There are many forms of CBD products available on the market. Each offers a potential path to therapeutic relief. The passage of the 2018 Farm Bill, which took effect in January 2019, legalized the production of hemp plants with THC content below 0.3%, placing hemp-derived CBD products under the watchful eye of the Food and Drug Administration (FDA).
In a 2019 retrospective case study published in the Permanente Journal, researchers examined the use of CBD for anxiety and sleep on 72 patients, 25 of which cited poor sleep as a primary concern. After a month of CBD treatment, 66% of the patients experienced an improvement in sleep, compared to 25% who actually had worse sleep. When the research team assessed the patients after two months, 56% reported an improvement in sleep compared to the first month. Still, the study found that subjects treated with CBD saw a more marked reduction in anxiety than in insomnia.
Types of CBD products
While these THC-enriched marijuana-derived CBD products are only legally available on the medical and adult-use market, the combination of these two cannabinoids leads to a synergistic relationship known as the entourage effect. For example, studies have shown that when CBD is combined with THC, it reduces the adverse effects associated with high levels of THC, such as paranoia and anxiety.
Long before CBD garnered mainstream appeal, it was widely considered to be an incredibly effective treatment in reducing epileptic seizures in both children and adults. In fact, Epidiolex, the very first cannabis-derived medication to be approved by the FDA, is a treatment option for people suffering from severe forms of epilepsy such as Dravet syndrome and Lennox-Gastaut syndrome, both of which cause frequent seizures in children. A 2018 study focused on pediatric patients found that whole-plant CBD oil reduced epileptic seizures in patients, while 10% end up becoming completely seizure-free.
Existing evidence suggests that, when CBD compounds are metabolized by the liver they undergo a process referred to as the “first pass effect.” When the cytochrome P450 (CYP450) oxidases enzymes in the liver, it reduces the concentration of CBD before whatever is left over and directed into the bloodstream and circulated throughout the body.
For students with generalized social anxiety, a four-minute talk, with minimal time to prepare, can be debilitating. Yet a small experiment in the journal Neuropsychopharmacology found that CBD seemed to reduce nervousness and cognitive impairment in patients with social anxiety in a simulated public speaking task.
However, a double-blind study found healthy volunteers administered CBD had little to no change in their emotional reaction to unpleasant images or words, compared to the placebo group. “If it’s a calming drug, it should change their responses to the stimuli,” said Harriet de Wit, co-author of the study and a professor in the University of Chicago’s department of psychiatry and behavioral neuroscience. “But it didn’t.”
Earlier research found fewer than a third of 84 products studied contained the amount of CBD on their labels. Some users of CBD have also failed drug tests when the product contained more THC than indicated.
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But he cautions that the side effects could have been because of an interaction with other medications the children were taking to control the seizures. So far, there hasn’t been a randomized, placebo-controlled, double-blind trial (the gold standard) on sleep disorders and CBD.