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Cannabidiol, or CBD, is the lesser-known child of the cannabis sativa plant; its more famous sibling, tetrahydrocannabinol, or THC, is the active ingredient in pot that catapults users’ “high.” With roots in Central Asia, the plant is believed to have been first used medicinally — or for rituals — around 750 B.C., though there are other estimates too.

Dr. Smita Das, chair of the American Psychiatric Association’s Council on Addiction Psychiatry’s cannabis work group, does not recommend CBD for anxiety, PTSD, sleep or depression. With patients turning to these to unproven products, she is worried that they may delay seeking appropriate mental health care: “I’m dually concerned with how exposure to CBD products can lead somebody into continuing to cannabis products.”

What are the claims?

A few drops of CBD oil in a mocha or smoothie are not likely to do anything, researchers contend. Doctors say another force may also be at play in people feeling good: the placebo effect. That’s when someone believes a drug is working and symptoms seem to improve.

Last year, the F.D.A. approved Epidiolex, a purified CBD extract, to treat rare seizure disorders in patients 2 years or older after three randomized, double-blind and placebo-controlled clinical trials with 516 patients that showed the drug, taken along with other medications, helped to reduce seizures. These types of studies are the gold standard in medicine, in which participants are divided by chance, and neither the subject nor the investigator knows which group is taking the placebo or the medication.

CBD is advertised as providing relief for anxiety, depression and post-traumatic stress disorder. It is also marketed to promote sleep. Part of CBD’s popularity is that it purports to be “nonpsychoactive,” and that consumers can reap health benefits from the plant without the high (or the midnight pizza munchies).

Formukong EA, Evans AT, Evans FJ. Analgesic and anti-inflammatory activity of constituents of Cannabis sativa L. Inflammation 1988;12(4):361-71. View abstract.

Bornheim LM, Everhart ET, Li J, Correia MA. Characterization of cannabidiol-mediated cytochrome P450 inactivation. Biochem Pharmacol 1993;45(6):1323-31. View abstract.

Product information for Marinol. AbbVie. North Chicago, IL 60064. August 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf.

Insufficient Evidence for

Shrivastava A, Kuzontkoski PM, Groopman JE, Prasad A. Cannabidiol induces programmed cell death in breast cancer cells by coordinating the cross-talk between apoptosis and autophagy. Mol Cancer Ther 2011;10(7):1161-72. View abstract.

Pretzsch CM, Voinescu B, Mendez MA, et al. The effect of cannabidiol (CBD) on low-frequency activity and functional connectivity in the brain of adults with and without autism spectrum disorder (ASD). J Psychopharmacol. 2019:269881119858306. View abstract.

Klotz KA, Grob D, Hirsch M, Metternich B, Schulze-Bonhage A, Jacobs J. Efficacy and Tolerance of Synthetic Cannabidiol for Treatment of Drug Resistant Epilepsy. Front Neurol. 2019 Dec 10;10:1313. View abstract.

Freeman TP, Hindocha C, Baio G, et al. Cannabidiol for the treatment of cannabis use disorder: a phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial. Lancet Psychiatry. 2020; 7(10):865-874. View abstract.

In the UK, while almost all cannabinoids are controlled substances under the Misuse of Drugs Act 1971, CBD is not. Bulgaria was the first in Europe and the United Kingdom is also leading the way, having just started selling CBD products en masse in popular health chain Holland & Barrett. The products must have less than 0.2% of THC in them in order to be sold, according to the Home Office. In other words, CBD products are allowed to contain miniscule traces of THC, but not so much that it is noticeable by users.

Tom concluded that much of CBD’s popularity comes from “its potential to give people balance in their lives.” He added that Grass & Co. would describe their range as “supplements to support a healthy and active lifestyle.”

Does it actually work?

However, this is not to be confused with the legalisation of medical marijuana, which is a much more divisive issue worldwide.

Many also swear by CBD in helping to moderate mental health conditions such as anxiety, depression and insomnia.

Hemp oil deriving from the seeds of the plant can also be used for cooking and provides protein powder, so virtually none of the plant is wasted. What’s more, industrial hemp absorbs a vast amount of CO2, when compared with any other commercial crop.