- CBD, or cannabidiol, is a non-psychoactive component of cannabis that won't get you high.
- Researchers are beginning to study its potential health applications, which range from pain relief to curbing certain types of epileptic seizures.
- Scientists and startups working on cannabis-based drugs say the biggest hole in CBD research has to do with dosing — so they're tackling that first.
I knew I'd arrived in California when a friend offered me an edible — for my dog.
The treat didn't contain THC, the component of marijuana that's responsible for getting you high. Instead, it was made with cannabidiol, or CBD, a non-psychoactive compound in cannabis.
CBD is thought to be responsible for many of marijuana's therapeutic effects, including pain relief and reducing inflammation or swelling. Because of that, the compound may have a range of therapeutic applications, but research on it remains in its infancy — mostly due to marijuana's status as a Schedule I drug in the US, which limits the scope of medical research on it.
Thanks to a wave of developments into new cannabis-based drugs, however, efforts to harness CBD's medicinal properties are likely to ramp up.
The most well documented application of CBD so far is as a potential treatment for some rare forms of epilepsy. Earlier this month, a US Food and Drug Administration committee gave a major green light to a medicine called Epidiolex, which is designed to treat two rare childhood forms of epilepsy. If Epidiolex gets the final okay, it would become the first FDA-approved drug made with CBD.
Drug companies like GW Pharmaceuticals, which is behind Epidiolex, and a handful of startups — some of which have support from pharma giants like Johnson & Johnson — are now finding ways to study CBD. Researchers are looking into applications for mental health disorders like anxiety and depression, skin conditions, and diseases like arthritis.
'It’s the inconsistency from product to product that concerns me'
In states where marijuana is legal, it is relatively easy to purchase products that claim to be packed with CBD.
But these items don't have to undergo the same federal approval process that drugs do, so there's a lot of room for error. CBD oils sold at dispensaries may have varying concentrations of the compound from batch to patch or even product to product.
Laura Lubbers, the chief scientific officer of a non-profit called CURE that funds epilepsy research, told Business Insider that's a concern for parents who seek out CBD oil to help control their children's seizures.
"It’s the inconsistency from product to product that concerns me as a researcher," Lubbers said. "You may get good results with one product and then go back to that dispensary and buy the same product and find that it may have a different effect."
Epidiolex, by comparison, is a well studied and well controlled product that is currently pending FDA approval to treat Lennox-Gastaut syndrome and Dravet syndrome.
Starting with the premise of dose control
Several startups are attempting to tackle the consistency problem in marijuana products — particularly those containing CBD.
One such company, a Toronto-based startup called Vapium Medical, is working to create a vape pen and connected app to help marijuana users track the effects of cannabis products and share their information with scientists. The product is called SmartFlow.
Lisa Harun, Vapium Medical's co-founder, told Business Insider that she started the company with a single goal: dose control.
"We believe that as with any medication, dosing is key," Harun said.
The SmartFlow pen and app launched to a limited number of people at this year's Consumer Electronics Show. Users can track the cannabis strain they're using and its CBD-to-THC ratio, note the condition that they are trying to treat, and record the effects they observe. Clinicians at Vapium have access to that user data, which they can use to analyze potential links between certain strains and ratios and their perceived effects.
"The real question for us is what does a higher CBD ratio actually mean?" Harun said.
Vapium Medical's vape pen and app are being developed as part of Johnson & Johnson's JLabs Innovation network, an incubator program designed to give budding companies access to resources and leadership to help them get off the ground.
"We aim to enable patients to use cannabis as medicine by giving them the data they need," Harun said. "It enables clinicians and patients to see if the medication they're using does what they think it does, and to home in on a treatment protocol."
CBD shows promise for pain and epilepsy, but more research is needed
Several studies analyzing the effects of various marijuana strains have been published in peer-reviewed journals, but most of that research hasn't isolated the effects of CBD alone. And many CBD-specific studies are still too small to determine what effects the compound is actually producing.
For example, scientists think marijuana may help reduce inflammation, which is a component of illnesses like rheumatoid arthritis. A preliminary 2005 study of 58 patients with that condition found that those who took a cannabis-based drug called Sativex saw "statistically significant improvements in pain on movement, pain at rest, [and] quality of sleep." But Sativex has a 1:1 ratio of CBD to THC, so it's impossible to say which compound is responsible for the observed benefits.
Epidiolex's research on CBD is the clearest example so far that the compound in isolation has therapeutic properties.
One clinical trial of the drug looked at its effects in 225 young people with Lennox-Gastaut syndrome. The researchers split the study participants into groups and gave them either a high dose of the drug, a low dose, or a placebo for 14 weeks. The results, presented at an American Academy of Neurology meeting, showed that participants in the high-dose group saw their seizure occurrence drop by 42%. Those given the low dose saw a decrease of roughly 37%. By comparison, those given the placebo saw only a 17% reduction in seizure occurrence.
Several new studies aim to pin down CBD's effects on mental health
Future research on CBD's effects on anxiety, PTSD, and addiction could help nail down a range of potential uses in those areas as well. A review of preliminary research published in 2015 in the journal Neurotherapeutics suggested that CBD held promise for mental health applications including anxiety, obsessive-compulsive disorder, and PTSD.
No strong, well-controlled studies on the subject have yet been published, but the National Institutes of Health is helping to fund one study that aims to test whether CBD could help people with PTSD and alcohol use disorder drink less and curb PTSD symptoms.
Another forthcoming study led by scientists at Mount Sinai School of Medicine is looking into CBD's potential for treating opioid use disorder. Some anecdotal research has hinted at that possible application, but that too has yet to be backed up by comprehensive studies.
Researchers are hopeful that once more findings start to emerge, we'll get a clearer picture of what CBD can — and can't — do.
At the very least, Vapium Medical's Lisa Harun said, there should be more standard procedures to ensure consistency in cannabis dosing.
"That's exactly what we're hoping to help create," she said.
