Thursday, 26 March 2020

CBD: It's (Biologically) More Intricate Than You Think

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In many ways, the hemp plant is intertwined with the history of the United States. British settlers even brought a store of hemp seeds along during their journey across the Atlantic and were “compelled by law to grow hemp.” Today, we understand that hemp has numerous medical benefits, but during colonial times, hemp was primarily used in textile and fiber-based applications, at least until 1937.

A guest post by Indiana Lee
That year, Congress passed the Marihuana Tax Act, which effectively made hemp cultivation a crime. At the time, hemp was considered dangerous, lumped in with its cousin marijuana, which has psychoactive effects when ingested or smoked. Yet the hemp plant contains only trace amounts of tetrahydrocannabinol (THC), the cannabinoid that’s responsible for a marijuana user’s “high.”

While, as the most notorious of the estimated 113 cannabinoids found in the cannabis plant, THC gets the bulk of press surrounding the plant, it’s not necessarily the star of the show. For instance, cannabidiol, commonly known as CBD, doesn’t induce euphoria but has shown promise in treating a wide variety of health conditions, from anxiety and insomnia to Alzheimer’s and neurodegenerative disorders.

For this reason, and thanks to the 2018 passage of the Hemp Farming Act of 2018 (H.R.5485), which re-legalized hemp cultivation at the federal level, CBD shops are popping up in strip malls and co-ops across the country. We still have more to learn about CBD, however, and consumers should note that not all products containing CBD are consistently effective.

Like its cousin marijuana, the cellular makeup of hemp can vary considerably between strains, resulting in differing effects depending on an individual's condition and the plant’s potency. In effect, the idea of “CBD” has been oversimplified for the masses, but it’s much more complex than meets the eye.

Cannabis Legalization and Terminology

Fast forward to the 21st century, where, after decades of prohibition, the hemp industry is once again booming. The passage of H.R. 5485 paved the way towards a greater understanding of and research on the ways in which hemp affects the body. (It’s important to note that hemp cultivation is still banned in Idaho and South Dakota.) To be considered “hemp,” a cannabis plant can contain no more than 0.3% THC.

When it comes to medical marijuana, CBD takes center stage as the plant’s most helpful cannabinoid. Derived directly from hemp, CBD interacts with your body’s endocannabinoid system (ECS). According to a 2017 study published on ScienceDirect, the ECS is “involved in many physiological regulation pathways in the human body,” such as mood, memory, appetite, and pain sensations.

ECS receptors and neurotransmitters are lipid-based, which is why CBD extract is often housed in some type of oil for greater effectiveness. The two primary ECS receptors are CB1 and CB2, and THC easily binds to both receptors. CBD, on the other hand, interacts with the ECS in a slightly different manner: The cannabinoid acts as a sort of influencer, modifying a receptor’s ability to bind to other cannabinoids.

Yet cannabinoids don’t work alone when it comes to effects on the body. The hemp plant contains a number of other components that may help determine treatment efficacy, such as terpenes. Like cannabinoids, terpenes are developed in the trichomes of the hemp plant, and are primarily responsible for producing the unique scent of a particular strain. Terpenes also play a role in a plant’s medicinal effects. For example, the limonene terpene (also found in lemons) may improve mood and reduce anxiety. 

Efficacy and Medical Uses for CBD

Reducing anxiety, in fact, is one of the most lauded effects of CBD. Studies indicate that CBD may directly activate the 5-HT1A serotonin receptor, inducing anti-anxiety and antidepressant effects. Therefore, CBD could ultimately replace a number of pharmaceutical medications, many of which come with negative side effects and may be addictive.

For its part, CBD is considered non-addictive and may also help with pain relief. To wit, researchers have proposed the use of CBD as an alternative to opioids for managing chronic pain. Opioid misuse has become a scourge on society in recent years, and preliminary data indicates that “opioid overdoses and abuse have been significantly lower in states that have legalized cannabinoids,” writes the Psychiatric Times. However, that data is in dispute, and more research is needed.

For now, we can at least focus on the proven benefits of CBD, including the reduction of seizure frequency on some patients. According to the American Epilepsy Society, CBD has been shown to reduce seizures among patients with treatment-resistant epilepsy, but CBD treatment effectiveness may wane over time, requiring higher doses. CBD works against seizures by conferring neuroprotective effects to the hippocampus, and side effects of the treatment may include nausea and vomiting. 

How CBD is Becoming a Mainstream Treatment Option

But the benefits of CBD may not be accessible to everyone. Despite the ubiquity of CBD and hemp shops across the U.S., many patients still lack access to the versatile cannabinoid. Although hemp is federally legal, many state legislators still have difficulty differentiating between its components, continuing to lump THC and CBD into the same category of dangerous substances, nearly 100 years after the implementation of the Marihuana Tax Act.

On a public health scale, the legal status of CBD is problematic. Ensuring high-quality care across diverse populations hinges on the concept of ranges — ranges of populations, conditions, choices, where both providers and patients can work together with a variety of options to create personalized treatment plans. Especially for those patients who have tried other methods without success, access to CBD may be paramount to long-term healing.

We still have a long way to go before the entire nation has access to alternative treatments like CBD and its potential benefits. Despite legal roadblocks, plenty of research on cannabidiol is being conducted, including the creation of enzymatic networks in yeast strains. As such, CBD promises to be an exciting component of the medical landscape well into the future.

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