What is CBD oil? Here is everything you need to know

Cannabidiol (CBD for short) is the non-psychoactive component of the cannabis plant. Proponents say it can soothe whatever ails you—from anxiety and arthritis to digestive troubles and even cancer.

What is CBD oil exactly?

CBD—or cannabidiol—is a type of cannabinoid, a family of molecules typically associated with marijuana, but in fact, also found in other plants and even humans (in us, they’re called endocannabinoids). There are hundreds of different cannabinoids in marijuana. The best known is tetrahydrocannabinol, or THC, a chemical in marijuana that targets and binds to certain receptors in the brain to give you a high. CBD is non-psychoactive and non-addictive, and it seems to bind to multiple target sites, thereby affecting a range of systems throughout the body.

How do you use it?

Extracts of CBD—either from marijuana or hemp (a cannabis variant that is essentially free of THC)—are sold as an oil or in tinctures. You can also get CBD via a transdermal patch, capsule, sublingual spray, gel, cream, or vapor. Some contain pure CBD extract (or so they say); others—particularly if you’re in a state where recreational marijuana is not legal—will contain hemp extract, which includes CBD as part of its makeup. As of this reporting, recreational marijuana is legal in nine U.S. states and medical marijuana in 29. Don’t miss these 50 weird things that are banned in the United States.

What is CBD oil used for?

Healthy folks vaguely looking to add a little spring in their step (via better sleep, reducing anxiety, or easing muscle soreness) drizzle a little oil into their smoothie or latte. They might also spot-treat with a dab of oil in problematic areas. In the past several years, published papers have suggested that the compound can help with a spectrum of medical conditions, including anxietyAlzheimer’s disease, addictionarthritis, inflammatory bowel diseasefracturesmigrainespsoriasis, and pain. In an animal study, purified extracts of CBD and THC appeared to slow the growth of a type of brain tumor.

“Scientists have been studying other constituents in the marijuana plant beside THC, and there has been an emerging interest in the medical community for a while,” says Ryan McLaughlin, PhD, assistant professor of integrative physiology and neuroscience at Washington State University in Pullman.

What is CBD oil going for?

It’s not cheap. A vial containing 500 mg of hemp extract from Mary’s Nutritionals, for instance, costs $110. CBD extract—on its own or as part of a hemp extract, or even with a little THC, if you live in a marijuana-legal state—can be found in a variety of edibles, too, including chocolate barshoney, and bitters.

“Some products are of little clinical value,” says Joanne Miller, a certified nutritionist at Swanson Health Center in Costa Mesa, CA. “But some can be a total game changer in people’s lives. There are many, many applications.”

Miller, whose clients include patients referred by physicians, uses CBD in a variety of delivery modalities that she has found effective. “Patches can be worn for pain or anxiety management. Capsules or concentrated drops can be taken orally for pain, inflammation, sleep, and anxiety. Balms and creams can be used on the hands and feet to manage arthritic pain. Vaping is another delivery method,” she says.

Her clients require therapeutic doses (generally speaking, 5 to 10 mg per dose), so she recommends brands that have shown results for her clients. Currently, she uses Mary’s Medicinals (available in marijuana-legal states) and Thorne.

How does CBD work?

No one’s really sure: “It’s astonishing that there’s still no real consensus on how CBD works,” says McLaughlin. “One thing we do know is that it doesn’t work through the same receptors as THC, and, in fact, seems to have the opposite effect.” THC mainly binds to a certain type of receptor (known as CB1) in the brain. But with CBD, he says, “there seems to be a lot of complex targets”—which means CBD may affect multiple pathways throughout the body.

From anecdotal evidence in humans and from animal studies, CBD appears to affect the way we experience pain, inflammation, and anxiety. “Scientists have identified a number of receptors in the nervous system where CBD acts,” says Orrin Devinsky, MD, professor of neurology, neurosurgery, and psychiatry at NYU Langone. “It’s established that CBD has anti-inflammatory properties and can increase activity at some serotonin [the feel-good neurotransmitter] receptors.”

50 PHOTOS
Marijuana laws by state
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Marijuana laws by state

Alabama

No legalization of any kind

(Photo: Dennis Macdonald via Getty Images)

Alaska

Marijuana legalized for medical and recreational use 

(Photo: Zoonar/N.Okhitin via Getty Images)

Arizona

Marijuana legalized for medical use

(photo: TaylorB90/Flickr)

Arkansas

No legalization of any kind 

(photo: yorkfoto)

California

Marijuana legalized for medical use

(Photo: Dorling Kindersley via Getty Images)

Colorado

Marijuana legalized for medical and recreational use  

(Photo: Shutterstock)

Connecticut

Marijuana legalized for medical use 

(photo: Shutterstock)

Delaware

Marijuana legalized for medical use 

(photo: Shutterstock)

Florida

No legalization of any kind

(photo: Shutterstock)

Georgia

No legalization of any kind

(photo: Shutterstock)

Hawaii

Marijuana legalized for medical use

(Photo: Shutterstock)

Idaho

No legalization of any kind

(photo: Shutterstock)

Illinois

Marijuana legalized for medical use

(Photo: VisionsofAmerica/Joe Sohm)

Indiana

No legalization of any kind

(Photo: Shutterstock)

Iowa

No legalization of any kind

(photo: yorkfoto)

Kansas

No legalization of any kind

(photo: Shutterstock)

Kentucky

No legalization of any kind

(Photo: Dorling Kindersley via Getty Images)

Louisiana

No legalization of any kind

(Photo: Shutterstock)

Maine

Marijuana legalized for medical use

(photo: Shutterstock)

Maryland

Marijuana legalized for medical use

(Photo: Shutterstock)

Massachusetts

Marijuana legalized for medical use

(photo: Shutterstock)

Michigan

Marijuana legalized for medical use

(photo: Shutterstock)

Minnesota

Marijuana legalized for medical use

(photo: anthonylibrarian/Flickr)

Mississippi

No legalization of any kind

(Photo: Medioimages/Photodisc via Getty Images)

Missouri

No legalization of any kind 

(Photo: Shutterstock)

Montana

Marijuana legalized for medical use

(photo: J.Stephen Conn/Flickr)

Nebraska

No legalization of any kind 

(photo: Shutterstock)

Nevada

Marijuana legalized for medical use

(photo: Shutterstock)

New Hampshire

Marijuana legalized for medical use

(photo: Shutterstock)

New Jersey

Marijuana legalized for medical use 

(Photo: Shutterstock)

New Mexico

Marijuana legalized for medical use 

(photo: Shutterstock)

New York

Marijuana legalized for medical use

(photo: Shutterstock)

North Carolina

No legalization of any kind

(photo: Getty Images)

North Dakota

No legalization of any kind

(Photo: Shutterstock)

Ohio

No legalization of any kind

(photo: Shutterstock)

Oklahoma

No legalization of any kind

(photo: Shutterstock)

Oregon

Marijuana legalized for medical and recreational use  

(Photo: Shutterstock)

Pennsylvania

No legalization of any kind

(photo: Henryk Sadura)

Rhode Island 

Marijuana legalized for medical use

(Photo: Shutterstock)

South Carolina

No legalization of any kind

(Photo: Shutterstock)

South Dakota

No legalization of any kind

(Photo: Norman B. Leventhal Map Center at the BPL/Flickr)

Tennessee

No legalization of any kind

(photo: Shutterstock)

Texas

No legalization of any kind

(Photo: Shutterstock)

Utah

No legalization of any kind 

(Photo: Shutterstock)

Vermont

Marijuana legalized for medical use

(photo: Shutterstock)

Virginia

No legalization of any kind

(photo: Shutterstock)

Washington

Marijuana legalized for medical and recreational use 

(photo: Shutterstock)

West Virginia 

No legalization of any kind

(Photo: dk_photos via Getty Images )

Wisconsin

No legalization of any kind 

(photo: Kubrak78)

Wyoming

No legalization of any kind

(Photo: Space Images via Getty Images)

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What does the science say?

Not much, as far as humans are concerned—at least not yet. The vast majority of studies have been on animals, as of yet, and there are few high-quality studies on humans. Even the oil’s effect on pain—something that CBD oil is popularly used for—isn’t proven. “The studies available are small or not well designed,” says Dr. Devinsky. “There’s a lot of religion out there, but not a lot of data.”

Dr. Devinsky’s research, which was recently published in The New England Journal of Medicine, is beginning to provide that much-needed data in the field of epilepsy research. In a landmark multinational randomized double-blind study for a treatment-resistant form of the condition, subjects taking an oral solution of 20 mg CBD per kilogram of body weight for 14 weeks, along with standard treatment, experienced a 42 percent reduction in drop seizures (the muscles go limp). Those taking a 10 mg CBD per kilogram of body weight saw a 37 percent decrease; patients who got a placebo saw a 17.2 percent decrease. The mechanism hasn’t quite been worked out yet, Dr. Devinsky says, though there’s some evidence that a receptor known as GPR55 may be critical for the anti-seizure effect.

How do I know if it’s really CBD oil in the product?

Unfortunately, you don’t. Even though more than half of all U.S. states now allow marijuana for medicinal purposes—and nine of those, plus Washington DC, allow it for recreational use—the Drug Enforcement Agency still views CBD as a banned substance and therefore doesn’t regulate it (since, in the eyes of the law, CBD shouldn’t be on the market). “I can start a company, put oil in a jar and sell it as CBD oil,” says McLaughlin—and no one has to vouch that what’s in there is for real. You have only the manufacturers word for it.

Should I be wary?

Yes: CBD extracts can’t always be trusted. A 2017 JAMA paper reported that almost 70 percent of all CBD products sold online do not contain the amount of CBD stated on the label. Of the 84 products bought from 31 different companies, 42 percent contained a higher concentration of CBD oil than the label claimed, and 26 percent of the products contained less than the label claimed. The remainder of products contained the labeled amount—give or take 10 percent.

Why are there so many fakes?

"There’s no oversight,” says Marcel Bonn-Miller, PhD, adjunct assistant professor of Psychology in Psychiatry at the University of Pennsylvania and author of the JAMA article. Beyond the label, he adds, “There’s no consistency. You know that every Hershey’s bar you buy and every Coke you buy will be exactly the same. But that’s not the case with the majority of CBD products. It’s not unexpected to see variability within a given brand.” This means that you may notice improvements the first time you buy and try a particular product, but none the next.

“There’s no way to know what you’re getting unless you bring the product yourself to a reputable lab and get it analyzed,” says Bonn-Miller.

Are there side effects to CBD oil?

As Dr. Devinsky points out in his research, side effects, at least in therapeutic doses, can include fatigue, diarrhea, and weight loss, just to name a few.

On its own, CBD is pretty safe; the side effects tend to come from the things it’s mixed with (which may or may not be on the label). “CBD is not the only ingredient in CBD extracts. They can have THC as well, sometimes in decent amounts,” says Bonn-Miller, “and that’s where it can get more complicated.”

THC-dominant edibles (like chocolates) can carry an even higher risk. “It can take one or two hours to feel an effect from ingestion as opposed to a few seconds from inhalation,” says Dr. Bonn-Miller. “This makes titration very difficult.” Add to that, an edible is made to taste good. So you can easily eat more than you should in the course of a few minutes—and end up feeling negative effects hours later.

8 PHOTOS
Health benefits of marijuana
See Gallery
Health benefits of marijuana

1. Parkinson's 

Cannabis has been found to help slow tremors and pain in Parkinson's patients. According to Medical News Today, the compounds in marijuana help to "reduce the effects of reduced dopamine in the brain". 

A study conducted by Israeli scientists found smoking marijuana helped reduce these tremors. "We not only saw improvement in tremor in these patients, but also in rigidity and in bradykinesia," said researcher Ruth Djaldetti.

Furthermore, marijuana has been found to slow the progression of Parkinson's because of its antioxidant qualities. 

2. Glaucoma 

The American Academy of Ophthalmology describes glaucoma as a condition in which the optic nerve is damaged over long periods of time. It can limit vision and sometimes lead to blindness. 

The link between glaucoma and marijuana has been studied since the 1970s, as smoking marijuana has been found to lower eye pressure. Doctors are working on ways to elongate the effects of marijuana. 

It has been speculated that smoking the drug can slow the progression of the disease. 

3. Chemo patients

There has been extensive research on the benefits of cannabis and chemotherapy patients. The "wonder drug", as it is hailed, does miracles for cancer patients. 

According to Dr. Donald Abrams, marijuana "is the only anti-nausea medicine that increases appetite.”

The American Cancer Society claims that the drug can also lower pain, reduce inflammation and calm anxieties of not just chemo patients, but patients suffering from a chronic illness or disease. 

Scientists have found that cannabinoids, one of the many chemical compounds found in the plant, can inhibit tumor growth. It was particularly effective in the inhibition of colon cancer. 

4. Alzheimer's

According to an article published by CNN Health, marijuana may be beneficial for Alzheimer's patients. It was found that THC, an ingredient in cannabis, blocks inflammation in the brain and "stimulates the removal of toxic plaque". 

Marijuana has also been used to help dementia patients. Author and doctor David Casarett told CNN, "I spoke to many family members of people with mild or moderate dementia who believed that THC or whole-plant marijuana was effective in alleviating the confusion and agitation that sometimes occurs."

5. Skin Diseases 

It is widely known that marijuana possesses antiinflammatory benefits, helpful to patients who suffer from arthritis and cancer, amongst many others.

A study published by the University of Colorado found that using the drug topically can alleviate pain and "may be effective against eczema, psoriasis, atopic and contact dermatitis. More and more dermatologists are encouraging the use of cannabinoid cream. 

6. Stroke victims 

Cannabis and stroke victims is an interesting topic of study for many researchers, some of whom contend the drug can "shrink" the damaged area of the brain. 

Doctors, who tested the drug on mice, rats and monkeys, believe the chemical "shows promise as a neuroprotective treatment for stroke”, according to the Huffington Post.

7. PTSD

Advocates have argued that marijuana can provide immense relief for patients, specifically veterans, who suffer from PTSD. In states like New Mexico, "medical marijuana is legally prescribed for PTSD". 

A study conducted by the University of Haifa fond that marijuana helped block the "development" and progression of PTSD in rats. But, researchers explain, that there is a critical window of what marijuana can do. 

Interior of room at the clinic
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What’s the best way to try some?

The Internet is lousy with the stuff, but for a safe and reliable source, talk to your physician, advises McLaughlin. She may be able to introduce you to a reputable practitioner who can offer CBD oils and related therapies—or she may know of a colleague who can make a referral. If you’re trying to treat a medical condition, it’s better to avoid the guesswork and find guidance from a practitioner who’s had experience in—and is knowledgeable about—the most reliable CBD products and doses for your condition. Here are 14 things you should never lie to your doctor about.

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