Hemp-based CBD is legal in all 50 U.S. states and research into its potential therapeutic benefits is exploding. Here's a look at the state of CBD research, what's been proven, what CBD does, and recent studies and trials.
What is CBD research?
CBD, short for cannabidiol, is one of many cannabinoids in cannabis and accounts for up to 40% of the plant's chemical makeup. This phytocannabinoid packs a wallop of pain and stress-relieving potential but without the psychoactive effects of THC, the other main cannabinoid in cannabis.
Though marijuana has been used medicinally since 2900 B.C., clinical scientific research is just beginning to show how the plant can benefit humans. With CBD products flooding the market, research has taken on more urgency.
Dr. Bonni Goldstein, a medical adviser to Weedmaps and director of Canna-Centers in Lawndale, California, says, "There are thousands of studies going on at any given moment. In the last 5 years, there were 1,690 studies with 'cannabidiol' as a subject and 632 of those were in the last year alone."
Defining CBD research
While there has been a recent uptick in clinical trials, human studies have historically been sparse. According to Goldstein, there are four notable areas of CBD research underway:
Botanical and agricultural: how the cannabis plant makes CBD and what uses it can serve in commercial agriculture, such as improving pest resistance.
In vitro: what CBD does in Petri dishes and other kinds of models, outside of a living organism.
In vivo: one of the more controversial types of research, which involves live animals.
Clinical trials: how CBD affects people in a controlled setting.
Scientists are focused on several specific use cases for CBD. These include:
- Parkinson's disease
- Alzheimer's disease
- Pain, including chronic and neuropathic pain
- Post-traumatic stress disorder (PTSD)
- Sleep disorders
- Bipolar Disorder
- Social Anxiety Disorder
Is CBD medically proven?
While there is evidence from different types of research to support the positive effects of CBD, the term “medically proven” carries more weight with scientists. According to Goldstein, for a medication to be deemed medically proven, it must have gone through the last stage of clinical trials. In fact, there is only one CBD-derived medication that meets this requirement and it's called Epidiolex.
Goldstein explained, "Randomized, cross-over, placebo-controlled trials have 'proven' that CBD is a safe and effective medication for pediatric patients suffering from Dravet syndrome, a specific kind of epilepsy."
These extensive clinical trials and reported patient experiences have shown that CBD may help reduce seizures in individuals with Dravet syndrome. Further, Epidiolex may decrease the severity and frequency of such seizures. The medication is available by prescription and is presently the only drug containing CBD to receive Food and Drug Administration approval.
Goldstein stressed, "The only other 'proven' thing about CBD is that it's very safe and well-tolerated. It does interact with some medications, so people should discuss it with their doctor, but it is very safe even in somewhat large, daily doses."
CBD is indeed difficult, though not impossible, to overdose on and has few side effects, unlike many prescription medications, which can come with a laundry list of adverse reactions.
Does CBD really do anything?
The answer is a resounding yes, according to Dr. Adie Rae Wilson-Poe, who has a Ph.D. in neuroscience and serves as a scientific adviser to Weedmaps. She revealed a plethora of other possibilities that have not yet been clinically proven but have demonstrated great promise. Wilson-Poe says, "Scientific investigations from all over the world have shown that CBD has the following medicinal properties: anticonvulsant, analgesic, anti-inflammatory, antioxidant, anti-anxiety, antidepressant, anti-nausea, antipsychotic, pain reliever, and anticancer."
CBD interacts with the endocannabinoid system, stimulating receptors in the brain and potentially enhancing everything from mood to memory. Citing several scientific studies, Goldstein agreed that the potential effects of CBD are both widespread and well-documented.
Recent CBD clinical trials and studies
A 2019 clinical trial detailed in the Brazilian Journal of Psychiatry found that using CBD seemed to reduce anxiety in the test subjects during a public speaking task. Researchers concluded that, with proper dosing, CBD products could be integrated into clinical practices.
Another 2019 clinical trial detailed in the American Journal of Psychiatry found that using CBD seemed to reduce anxiety and cravings in people who were addicted to opioids. Researchers noted that CBD seemed to have no serious side effects or influence on cognition during the trial.
A 2017 review published in the journal Current Neuropharmacology showed that CBD may succeed as a treatment for panic.The authors of the comprehensive review stated "CBD seems to be a promising drug for the treatment of PD (panic disorder)."
Similarly, CBD has also demonstrated potential efficacy in treating anxiety and sleep disorders. A 2019 case series published in the Permanente Journal found that CBD improved anxiety and sleep scores in the majority of participants in a psychiatric clinical trial. By the end of the first month of CBD treatment, nearly 80% of patients had less anxiety and approximately 67% slept better, though researchers observed fluctuations.
CBD may also have antipsychotic properties, according to a 2018 clinical trial detailed in the American Journal of Psychiatry. The results of this trial indicated that CBD may help as an add-on therapy for people with schizophrenia, which is a notoriously difficult condition to treat.
Autism spectrum disorder is also challenging for clinicians to treat, as many prescription medications are not well-tolerated and can exacerbate symptoms in certain individuals. A 2019 report published in the Journal of Autism and Developmental Disorders offered hope for children with severe behavioral problems, as CBD showed promise for treating autism. But there is a long way to go to reach the medically proven gold standard, as researchers mused, "Anecdotal evidence of successful cannabis treatment in autism spectrum disorder (ASD) are accumulating but clinical trials are lacking."
The future of CBD research
The completion of additional clinical trials is clearly the best pathway for CBD to enter the mainstream medical world. The FDA approval of Epidiolex was a major victory for cannabis proponents and paves the way for other CBD-based medicine to gain widespread acceptance.
As outlined on ClinicalTrials.gov, part of the U.S. National Library of Medicine, many CBD clinical trials are forming. A few of the newest studies include trials on CBD as a treatment for early psychosis, alcohol use disorder, and Crohn's disease.
Using CBD to treat chronic pain, mood disorders, and other wide-ranging health conditions may become commonplace if future clinical trials continue to yield encouraging results.