannabis-based medicines in neuropathic pain. There was insufficient evidence of any cannabis-based help for pain management in patients with rheumatic diseases (three systematic reviews) and cancer pain (two systematic reviews). Fortunately, IMHO CBD oil benefits are promising in joint and soft tissue disorders.
There have been a small number of studies involving pain-relieving effects of individual cannabinoids in patients with rheumatic diseases, most notably any type of inflammatory arthritis and fibromyalgia. A meta-analysis of Canadian data concluded no positive effect could be detected, but the authors of the meta-analysis expressed the quality of data analyzed (which concluded “no helpfulness for pain”) was poor. Therefore, they recommended more extensive trials in light of positive reports from other noncontrolled human trials.
A German meta-analysis similarly found minimal relief in patients with fibromyalgia or rheumatoid arthritis. These authors also commented on the inadequacy of the data and how their findings conflicted with self-reporting of patients who took the CBD. A survey of close to 3,000 U.K. “arthritis patients” revealed 16% had obtained herbal cannabis (mainly CBD) specifically for the control of their symptoms and were highly satisfied. Similarly, in a recent online patient survey by the U.S. National Pain Foundation, 1,300 fibromyalgia patients rated CBD as more effective than Cymbalta, Savella or even Lyrica! Moreover, whereas the majority of patients rated the three drugs as “unhelpful,” 62% rated the cannabis as “very effective.”
Meanwhile, animal studies demonstrate that CBD oil will increase endogenous endorphins. This is a good sign especially for those unfortunate patients with CIRS (chronic mold or Lyme disease) with posterior pituitary involvement and endorphin deficits. Lastly, the most recent data is optimistic for neuropathic pain in particular (despite what I mentioned initially.)
CBD Benefits Patients with Spasticity in Multiple Sclerosis
In landmark clinical trials of THC:CBD oral spray, a statistically significant proportion of patients with resistant MS spasticity improved with active treatment versus placebo.
THC:CBD oral-mucosal spray was well tolerated in these studies, with no evidence of effects on cognition or coordination that is recognized with recreational cannabis. Impressively, after 50 weeks of treatment, approximately two-thirds of patients and their caregivers reported improvement in pain and lack of motion associated with spasticity.
CBD Oil Benefits for Seizure Disorders
One recent study shows CBD treatment yields a significant positive effect on the number of seizures adults and children experience. A whopping 89% of the children’s caregivers report a reduction in seizure frequency. In addition, observations show improvement in alertness, communication and motor skills as well as sleep. (The study doesn’t demonstrate sleep improvement as a single factor, and so it is not a part of this discussion.) The reason many people enjoy the benefits of CBD oil is due to a noticeable improvement in their anxiety.
CBD Oil Benefits for Types of Social Anxiety
Several studies suggest that CBD has anxiolytic (anxiety-busting) effects in various stressful social situations. In fact, in one study, a dose of only 300 mg of CBD quelled the anxiety of public speaking as well as 10 mg of valium!
In other studies, CBD reduced anxiety in individuals with a social anxiety disorder during public speaking events. Still, other studies of SPECT brain imaging showed reduced amygdala responses to social fear. Further, yet another SPECT study showed reduced anxiety in response to a stressful medical procedure. All of these findings suggest that CBD may possess anti-anxiety properties similar to those of anxiolytic drugs.
CBD for Social Anxiety Disorder
Generalized Social Anxiety Disorder (GSAD) is the most common anxiety condition which leads to demonstrable impairment in social lives. A thorough study looked to compare the effects of a simulated public speaking on healthy control patients versus other patients who had a diagnosis of Social Anxiety Disorder. A single dose of CBD or placebo was given in the following manner.
A group of untreated GSAD patients received either CBD (600 mg) or placebo in a double-blind, randomized study 90 minutes before the speaking test. Each volunteer participated in one experimental speaking session in a double-blind procedure. Subjective measurements of anxiety, as well as physiological measures (such as blood pressure and heart rate), were measured at six controlled points during the test.
Pretreatment with CBD significantly reduced anxiety as well as mild cognitive impairment and discomfort in speech performances. It also considerably decreased anticipatory anxiety symptoms. On the other hand, the placebo group suffered from measurably more anxiety, cognitive impairment, discomfort, and hyper-alert sensorium levels.
CBD for Neurodegenerative Disorders
Evidence demonstrates CBD attenuates brain damage associated with neurodegenerative disorders; from TBE to Alzheimer’s to Parkinson’s disease and even ischemic strokes. CBD also facilitates neurogenesis by augmenting synaptic plasticity (neural regeneration). The mechanisms of these effects are still not entirely clear, but they appear to involve multiple cellular targets.
More recently, demonstrations show CBD modulates such regulatory pathways as autophagy as well as other critical pathways for neuronal survival. In fact, brain experts (including myself) feel that CBD’s ability to reduce inflammation-associated neurodegeneration along with its other properties indicates this “drug” (AKA one of the best brain supplements) could be a useful new approach to treat several neurodegenerative disorders.
A user’s guide to cannabinoid therapies in oncology
Regulation of nausea and vomiting by cannabinoids
Cannabidiol, a non-psychotropic component of cannabis, attenuates vomiting and nausea-like behaviour via indirect agonism of 5-HT(1A) somatodendritic autoreceptors in the dorsal raphe nucleus.
Eur J Pain. 2017 Oct 15. doi: 10.1002/ejp.1118. [Epub ahead of print]
Efficacy, tolerability and safety of cannabis-based medicines for chronic pain management – An overview of systematic reviews.
Häuser W, Petzke F, Fitzcharles MA
Cannabinoids in Pain Management and Palliative Medicine
Advances in the Management of Multiple Sclerosis Spasticity: Recent Clinical Trials
Seizure (European Journal of Epilepsy) DOI: http://dx.doi.org/10.1016/j.seizure.2016.01.004
CBD-enriched medical cannabis for intractable pediatric epilepsy
The current Israeli experience
Neurotherapeutics. 2015 Oct; 12(4): 825–836.
Cannabidiol as a Potential Treatment for Anxiety Disorders
Rev. Bras. Psiquiatr. vol.34 supl.1 São Paulo June 2012
Cannabidiol, a Cannabis sativa constituent, as an anxiolytic drug
Alexandre Rafael de Mello Schier; Natalia Pinho de Oliveira Ribeiro; Adriana Cardoso de Oliveira e Silva; Jaime Eduardo Cecílio Hallak; José Alexandre S. Crippa; Antonio E. Nardi; Antonio Waldo Zuardi
Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients
Plastic and Neuroprotective Mechanisms Involved in the Therapeutic Effects of Cannabidiol in Psychiatric Disorders
Cannabidiol Does Not Dampen Responses to Emotional Stimuli in Healthy Adults
Cannabidiol, neuroprotection and neuropsychiatric disorders.
Cannabinoids for Medical Use: A Systematic Review and Meta-analysis.